Redefining the treponemal history through pre-Columbian genomes from Brazil.

The origins of treponemal diseases have long remained unknown, especially considering the sudden onset of the first syphilis epidemic in the late 15th century in Europe and its hypothesized arrival from the Americas with Columbus' expeditions1,2. Recently, ancient DNA evidence has revealed various treponemal infections circulating in early modern Europe and colonial-era Mexico3-6. However, there has been to our knowledge no genomic evidence of treponematosis recovered from either the Americas or the Old World that can be reliably dated to the time before the first trans-Atlantic contacts. Here, we present treponemal genomes from nearly 2,000-year-old human remains from Brazil. We reconstruct four ancient genomes of a prehistoric treponemal pathogen, most closely related to the bejel-causing agent Treponema pallidum endemicum. Contradicting the modern day geographical niche of bejel in the arid regions of the world, the results call into question the previous palaeopathological characterization of treponeme subspecies and showcase their adaptive potential. A high-coverage genome is used to improve molecular clock date estimations, placing the divergence of modern T. pallidum subspecies firmly in pre-Columbian times. Overall, our study demonstrates the opportunities within archaeogenetics to uncover key events in pathogen evolution and emergence, paving the way to new hypotheses on the origin and spread of treponematoses.

[The venereal morbidity in Russia in 1914-1924].

It is accepted to explain increasing of venereal diseases during years of the Revolution by degradation of morality and general disorder of system of state administration and sanitary services in Russia. The cross-verification of information presented in scientific publications and primary information sources makes it possible to look into following issues: degree of venereal (syphilitic) contamination of population of pre-revolutionary Russia; influence on sanitary statistics by erroneous diagnostics and convictions of Zemstvo medicine about predominantly non-sexual path of transmission of syphilis pathogen in Russian countryside; dynamics and sources of venereal morbidity in wartime. The high indicators of pre-revolutionary statistics of venereal infections could be affected by diagnostic errors. The "village syphilis" encountered in public milieu could be completely different disease not sexually transmitted and not chronic form of disease. The primary documents allow to discuss increasing of the number of venereal patients during war years, that however, does not reach catastrophic numbers that can be found even in scientific publications. This is also confirmed by data of Chief Military Sanitary Board of the Red Army for 1920s and statistical materials of People's Commissariat of Health Care of the RSFSR. The high morbidity was demonstrated by same Gubernias that were problematic before the Revolution and only later by those ones through which during the war years passed army masses. In Russia, total level of syphilis morbidity after the end of Civil War occurred to be more than twice lower than in pre-war 1913 and continued to decrease under impact of sanitary measures of Soviet public health.

Ten Famous Composers of the Romantic Era and Their Causes of Death.

The musical composers in the Romantic Era (1800-1910) strived for compositions that expressed human life, including happiness, harmony, and despair. They lived in a period in which freedom of thought, expression of emotion, and inspiration by nature predominated. During this period, intensive trading with other parts of the world brought new microorganisms along, which made infections and epidemics very common. This article serves to address the cause of death and relevant biographic data of a number of well-known Romantic composers. Primarily, this review refers to clinically significant findings using reports that were retrieved from PubMed, Embase, and Google over the 19th, 20th, and 21st centuries till 14th June 2021. This text dwells on diseases and the cause of death of ten composers, namely Mozart, Beethoven, Chopin, Schubert, Schumann, Mendelssohn, Brahms, Liszt, Mahler, and Bruckner. It is evident that from the perspective of modern medicine, symptoms and forensic facts are not complete, but witnesses' reports and recent medical research have provided passable and plausible clarity. Although many questions will remain unanswered, it appears that the diseases of these composers and their causes of death have their origins in alcohol abuses, age, epidemics (like tuberculosis), and syphilis.

Psychiatric wards of Soochow Elizabeth Blake Hospital (1898-1937): a missing piece in the history of modern Chinese psychiatry.

The history of modern psychiatry in China began at the end of the nineteenth century, as a result of the work of missionaries. Soochow was one of the first cities to establish a hospital for the treatment of mental patients, but historians knew little about it. It provided a valuable service from 1898 to 1937. In the 1930s, there were 200 beds in the psychiatry and neurology section, making it the most influential psychiatric hospital in East China. After Soochow was occupied by the Japanese army in 1937, the hospital was destroyed and shut down.

Noddle Pox: Syphilis and the Conception of Nosomania/Nosophobia (c. 1665-c. 1965).

Hypochondriac or phobic reactions to venereal disease, specifically syphilis, have invited over three centuries of medical reification and nosological reframing. This bibliographic overview establishes that the early specification and psychiatricization of early modern concepts of melancholy and hypochondriasis, imaginary syphilis or syphilophobia, animated the early respective territorializations of venereology, infectiology more broadly, neurology, and mental medicine. Together with mercuriophobia and a wider emergent clinical sensitivity to sexual angst, the diagnosis, while evidently only sporadically made, functioned as a durable soundboard in the confrontation of emergent medical rationale with various confounders and contenders: medically literate and increasingly mobile but possibly deluded patients; charlatans and putative malpractitioners; self-referral laboratory serology (after 1906); and eventually, through psychoanalysis, the patient's unconscious. Requiring medical psychology early on, syphilology became and remained self-conscious and circumspect, attentive to the casualties of overdiagnosis, overtreatment, and iatrogenesis. Finally, patient apprehension led to makeshift forms of "moral treatment," including fear-instilling and placebos.

Availability of Injectable Antimicrobial Drugs for Gonorrhea and Syphilis, United States, 2016.

We estimated the availability of the injectable antimicrobial drugs recommended for point-of-care treatment of gonorrhea and syphilis among US physicians who evaluated patients with sexually transmitted infections in 2016. Most physicians did not have these drugs available on-site. Further research is needed to determine the reasons for the unavailability of these drugs.

[Identity and Integration - Salomon Neumann on the issue of Syphilis in Berlin]. / Identität und Integration ­ Salomon Neumann zur Syphilisfrage in Berlin.

The essay "The issue of syphilis in Berlin. A contribution to public health in Berlin" highlights the importance of Salomon Neumann as an initiator of social medicine and a promoter of the communal medical statistics in the middle of the 19th century. Being a physician-member of the Berlin Health Care association and a doctor for the poor, he provides a sociomedical report on the interaction between syphilis as a disease and society with its regulatory measures (vice squad, public administration) and the deficient hospital and ambulatory care structures for the poor in Berlin in the middle of the 19th century, both with a prospective orientation.

[Johann Heinrich Rille (1864-1956): the long way to the chair in dermatology in Leipzig 100 years ago]. / Johann Heinrich Rille (1864­1956): der lange Weg zum Leipziger Ordinariat vor 100 Jahren.

Johann Heinrich Rille, also characterized as a renowned nestor of German-speaking dermatovenereology, was named as extraordinary professor for syphilis and skin diseases in Leipzig in 1902, the second oldest university in Germany. Although the chair of dermatology was promised this was postponed for many years, not only because of World War I but also due to an ongoing struggle for dermatology to be accepted as an independent specialty in Germany. Finally, in 1919, the long overdue promotion to full professor was granted. Rille commented on this as "successful partial coping with the ordeal of German dermatology in Leipzig".

[A brief history of syphilis. The disease through the art and the artist]. / Une petite histoire de la syphilis. La maladie à travers l'art et l'artiste.

Considering its strong symbolic connotations and its rich history, syphilis could be regarded as the perfect example of venerian disease. It could also be seen as a representative disease of the whole medical history and the evolution of both medical ways of thinking and curing. In this work we will briefly discuss the history of the syphilitic disease and try to show how this condition has affected the life and works of some of the most famous artists of the 19th century. Moreover, we shall try to evoke the complex relationship between art and pathology.

Par ses connotations historiques et symboliques, la syphilis constitue la maladie vénérienne par excellence. Elle peut également être considérée à plus d'un titre comme une maladie représentative de l'histoire de la médecine et paradigmatique de l'évolution de la pensée médicale. Au travers de ce petit historique, nous tenterons de dresser une brève histoire de la maladie et de son traitement avant d'envisager la façon dont elle a pu influencer le parcours créatif de plusieurs figures artistiques majeures du XIXème siècle. Plus encore, nous discuterons brièvement des liens complexes que peuvent entretenir l'art et la maladie.

Race, alcohol and general paralysis: Emil Kraepelin's comparative psychiatry and his trips to Java (1904) and North America (1925).

This article examines Emil Kraepelin's notion of comparative psychiatry and relates it to the clinical research he conducted at psychiatric hospitals in South-East Asia (1904) and the USA (1925). It argues that his research fits awkwardly within the common historiographic narratives of colonial psychiatry. It also disputes claims that his work can be interpreted meaningfully as the fons et origio of transcultural psychiatry. Instead, it argues that his comparative psychiatry was part of a larger neo-Lamarckian project of clinical epidemiology and was thus primarily a reflection of his own long-standing diagnostic practices and research agendas. However, the hospitals in Java and America exposed the institutional constraints and limitations of those practices and agendas.

Tuskegee as Sacred Rhetoric: Focal Point for the Emergent Field of African American Religion and Health.

Scholars in African American religion engage the Tuskegee Syphilis Study as the focal point of the African American experience in institutional medicine. Seeking a way forward from this history and its intentional evil, the author proposes to position Tuskegee as a form of Lynch's culturally contextual sacred rhetoric to make use of its metaphoric value in the emerging field of African American religion and health. In this broader meaning-making frame, Tuskegee serves as a reminder that African American religious sensibility has long been an agential resource that counters abuse of the Black body. It also acknowledges the complex decisions facing African American clinical trial participants.

Despite Being "Known, Highly Promiscuous and Active": Presumed Heterosexuality in the USPHS's STD Inoculation Study, 1946-48.

The Sexually Transmitted Disease Inoculation Study of the United States Public Health Service (USPHS) was a short-term deliberate exposure experiment into the prevention of venereal diseases. Between 1946 and 1948, over 1,300 Guatemalan prisoners, psychiatric patients, soldiers, and sex workers were exposed to syphilis, gonorrhoea, and chancroid. USPHS researchers initially proposed hiring sex workers to "naturally" transmit venereal diseases to male subjects who would then be given various prophylaxes. The researchers were interested in studying the effectiveness of new preventative measures. In other words, the USPHS study was designed to transmit venereal diseases heterosexually from an "infected" female body to the men who, it was assumed, were sexually isolated subjects. However, the researchers did record instances of male-to-male disease transmission among their subject populations, instances that challenged the presumption of heterosexuality on which the study was based.

Sexually Transmitted Infections in Melbourne, Australia from 1918 to 2016: nearly a century of data.

INTRODUCTION: Our aim was to describe trends in the number of bacterial sexually transmitted infections (STIs) diagnosed at Melbourne's sexual health clinic over a century. METHODS: A retrospective analysis of STI diagnoses (gonorrhoea, infectious syphilis and chancroid) among individuals attending Melbourne's sexual health service over 99 years between 1918 and 2016. RESULTS: Substantial increases in STI rates coincided with World War II, the 'Sexual Revolution of the 1960s and 1970s', and the last 10 years. Substantial declines coincided with the advent of antibiotics and the HIV/AIDS pandemic. There were also key differences between STIs. Chancroid virtually disappeared after 1950. Syphilis fell to very low levels in women after about 1950 and has only rebounded in men. The declines in gonorrhoea were less marked. A substantial peak in gonorrhoea occurred in women in the early 1970s and rates are currently rising in women, albeit much less than in men. CONCLUSIONS: Both antibiotics and changing sexual behaviour have had a powerful effect on STI rates. These data suggest gonorrhoea is more difficult to control than syphilis or chancroid. Indeed, the past rates suggest substantial endemic gonorrhoea transmission in heterosexuals occurred in the third quarter of last century before the appearance of the HIV pandemic. Worryingly, there is a suggestion that endemic heterosexual gonorrhoea may be returning. The data also suggest that future control of gonorrhoea and syphilis in men who have sex with men is going to be challenging.

'He would by no means risque his Reputation': patient and doctor shame in Daniel Turner's De Morbis Cutaneis (1714) and Syphilis (1717).

This article offers a historical corollary to the examination of shame in medical practice by considering the negotiation of shame in the treatment of a stigmatised disease at a time in which surgeons themselves occupied a highly ambivalent social position. It will focus on case studies provided by Daniel Turner (1667-1741), prominent surgeon and later member of the College of Physicians, in his textbooks De Morbis Cutaneis. A Treatise of Diseases Incident to the Skin (1714) and Syphilis. A Practical Dissertation on the Venereal Disease (1717). Turner demonstrates an awareness of the precarious position of both the surgeon and the syphilitic, and devotes significant portions of his text to advising the trainee surgeon on how to manage patients' reticence over disclosure of symptoms, expectations for cure and impudence towards medical authority. In turn, the trainee must manage his own reputation as a moral and medical authority who can treat all distempers, yet without condoning or facilitating the shameful behaviours associated with a sexual disease. Furthermore, shaming plays a key role in enabling Turner to fashion an ideal patient whose successful cure will both respond to and build the surgeon's medical authority and that of the medical field in general.

Syphilization and Its Discontents: Experimental Inoculation against Syphilis at the London Lock Hospital.

In 1867 James Lane and George Gascoyen, surgeons to the London Lock Hospital, compiled a report on their experiments with a new and controversial treatment. The procedure, known as "syphilization," saw patients be inoculated with infective matter taken from a primary syphilitic ulcer or the artificial sores produced in another patient. Each patient received between 102 and 468 inoculations to determine whether syphilization could cure syphilis and produce immunity against reinfection. This article examines the theory and practice of this experimental treatment. Conducted against the backdrop of the Contagious Diseases Acts, the English syphilization experiments have been largely forgotten. Yet they constitute an important case study of how doctors thought about the etiology and pathology of syphilis, as well as their responsibilities to their patients, at a crucial moment before the advent of the bacteriological revolution.

The 'secret' source of 'female hysteria': the role that syphilis played in the construction of female sexuality and psychoanalysis in the late nineteenth and early twentieth centuries.

In the late nineteenth and early twentieth centuries, the unspoken fear of syphilis played a significant role in the development of beliefs about female sexuality. Many women were afraid of sexual relationships with men because they feared contracting syphilis, which was, at that time, untreatable. Women also feared passing this disease on to their children. Women's sexual aversion, or repression, became a focus for Freud and his colleagues, whose theory of psychosexual development was based on their treatment of women. This article examines the case of Dora, the memoirs of Mabel Dodge Luhan and other sources to argue that the fear of syphilis was a significant factor in upper- and middle-class women's avoidance of heterosexual relationships. The fear of syphilis, in turn, became a significant factor in the psychoanalytic construction of female sexuality. The social suppression of the fear of syphilis has had a profound impact on theories of women's development. The implication for psychiatry is that our models of psychological development occur within a sociocultural milieu and cannot escape suppressed aspects of our culture.