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Columbus and Treponema Pallidum

October 7th, 2005 Nicholas Genes the good old days...

columbus.jpgIt’s Columbus Day weekend in the United States, and naturally our thoughts turn to venereal diseases. Specifically, did Columbus bring syphilis from the New World, back to the Old?
It turns out, the spread of syphilis (T. pallidum) is a contentious issue. Here’s a snippet from Science on the matter:

The so-called Columbian theory of syphilis’s spread was based on finding skeletal remains bearing the signature of the disease–thickened leg and arm bones and skull scars–in a suggestive pattern. Although 18th and 19th century archaeologists had discovered plenty of diseased remains at prehistoric sites in the Americas, they found no traces of the disease in European bones until a major epidemic hit Europe about 1500, just after Columbus returned from his 1493 voyage. In the last decade, however, researchers have unearthed about a dozen pre-Columbian skeletons in England and Ireland that also showed signs of the disease. But until recently the oddball cases weren’t enough to sink the Columbian theory.

They go on to describe the discovery of more than 100 skeletons in England with trace or frank bony changes, suggestive of syphilis. How did syphilis get to England, then? Maybe Vikings.
treponema.jpg
Wikipedia, as usual, has an informative entry on the history of syphilis:

Alfred Crosby has argued that neither side has the full story. Syphilis is a form of Yaws, which has existed in the Old World since time immemorial. Crosby argues that syphilis is a specific form of Yaws that had evolved in the New World and was brought back to the old, “the differing ecological conditions produced different types of treponematosis and, in time, closely related but different diseases”.
The epidemiology of the first syphilis epidemic indicates that the disease was either new or a mutated form of an earlier disease. The disease swept across Europe from the early epicenter at Naples. The early form was much more virulent than the disease of today, the incubation period was shorter, only a few months, and the symptoms were more severe. In addition, the disease was more frequently fatal than it is today. By 1546, the disease had evolved into the form we know now.
Syphilis had many different names. Great pox was used during the 16th century to distinguish it from smallpox. Great pox produced a similar rash in its early stages to small pox, but other than that it has no relation to the Variola virus. However the name is misleading, as small pox was a far more deadly disease. Because of the outbreak in the French army, it was first called morbus gallicus, or the French disease. In that time it is noteworthy that the Italians also called it the “Spanish disease”, the French called it the la maladie anglaise – the English disease and “Italian” or “Neapolitan disease”, the Russians called it the “Polish disease”, and the Arabs called it the “Disease of the Christians”.
The name “syphilis” was first applied by Girolamo Fracastoro in 1530 from the name of a shepherd in a poem by Leonardo da Vinci.

Answers.com has more on that poem:

In Fracastoro’s poem the name of this dreaded venereal disease is an altered form of the name of the hero Syphilus, a shepherd who is supposed to have been the first victim of the disease. Where the name Syphilus itself came from is not known for certain, but it has been suggested that Fracastoro borrowed it from Ovid’s Metamorphoses. In Ovid’s work Sipylus (spelled Siphylus in some manuscripts) is the oldest son of Niobe, who lived not far from Mount Sipylon in Asia Minor. Fracastoro’s poem about Syphilus was modeled on the story of Niobe. Fracastoro went on to use the term syphilis again in his medical treatise De Contagione, published in 1546. The word that Fracastoro used in Latin was eventually borrowed into English, being first recorded in 1718.

A poet who writes a medical treatise! It anticipates the doctor/blogger phenomenon by 500 years. But alas, the poem is in another language. So in our search for some good syphilis poetry, we found an excerpt from a limerick about syphilis, which ran in JAMA in 1932 (this is what medical journals were like before evidence-based medicine came along):

Consider his terrible plight–
His eyes won’t react to to the light
His hands are apraxic,
His gait is ataxic,
He’s developing gun-barrel sight.

The Argyll-Robertson pupil has never been described better (well, maybe). If we had this poem in medical school, microbiology would have been a good deal more… memorable.
But alas, it’s hard to stay lighthearted when it comes to syphilis and Columbus. We’d be remiss if we didn’t link to a story about the infamous Tuskegee experiment and syphilis treatment in the US, and the painful classic from Bartoleme de Las Casas, a Brief Account of the Devastation of the Indies.
More from the CDC’s Syphilis Elimination Effort, a plan to rid the US of one of its earliest inhabitants…
That’s all for this week. Have a safe and fun long weekend, and come back for more medgadgets on Tuesday!

Nicholas Genes

Nicholas Genes, MD, PhD, has been with Medgadget since almost the beginning. He's now Assistant Professor of Emergency Medicine at Mount Sinai, where in addition to patient care and teaching responsibilities, he studies EHR usability and physician uses of social media. Dr. Genes serves on the editorial boards of Emergency Physicians Monthly and Emergency Medicine Practice. More about Nick: http://nickgenes.com

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