Syphilis: The Painful History of an Odd Bug

From the beginning, syphilis has been a deeply stigmatized, shameful disease. A letter written in June 1495 by an Italian doctor named Nicolò Squillaci contains one of the first written mentions of syphilis: “There are itching sensations and an unpleasant pain in the joints,” he wrote. “The skin is inflamed with revolting scabs and is covered in swellings and tubercules, which are of a livid red color at first and then become blacker.

“It most often begins with the private parts,” he noted. “Nothing could be more serious than this curse, this barbarian poison.”

Squillaci wrote his letter during the first major syphilis epidemic to sweep through Europe.

When syphilis first arrived in Europe in the 15th century, it appears to have been a more severe illness than it is today. The disease seems to have killed its victims more quickly back then and also to have spread faster, based on writings and artworks from that time. Scholars think that syphilis may have been so brutal in those earlier years because it was a new illness in Europe and people had no immunity to it yet.

People of the 15th century called syphilis “the great pox” in light of its painful, repulsive symptoms. At the time, treatments were few and ineffective. Physicians tried remedies such as mercury ointments, some of which caused patients great pain and even killed them.

Sweat baths were also used, as some healers believed sweating purged the body of syphilitic poisons.

Looking for Others to Blame

Squillaci called syphilis the “French disease” in his letter. By doing so, the Italian doctor fell in line with an often-seen tendency in early discussions of the illness. That is, people from one area have repeatedly blamed people from another area for the illness.

Like Squillaci, residents of parts of Europe we now call Germany and the United Kingdom also used to call syphilis “the French disease.” Meanwhile, French people referred to syphilis as “the Neapolitan disease,” meaning it came from Naples, Italy.

Russians have called it “the Polish disease,” while Poles have called it “the German disease.” Turks used to call syphilis “the Christian disease,” while Muslims blamed syphilis on the Hindus. In fact, few groups have not been blamed for syphilis at one time or another.

Source of the Name ‘Syphilis’

An Italian poet named Giralamo Fracastoro was the first person to call the illness “syphilis.” In a long poem of that title published in 1530, Syphilis is a character, possibly based on one in Ovid’s Metamorphoses, who is a shepherd to a king. This shepherd angers the sun god Apollo by blaming the god for a drought. In response, Apollo curses Syphilis with a dreadful disease that spreads wildly throughout the area where Syphilis lives. It even infects the king whose flock Syphilis tends.

The fact that this story describes syphilis infecting a king would have rung true to the poem’s audience. Many leaders, writers, and artists throughout history appear likely to have had syphilis. Although the facts are not always clear, records of the illnesses of many famous people strongly suggest that their troubles were caused by syphilis.

Among those greats who may have had syphilis are the composers Ludwig van Beethoven and Franz Schubert, the writers Oscar Wilde and James Joyce, and political figures such as Napoleon Bonaparte. Many other renowned people probably had the illness too, writes Deborah Hayden in her book Pox: Genius, Madness, and the Mysteries of Syphilis.

Spreading Worldwide

Syphilis swept across Europe in short order. By the end of 1495, it had reached France, Switzerland, and Germany. By 1497, it took hold in England and Scotland. By 1500, the epidemic had Scandinavia, Hungary, Greece, Poland, and Russia in its grip.

During the 1400s and 1500s, European explorers sailed the globe. These explorers brought syphilis with them to India, Africa, the Near East, China, Japan, and the Pacific islands.

In the 16th and 17th centuries, some people thought of syphilis as a punishment for sin and believed that people with the disease didn’t deserve treatment. Some people believed that people with syphilis should be subjected to harsh, painful remedies.

Taking a more enlightened view in 1673, a British physician named Thomas Sydenham wrote that any moral aspects of the disease should be of no concern to doctors. He believed that all people deserved to be treated for their ills and not be judged by physicians.

By the early 18th century, syphilis was no longer the highly virulent epidemic it had been in previous years. It then came to resemble more closely the version of the disease we find today.

Scientific Inquiry and a Cure

In 1905, Fritz Richard Schaudinn, a German zoologist, and Erich Hoffman, a dermatologist, discovered the cause of syphilis: the bacterium called Treponema pallidum.

Then, in 1928, Alexander Fleming, a London scientist, discovered penicillin.

Finally, 15 years after that, in 1943, three doctors working at the U.S. Marine Hospital on Staten Island, in New York, first treated and cured four patients with syphilis by giving them penicillin. To this day, penicillin remains the cure for syphilis.

An Odd Bug

Syphilis belongs to a group of four diseases known to be caused by bacteria that are members of the Treponema family. The others are yaws, bejel, and pinta, all of which are spread through skin contact, primarily among children living in areas with poor hygiene.

As mentioned above, in the case of syphilis, the culprit is a spiral-shaped organism known as Treponema pallidum.

“This is an odd bug. It can’t make its own proteins or lipids [fats], which other bacteria typically do. It cuts off parts of itself so it can bind closely to the cells of the host [the infected person],” says Sheila A. Lukehart, PhD, a professor emeritus at the University of Washington in Seattle and an expert on Treponema pallidum. “It has only the characteristics it needs to survive.”

Prospects for Control of Syphilis

Some of its traits make this bacterium extra tricky to address with a vaccine, says Dr. Lukehart. Nonetheless, researchers are trying to find a vaccine that will work against syphilis, although progress has been slow, according to a 2016 review that looked at work on syphilis vaccines over the past decade. On one hand, the authors noted that an effective vaccine could be viable, based on recent trials; but significantly more funding and public health support would be required to make a vaccine a reality.

Lukehart is optimistic, with some reservations. “I don’t think we are ever going to treat syphilis out of existence, but I do hope that we can treat congenital syphilis [the kind passed from a pregnant woman to her baby] out of existence. By screening you should be able to do that.”