New York Medical College - Fleuroscope Yearbook (Valhalla, NY)

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SOME HISTORICAL AND SOCIAL ASPECTS OF SYPHILIS THE most important aspect of syphilis is its eradication. Though it has been known and written about for centuries, it is only now, in the past few years that rational steps have been taken in an attempt to decrease its incidence. And even now, there is much opposition to be overcome, much prudishness to educate, before we can reach the point where syphilis can be added to the list of rare diseases. ln the United States, in which syphilis has been reportable since l920, there have been 35,000 more cases of syphilis reported than of Scarlet Fever, 79,000 more than Tuberculosis, 500,000 more than Diphtheria, three times as much syphilis as Smallpox and five times as much syphilis as Typhoid Fever. In the Scandinavian Countries, where anti-syphilis regulation is most ad- vanced, there are only 1,600 new cases a year. The United States have 500,000 new cases a year and 7,000,000 new and old cases currently in progress. It was only three years ago that a newspaper in one of our larger cities shocked the public by printing the Word syphilis in one of its columns. Last year a large radio corporation refused to permit the Department of Health to lecture on venereal disease over its network. The campaign unremittingly driven by Doctor Thomas Parran, Ir., Surgeon-General of the United States Public Health Service is attempting to make the word syphilis represent a serious and urgent problem rather than a shameful punishment for sin. We have Christmas seals advertising the treatment of Tuberculosis and subway posters urging early treatment of Cancer. Should we, as scientists, whose work lies in the healing of the sick give less prominence to a disease which is more widely prevalent than either of these, and which is the cause of un- told death and misery every year, simply because it is contracted through sexual relations? In any effort to eradicate a disease it is not only necessary to educate the public. We who are to do this work must know all of its aspects. We cannot here attempt to cover the medical or public health phases of sYphilis. No aspect of medical history presents such interest, no problem is ramified with as much claim and counterclaim, accusation and counteraccusation as the disease syphilis. ORIGIN OF SYPHILIS Even today with many books and articles, displaying over-whelming erudition, the origin of syphilis is still a moot question. In general, partisan- ship on the question of the origin divides itself into two belligerent camps. One group upholds the European beginnings of the disease while the other gives America the dubious distinction of first mothering it. The Eurasion School labors under the difficulty that there was no accurate description of the disease manifestations before the first epidemic occurred at Naples in 1496. Isolated reference to genital sores, ulcerations, eruptions, etc., which can be attributed to syphilis can also be ascribed to various other diseases, One hundred sixty-four

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ality of the thoughts and theories of today will provide only foundation f o r the progress of the future. The drawings illus- trate the customs of a by-gone era the liter- ary contributions of the following pages reflect the theories and trends of present day Medicine. kgs X. xl N x x W Qt . l. K F 1' ' -7-1' WN Y J E I5 Xe it ' NNW x- N 7'-X !xNs !s6 t if i It I, lu' iw X ' y xx ' lf 'C E' S feet 5 :5IA i, .yi-gtg. nl gr 471- --x Aww Qt' i ,Qt 'N ' N. .QQ X Vp S- iv , Swv .2-.a'vfix, ' 1' ,st xxx 5,7 .V y A 'l i si t N l Wt' 'Wt lA'i' lI'f 'l l Z itll- 5-i t its . 2 , N 'ltttl 7 l t fl 'l l I t , -s al f tttt tt. .P df l t 1 f QQQN , - ,t-zxtig' Nt, If-:, 4. 1 4 pttt 5 Xxf f if U M 31 Vzpw tlflfz' ' l N X ,fsst f l rp tt N fs.-ftp I-WfQvs I ff f ltlfflf fl i f fl l if' f xi Mt t mst f . X t tt uf lt L tie X ' f A li ft: if X .T-. lhljlnvifjl-igfttfg., ,i l J! 'I lt ' iff r f f My f ' ft vx igff , QWQER it '- l' l.lX1 ' x 7 ' - tl' tt -e f-3 tt A Q r tt it X - A 1 l 1 tt 1. S ' -l X l tw ,LC-V 4 .. Branding iron-'panacea for all ills! Egyptian medicine-tncantations! One hundred sixty three

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BY SIDNEY LIPENI-IOLTZ LOUISE FISCHER venereal or non-venereal-such as Chancroid, Tuberculosis, Leprosy and Car- cinoma. Our first considerations will involve an examination of the claims of the Eurasion School. Butler claims that Salicento in 1269 learned that syphilis followed Coitus cum meretrice. However, he does not state upon what basis the disease was diagnosed as syphilis. In the first century Celsus described hard and soft genital sores. Antyllus during the first and second centuries described and perfected a technique for the cure of aneurysm. This became the accepted surgical treatment for fifteen centuries. The claim is made that since aneurysm is nearly always a luetic process, syphilis was therefore common among Romans. Albrecht Durer's wood-cut, The First Syphilitic, bears the date 1484. The life of Caligula, Emperor of Rome as described by Suetonius, and Ralph Graves in his recent biography, Claudius the God and His Wife Messa1ina, seems to indicate that this monster was a victim of paresis. Wil- liams weighs the pros and cons of evidence of syphilis among the ancients. The conclusion we can draw from this interesting investigation is that ancient evidences of syphilis are very doubtful, and if accepted, extremely inferential. Chin-Shie-Lei living in China during the dynasty of Ming C3168-1644 B. CJ wrote a secret manuscript in which many supposed luetic manifestations are de- scribed, but again it is impossible to identify them exactly with syphilis. Other historians, notably Buret and Sudhoff, have written fascinating works on the Old World origin of Syphilis but the material they present does not entirely meet the test of critical investigation. The New 'World school bases its chief claim on the fact that the earliest recognition of syphilis as a disease entity, its name, and earliest suggestions for treatment were made after Columbus returned from. America. The story of the first epidemic of syphilis in Europe is too well known to be repeated in its entirety. Suffice it to know that in August 1494, Ferdinand of Spain marched against Charles VIII who had occupied Milan with an army of nondescript mercenaries, many of whom had been in the West Indies with Columbus. This dated the arrival of syphilis to Europe. As Iohn Astruc, phy- sician to Louis XIV says: And therefore it is by no means strange that many Neopolitans should be infected with the same Distemper, as they served under the same colors and had to do with the same women who followed the camp. And for the same reason the contagion would not but soon be communicated by one or both of them to the French, for as the success of the war continued, doubtless the same towns were taken and recovered by both parties, 'tis plain. that the French also must have had communication with the same women and thus the seeds of Veneral Disease must have naturally passed from one to the other. In 1496 the invaders were expelled from Naples and the members of the mercenary army scattered to their own countries. Thus it followed in their wake to France, Germany, Switzerland, Holland and Greece in 1496: Scotland in 14977 and Hungary and Russia in 1498. Vasco da Gama brought it to India in 1498. China was affected in 1505. It spread to the remaining portions of the World through the medium of those who opened them to civil- ization. It may well be said, with Haggard, that syphilization followed civiliza- tion. Reconsidering the question, the weight of evidence inclines one's opinion toward a New World origin-but the problem is far from being settled. One hundred sixty five