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

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Syphilis received its name from Fracastorius who in 1521 wrote a poem entitled Syphilis Sive Morbus Galliousf' a portion of which reads as follows: A Shepherd once tdistrust not ancient farnel Possessed these downs and Syphilis was his name. A thousand heifers in these vales he fed A thousand ewes to those fair rivers led From his the malady received its name. Heretofore, the stigma of dissemination was passed from nation to nation. The appearance of syphilis on the European coast enhanced the lexicon of national rivalry with pelvic phraseology. Fracastorius in shifting the burden of the source to the mythological swineherd Syphilis contributed to much inter- national accord, if not to the poetic art. . SYPHILIS IN HISTORY AND LITERATURE The role of syphilis in modern history is of great significance, a signifi- cance rarely emphasized by the non-medical historian. Its presence as an ever hovering pall of death and destruction penetrated the lives, customs, literature and politics of men. Syphilis spared neither rich nor poor. A list of historic figures who were syphilitic can fill an international who's who. The college of luetic notables can claim such men as Francis I of France, Benve- nuto Cellini, Louis XIV, Henry VIII, and Ivan the Terrible of Russia. One can not help marvelling how the course of history might have been altered by a course of arsenicals. The imprint of the disease is found in classical literature. Thus Rabelais, Ben Iohnson and Shakespeare are replete with references to the malady. Shakespeare showed an acute understanding of the disease and its manifestations. References as to origin, symptoms or cure are found in King Lear, As You Like It, Henry V, Pericles, Measure for Measure, Loves' Labour Lost, Timon of Athens, I-Ienry IV, Troilus and Cresidef' and I-Iamlet : in Timon of Athens CIV III 168-1837 the great master exhibits keen knowledge of the disease: Consumption sow In hollow bones of manl strike their sharp skins And mar man's spurring. Crack the 1awyer's voice That he may never more false title plead Nor sound his quillets shrilly: hoar the flames That scolds against the quality of flesh And not believe himself: down with the nose Down with it flat, take the bridge quite away Of him that, his particular to foresee Smells from the general weal: Make Curled-Pate ruiiians bald An-d let the unscarred braggarts of the war Derive some pain from you: Plague all That your activity may defeat and quell The service of all erection. There's more gold: Do you damn other, and let this damn you And ditches grave you alll One hundred sixty-six

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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

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' ETIOLOGY OF SYPHILIS The developments of concepts as to the cause of syphilis provides a fascinating chapter in the history of the disease. Before the role of bacteria and other infectious organisms in disease was understood, notions on the etiology of syphilis were indeed fantastic. ln the 18th century an astrologic origin was postulated. Some claimed a dietary origin, others attributed it to poisoning. The teachings of the versa- tile Paracelsus on the subject were most novel: The French Disease Csyphilisl derives its origin from the coitus of the leprous Frenchman with an impudent female, who had venereal Bubas, and after that infected everyone that cohabitated with her: and thus from the Leprosy and venereal Bubas, the French Disease arising, infected the whole world with its contagion, and in the same manner as from the coitus of a Horse and Ass the race of Mules is produced. Syphilis generally became recognized as a disease of venereal origin, but for a long time was confused with gonorrhea. Much of this confusion was due to the heroic but misleading experiment of Iohn Hunter. Hunter con- tended that gonorrhea was a mucous membrane manifestation of the same virus which when affecting the skin caused syphilis. He subjected himself to a skin inoculation of pus from a case of gonorrhea and developed syphilis. What Hunter failed to realize was that the source of infection suffered from a concomitant syphilis. The Hunterian concept was finally destroyed by the work of Phillippe Ricord H8389 in distinguishing the two diseases. The recent history in the development of syphilology is well known to all. The epoch making work of Pasteur stimulated the search for the bacterial cause of syphilis. In 1903, Metchnikoff, though failing. to find the organism, demonstrated that the disease could be transmitted to the higher apes. He also showed that the organism was microscopic in size since it did not pass through a porcelain filter. It remained for Schaudinn and Hoffman in 1905 to find the Treponema pallidum by use of dark field illumination. In 1906 Wasserman perfected the diagnostic test for syphilis. Closely succeeding each other came the important developments of salvarsan by Ehrlich in l9lO, the discovery of Treponema in paresis by Noguchi in l9l3, and the culturing df the organism by the latter scientists. CURES FOR SYPHILIS Men soon began to grope for a cure. Mercury became the sheet anchor in the treatment of syphilis. It is said that Europe was acquainted with the use of Mercury by the Arabian empiricists. Diaz de Isla, in 1521, is accredited with being the first European physician to employ mercury as a cure. How- ever, the drug was so misused that most patients preferred the disease to the cure. The patient was frequently annointed from head to foot with mercury ointment, the drug being pushed to salivation. Others accompanied vigorous mercurial inunctions with fasting. In Shakespear's time fumigation with mer- cury vapor, sweating and diets were popular. The victim entered a tub into which cinnabar was thrown on a hot dish. The dramatist refers to this pro- cedure in Timon of Athens CIV Ill-9-92l: One hundred sixty -SGVGI1