400 Years of Syphilis Treatment
Syphilis emerged in Western Europe in 1494-1495. The origin of the disease is still debated, but the most prevalent theory suggests that it was brought from the Americas by the returning crew of Christopher Columbus. Early treatments included botanicals, particularly guaiacum, a tree discovered in the New World. Mercury was in use by the early 16th century, and remained the primary treatment for syphilis until the early 20th century. Syphilis led to stigmatizing disfigurations that were treated with surgery, including pioneering attempts in rhinoplasty.
The first modern breakthrough in syphilis treatment was the development of Salvarsan, which was available as a drug in 1910. In the mid-1940s, industrialized production of penicillin finally brought about an effective and accessible cure for the disease.
Women, Families, and Disease
In the 19th and early 20th centuries, many medical texts aimed at both consumers and providers presented a recurring trope: A young man arrives in a physician's office with a venereal disease resulting from promiscuous behavior. It is implied that the young man had intercourse with a prostitute. The young man is now seeking treatment because he is engaged to be married, and does not want to infect his wife or their future children. Medical texts also abound with cautionary tales of husbands who infect their innocent families rather than seeing their doctors.
In contrast, married women with venereal disease are presented as victims of careless husbands. The possibility of a young, unmarried woman approaching her doctor for treatment is not broached. Unmarried women infected with venereal disease were invariably characterized as prostitutes. At best, it was recommended that prostitutes receive treatment to avoid infecting others. At worst, they were to be forcibly removed from communities.
Social norms also obstructed understanding of sexually transmitted diseases in children. Denial of the tragedy of child abuse contributed to ignorance of how children could be infected with gonorrhea and syphilis, even after the distinctions between hereditary and sexual transmission of the diseases were well understood.
Sex Education and the Military
The relationship between military medicine and modern sex education is a fascinating historical development. The first reported outbreak of syphilis was during a military campaign in Europe. For centuries, military medicine was challenged by the effect of sexually transmitted disease on combat readiness, and thus national security.
In response to widespread syphilis and gonorrhea infection among soldiers in the 19th and early 20th centuries, the U.S. military began distributing prophylactics and informational materials during World War I. These actions dovetailed with Progressive-era priorities for public health, which emphasized education and infectious disease prevention. Public health agencies and the military synergized their interests into successful campaigns. The ideal of a healthy military force helped advance sex education as an acceptable subject and worthy endeavor for social agencies.
The Poetry of Syphilis
Syphilis has been a recurring subject of poetry since Girolamo Fracastoro published the epic Syphilis sive morbus gallicus in 1530. The great clinician William Osler (1849-1919) pronounced Fracastoro's work "the most successful medical poem ever written." Perhaps inspired by Fracastoro's achievement, generations of poet-physicians have addressed syphilis in their writing. As an avocational endeavor, poetry was a way for physicians to express ideas they couldn't easily share in their professional capacities.
Text and selections by Maija Anderson, Director, Curatorial Services