The Strange Story of Syphilis
The origin of syphilis is widely disputed. However, this debate mainly centers on the spread of the disease between the Old World and the New World. The argument is about the fact that syphilis was present in the Americas before European contact, so they say it may have been carried from the Americas to Europe by the returning crewmen from Columbus’s (in)famous voyage, or it may have existed in Europe previously but gone unrecognized until shortly after Columbus’s return. These are the Columbian and pre-Columbian hypotheses, respectively. I’m here to set the record straight. The fact is that there are venereal and non-venereal forms of syphilis, and this is where most of the confusion comes into the debate.
In order to survive, syphilis has mutated to adapt to different climates and different cultures. Epidemiological research shows that syphilis was present in rural societies around the world, but in a much milder form that was not sexually transmitted. Mary Powell studies the evolution of the bacteria, and how it has spread among the indigenous communities of the New World. She points out that, in pre-Columbian North America, the communal sharing of eating and drinking utensils led to widespread infection. There were abundant opportunities in every generation for the disease to be transmitted without any sort of sexual contact involved. What the non-mutated syphilis bacteria needed in order to spread is skin-to-skin contact. Everyone who caught it as a child was immunized against the dangerous venereal form of the disease. It caused an ugly skin disease that everyone caught in childhood, but rarely developed into something more serious.
The real question is, why do the bacteria only sometimes mutate into a sexually transmitted epidemic? Well, the thing that links sites like Metaponto, Pompeii, Hull, and Naples is that they were all major port cities in the past. So, venereal syphilis is primarily a disease of big cities with advanced health measures. Thus, civilization means syphilization. Among the sophisticated urban elite of ancient and medieval society, the mild form of the disease simply couldn’t survive. So the syphilis bacteria sought out the warm, sensual parts of the human body and began to thrive. Then, the evolution of the disease wreaked havoc on Europe. In the aftermath of that, venereal syphilis came to the New World from the Old World. The result this had on Native American populations was as devastating as it had been on the Europeans hundreds of years earlier. With the loss of so many people, they also lost their immunity to syphilis. The cycle of protection given to each generation by the existence of the non-venereal form of the disease had been disrupted.
This is important because syphilis is only infectious in the first stages of the disease, so the best forensic evidence for venereal syphilis is actually found in children’s skeletons. This is because if a woman becomes pregnant during this time, then the teeth forming in the unborn child will have a unique mark on them. They develop a groove that’s horizontal going across a tooth. Thus, the only way to prove the existence of syphilis in adults is to identify it in the skeletons of their children. These have been found in both the Old World and the New, prior to 1492. This is important because Maciej and Renata Henneberg excavated nearly 300 skeletons from an ancient Greek settlement in southern Italy. Metaponto was a busy port of forty thousand inhabitants that flourished from 600 BCE.
Maciej found many bones with the classic syphilis lesions and formations at Metaponto. Then Renata, a dental expert, found the clinching proof. She found two examples of the teeth change accrue as it is found in congenital syphilis. Thus, the Hennebergs proved that the presence of syphilis in Europe had nothing to do with Columbus or the Native Americans. They also examined the ancient Roman remains at Pompeii to search for the disease and found evidence everywhere that convinced them that syphilis was rampant in the city. It was also a seaport and a trading center. So, there are various strings of evidence from written sources, from the business of prostitutes to the cultural functioning of the city. This supports the hypothesis of the presence of syphilis in the classical antiquity of Europe.
In Hull, a port city in East Yorkshire, England, 240 skeletons were unearthed in an old friary. Among the remains, “skeleton 1216” is from a 25 to 35-year old male, which was analyzed at the University of Bradford. It has been examined by Charlotte Roberts, who is an expert in paleopathology, the archaeology of disease. She has found signs of venereal syphilis in more than 60% of the skeletons, including pockmark lesions on the skull of skeleton 1216. These are telltale holes in the bone that are characteristic of the sexually transmitted disease or STD. This doesn’t manifest itself in any of the other syndromes. So, she sent bone fragments to the carbon dating laboratory in Oxford. They found that when the carbon age of skeleton 1216 is converted into calendar time, even with a cautious margin of error, the young man with venereal syphilis must have died between 1300 and 1420.
Apart from skeleton 1216, the dig site contained two more classic cases of the disease. Furthermore, all the evidence from the dig suggests that he died sometime in the 1300s. For instance, the waterlogged conditions of the site preserved a remarkable number of coffins, making the wood an ideal and rare material from which to get a very reliable date. Ian Tyers, from the dendrochronology unit in Sheffield, took over 300 samples back to his lab. By comparing the tree rings from the wood in a database they were able to determine that the year the trees were felled was circa 1350. This proves that venereal syphilis was not contracted by the crew of Christopher Columbus during his voyages to the New World. So, the question is, who really gave syphilis to whom, and how?
Well, here’s the thing. If the STD was apparently so pervasive in Medieval Europe, the critics ask then why don’t more bones from that period have the signature lesions? The answer is simple. Europe was ravaged by numerous different contagious diseases that killed people off long before the late stages of venereal syphilis could ever manifest. The sexually transmitted disease doesn’t show up on bones until the third stage of the disease, oftentimes not until decades after the initial infection. Simply put, only a small proportion of people with syphilis got the bone change because the Black Death took them out first. So, there are a number of confounding factors that make it difficult to get a handle on what the rate of any disease was in England at that time. Nonetheless, the facts are indisputable. The evidence all leads to the fact that the pre-Columbian hypothesis is the tenable solution.
So, in the end, venereal syphilis was brought from the Old World to the New, not the other way around. This disease has adapted to its environment by mutating in places like ports that are known for promiscuity. More importantly, the causative organism, Treponema pallidum, was first identified by Fritz Schaudinn and Erich Hoffmann in 1905. Then, the first effective treatment for syphilis was discovered by Sahachiro Hata in 1909. The organoarsenic compound was the first modern chemotherapeutic agent. Finally, penicillin was discovered in 1928, and the effectiveness of treatment with the drug was confirmed in trials in 1943, at which time it became the main form of treatment.
Of course, any proper account of syphilis has to include the Tuskegee Experiment, conducted between 1932 and 1972. The purpose of this “study” was to observe the natural progression of untreated syphilis. The thing is that the African-American men in the study were only told that they were receiving free health care from the government. The white racist researchers enrolled a total of 600 impoverished, black sharecroppers from Macon County, Alabama. Of these, 399 had latent syphilis and 201 did not. The test subjects were told that the study was only going to last six months, but it actually lasted 40 years. None of the men were told that they had the disease, or allowed to be treated with antibiotics, the entire time. Thankfully, the revelation in 1972 of study failures by Peter Buxtun led to major changes in US law on the protection of participants in clinical studies. As a result of this, studies now require informed consent, communication of diagnosis, and accurate reporting of test results.
Fortunately, in the developed world during the early 20th century, infections declined rapidly with the widespread use of antibiotics, until the 1980s and 1990s when AIDS began to spread. Unfortunately, syphilis increases the risk of HIV transmission by two to five times, and co-infection is common. Since 2000, rates of venereal syphilis have been increasing in the US, Canada, the UK, Australia, and Europe, primarily among homosexual men. In the United States alone, more than 55,500 people are newly infected each year. Here, the rates of syphilis as of 2007 were six times greater in men than in women, although they were nearly equal ten years earlier. As of 2014, syphilis infections continue to increase here in America. To make matters worse, there is now an antibiotic-resistant strain on the rise, across the globe. Plus, there is no vaccine that is effective for prevention and even if there was there are far too many anti-vaxxers in the world for eradication to occur. With that being said, in spite of and because of modern medicine, it seems as though syphilis is here to stay.