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.

Photograph as Skin, Skin as Wax: Indexicality and the Visualisation of Syphilis in Fin-de-Siècle France The William Bynum Prize Essay.

In early twentieth-century France, syphilis and its controversial status as a hereditary disease reigned as a chief concern for physicians and public health officials. As syphilis primarily presented visually on the surface of the skin, its study fell within the realms of both dermatologists and venereologists, who relied heavily on visual evidence in their detection, diagnosis, and treatment of the disease. Thus, in educational textbooks, atlases, and medical models, accurately reproducing the visible signposts of syphilis - the colour, texture, and patterns of primary chancres or secondary rashes - was of preeminent importance. Photography, with its potential claims to mechanical objectivity, would seem to provide the logical tool for such representations. Yet photography's relationship to syphilographie warrants further unpacking. Despite the rise of a desire for mechanical objectivity charted in the late nineteenth century, artist-produced, three-dimensional, wax-cast moulages coexisted with photographs as significant educational tools for dermatologists; at times, these models were further mediated through photographic reproduction in texts. Additionally, the rise of phototherapy complicated this relationship by fostering the clinical equation of the light-sensitive photographic plate with the patient's skin, which became the photographic record of disease and successful treatment. This paper explores these complexities to delineate a more nuanced understanding of objectivity vis-à-vis photography and syphilis. Rather than a desire to produce an unbiased image, fin-de-siècle dermatologists marshalled the photographic to exploit the verbal and visual rhetoric of objectivity, authority, and persuasion inextricably linked to culturally constructed understandings of the photograph. This rhetoric was often couched in the Peircean concept of indexicality, which physicians formulated through the language of witness, testimony, and direct connection.

Review of the Captain America Graphic Novel 'TRUTH: Red, White and Black' Focusing on Parallels with the Infamous USPHS Syphilis Study at Tuskegee.

This review presents the first detailed presentation of the parallelism between the Tuskegee Syphilis Study and the Captain America graphic novel 'TRUTH: Red, White and Black', published as a graphic novel by Marvel Comics in 2004 as a paperback, and then in 2009 as a hardcover. First written, published and distributed monthly in 2003 as pre-sequel seven comic book series to tell the story of the origins of the WWII superhero Captain America. In 2003, Marvel Comics chose to tell a 'very dark story' to explain the origins of Captain America, a half century after the initial introduction of Captain America as a WWII action hero in 1940. By detailing-for the first time-nine parallel aspects between these two storylines, this review demonstrates how Marvel Comics brought the tragic Tuskegee Syphilis Study story into the popular press, thus reaching an audience far beyond traditional bioethics academicians. This review is intended to stimulate and guide classroom discussions on the ethical issues at the core of the infamous Tuskegee Syphilis Study allowing bioethical issues to be made more accessible to the general public, via school curriculums, by the use of graphic novels.

[Treatment of syphilis with malaria or heat]. / Behandeling van syfilis met malaria of warmte.

Until the end of the Second World War, syphilis was a common sexually transmitted infection. This stigmatising infectious disease caused mental decline, paralysis and eventually death. The history of syphilis was given public attention because of 'malaria therapy', which had been applied from the First World War onwards in patients with paralytic dementia. In 1917, the Austrian physician Julius Wagner-Jauregg (1857-1940) induced fever in these patients by infecting them with malaria parasites; in 1927, he received the Nobel Prize for his discovery of the healing properties of malarial fever. One source, not cited anywhere, is an interview that the American bacteriologist and science writer/medical journalist Paul de Kruif conducted with Wagner-Jauregg in 1930. The reporting of this meeting, and De Kruif's later involvement in the mechanical heat treatment of patients with syphilis, form the inspiration for this article. When penicillin became available, both treatments became obsolete.

Which theory for the origin of syphilis is true?

INTRODUCTION: There are four theories about the origin of syphilis, of which the mostly represented one is the Columbian theory. This theory suggests that syphilis was brought into Europe in 1493 ad by the ship from Caribbean islands. AIM: The aim of this study is to test all theories on a sample of 403 skeletons: 135 from prehistory, 134 from antique, and 134 from medieval period and new age from the Dalmatia (Croatia). METHODS: All skeletons were examined using standard anthropological methods. Paleopathological analysis was performed on each skeleton as well as additional radiographic method on one isolated skeleton. MAIN OUTCOME MEASURES: Paleopathological changes on skeletal remains connected with treponematosis. RESULTS: Paleopathological analysis revealed one skeleton from the antique period (second to 6th century A.D.) that exhibited skeletal markers similar to those described in one clinical case in which congenital syphilis was confirmed by a Wasserman reaction. Skeletal remains of this person were examined macroscopically and radiographically, and the differential diagnostics eliminated other considered pathologies as well as trauma. CONCLUSIONS: The finding of skeletal markers of syphilis on a skeleton from the antique supports the theory of pre-Columbian syphilis origin.

Yaws, syphilis, sexuality, and the circulation of medical knowledge in the British Caribbean and the Atlantic world.

This history of the disease categories "yaws" and "syphilis" explores the interplay between European and African medical cultures in the early modern Atlantic world. The assertion made by both early modern and modern medical authorities, that yaws and syphilis are the same disease, prompts a case study of the history of disease that reflects on a variety of issues in the history of medicine: the use of ideas about contagion to demarcate racial and sexual difference at sites around the British Empire; the contrast between persistently holistic ideas about disease causation in the Black Atlantic and the growth of ontological theories of disease among Europeans and Euro-Americans; and the controversy over the African practice of yaws inoculation, which may once have been an effective treatment but was stamped out by plantation owners who viewed it as a waste of their enslaved laborers' valuable time.

[Position hopeless lost--Heinrich Dreuw's lonely struggle against syphilis and Salvarsan]. / Auf verlorenem Posten--der einsame Kampf des Heinrich Dreuw gegen Syphilis und Salvarsan.

The invention of Salvarsan (Triaminotrihydroxy-arsenobenzol) in 1910 meant a revolution in the medical treatment. Chemotherapy was born and its founder Paul Ehrlich is still famous for his experimental work. In medical history mostly successes, not widespread discussions about misuse or failing of the new drug were. The Berlin doctor Heinrich Dreuw was a key figure in these debates. He and his colleagues presented evidence that Salvarsan was not an effective drug and just an expensive placebo, which helped pharmaceutical trusts earning more money. Dreuw even attacked state medical branches for infringement against patients. At last doubts about Salvarsan never disappeared.

[Contribution of paleopathology to defining the pathocoenosis of infectious diseases (Part one)]. / Apporti della paleopatologia alla definizione della patocenosi delle malattie infettive (prima parte).

Studying the remains of mummies obtained by archaeological research may provide key information concerning historical pathocoenosis. Paleopathology makes it possible to recognise, characterise and connect different features involved in human pathocoenosis, such as epidemiology, in a historical perspective, and cultural development, via the introduction of new livestock farming techniques and agriculture in general. Several distinct pathologies may produce direct and indirect changes in the skeleton of affected individuals. Therefore bone remains represent very important sources of information to study such diseases. Changes related to trauma and nutrition deficiency as well as secondary signs, induced by tuberculosis, brucellosis, leprosy, syphilis, malaria, periostitis and aspecific osteomyelitis, persist in bones. In addition, other diseases may cause indirect alterations and subsequent secondary bone in the skeleton via different mechanisms. A secondary bone dimorphism may be induced by poliomyelitis. Aspecific lesions may arise in a skeletal bone and then cause secondary alterations in near-bone segments. Reviewing studies of paleopathologic research found in the literature, we emphasize the relationship between the appearance of major infectious diseases and the development of human activities; whereas it is clear that the introduction of livestock farming had a key role in the pathocoenosis of distinct infections such as tuberculosis, brucellosis and leprosy, some doubts and uncertainty remain in relation to the origin of others with epidemiologically important pathologies, such as syphilis.

[Mercury--a major agent in the history of medicine and alchemy]. / Kviksølv--et centralt stof i medicinens og alkymiens historie.

From ancient time the history of mercury has been connected with that of the medicine and chemistry. Mercury therefore contributes to the history of science throughout times. Knowledge of cinnabar (HgS) is traced back to ancient Assyria and Egypt, but also to China. The Greek philosophers were the initiators of theoretical science. The idea of the four elements, earth, air, water and fire, was introduced mainly by Empedocles and Aristotle in the 5th and 4th century BC. The theory encouraged the hope of transmuting metal to gold. The early development of practical alchemy is obscure, but some hints are given in the encyclopedia compiled by Zosimos about 300 A.D. in Alexandria. It also includes the invention of equipment such as stills, furnaces and heating baths. Medical treatment is described by Pliny and Celsus, e.g. the use of cinnabar in trachoma and venereal diseases. When the Arabs learned Greek alchemy by the Nestorians, they introduced or improved chemical equipments and new chemicals were obtained such as sublimate (HgCl2), different salts, acids, alkaline carbonates and metal oxides. The first recorded account of animal experimentation on the toxicity of mercury comes from Rhazes (al-Razi) in the 9th century and in the 11th century Avicenna (Ibn Sina) had the foresight to recommend the use of mercury only as an external remedy, and quicksilver ointments were used by the Arabs in the treating of skin diseases. In the medieval west scientific experiments were forbidden since the interpretation of the world order should not be changed. Greek and Arabic medicine and alchemy were therefore authoritative and the breakthrough in scientific inventions first appeared after the introduction of the Renaissance. The Renaissance medicine included ancient medicine as well as "modern medicine", based on iatrochemistry, and this chemical approach was introduced by Paracelsus. The medicine included sulphur and salts or oxides of for instance mercury, copper, iron, antimony, bismuth and lead. Most important was mercury when the outbreak of syphilis appeared in Europe at the end of the 15th century. The Arabian quicksilver ointment was remembered and used for the treatment of syphilis, but the treatment also included pills and ointments of sublimate and calomel (Hg2Cl2). The breakthrough in science was the discovery of oxygen by Priestley in the late 18th century. Priestley heated the oxide of mercury and examined the gas and thereafter Lavoisier recognized that combustion involves oxidation. All this led to a new understanding of respiration and furthermore established the basis of modern chemistry. The apothecaries of the 19th and 20th century showed many colourful mercurials as calomel, sublimate, cinnober, oxides of mercury and mercury. Calomel pills were used in acute and chronic diseases and furthermore as a diuretic drug before the organomercurials appeared in the 1920s. Skin diseases were treated with ointments or plasters of the mercurials or quicksilver. Antiseptics were introduced by Semmelweis hand-washing with chlorinated water before deliveries in obstetrics and by Lister's antiseptic ritual with carbolic acid during surgical operations. Also organomercurial "antiseptics" were used but unfortunately these agents were bacteriostatic rather than bacteriocidal and allergic contact dermatitis has been observed. Today the problems are solved by sterilization and aseptic conditions. Penicillin appeared in the 1940s and chlorothiazide in 1957 and new effective agents have taken over in the treatment of diseases with mercurials.

["Galli vocant istvm morbvm morbvm eius cvivs est.": another designation for the French disease]. / "Galli vocant istvm morbvm morbvm eius cvivs est.": otra designación para el "mal francés."

Berengario da Carpi, in "Anatomiam Mundini Commentarius" (1521) writes "morbus eius cuius est" as equivalent of "Morbus Gallicus." We aim to understand this expression in its morphology as well as in the way the medical profession considered this illness at his time.

Demons, nature, or God? Witchcraft accusations and the French disease in early modern Venice.

In early modern Venice, establishing the cause of a disease was critical to determining the appropriate cure: natural remedies for natural illnesses, spiritual solutions for supernatural or demonic ones. One common ailment was the French disease (syphilis), widely distributed throughout Venice's neighborhoods and social hierarchy, and evenly distributed between men and women. The disease was widely regarded as curable by the mid-sixteenth century, and cases that did not respond to natural remedies presented problems of interpretation to physicians and laypeople. Witchcraft was one possible explanation; using expert testimony from physicians, however, the Holy Office ruled out witchcraft as a cause of incurable cases and reinforced perceptions that the disease was of natural origin. Incurable cases were explained as the result of immoral behavior, thereby reinforcing the associated stigma. This article uses archival material from Venice's Inquisition records from 1580 to 1650, as well as mortality data.

[A comparative study of the emergence of the AIDS and syphilis pandemics]. / Etude comparée sur l'origine et l'émergence de la syphilis et du sida.

A historical and comparative study of the origins and emergence of syphilis and AIDS show that both result from human intrusions. Treponema probably existed in primates before human infection, and nonvenereal treponemal infection existed in prehistoric tropical Africa. When humans began wearing clothes, the disappearance of endemic infection ended immunity and led to receptivity to venereal infection. It was long thought that syphilis was first introduced in Europe by the conquistadors, but lesions typical of treponematosis dating from before the Common Era have been found in Europe. It is possible that the first navigators transferred treponemal infections to Latin America. AIDS seems to have appeared throughout the Congo River basin around 1950, and genetic studies attest to its long history in primates. It may have resulted from the Bantu migration and its strong human intrusion into the forest. After the initial human infection, new epidemiological factors in a transformed environment and behavioral changes led at 500-year intervals (1480-1490 for syphilis and 1940-1950 for AIDS) to the widespread emergence and subsequent pandemic of each disease.

La treponematosis precolombina en Cuba / Pre-Columbian treponematosis in Cuba

Se realiza una revisión de la infección por treponema pallidum, agente de la sífilis, en aborígenes cubanos con una discusión sobre su existencia en la Isla en una etapa presumiblemente anterior al 3 000 ANE, habida cuenta la antigüedad de los restos datados y los contextos culturales a que estos están asociados. Se presume que la entidad se presentó en su variante endémica y no bajo las formas venéreo o congénitas. Las poblaciones más atacadas fueron las del período mesolítico cubano, sin que existan reportes dentro del material estudiado que alcancen a los sujetos ubicados dentro del neolítico del occidente del país, detalle que contrasta con los hallazgos de Luna Calderón en La Española. Se analizan además, las posibles vías de migración de la entidad patológica a Cuba, excluyendo la ruta norte-sur, toda vez que las dataciones de restos con evidencias de treponematosis aborigen americana no alcanzan datas remotas como las observadas en Cuba. En su lugar se plantea la ruta sur-norte desde el continente a la Isla , sin cruzar, en esta etapa, por el arco de las Antillas. En este estudio se presentan las características de las secuelas óseas y sus elementos diferenciales con otras noxas infecciosas en aborígenes(AU)

Estratégias anticoloniais: sífilis, raça e identidade nacional no Brasil do entre-guerras / Anti-colonial strategies: syphilis, race and national identity in interwar Brazil

Procura contribuir para o estudo da `engenharia` simbólica por meio da qual cientistas identificados a grupos sociais estigmatizados ou a naçöes periféricas reagiram às teorias científicas que os estigmatizavam ou inferiorizavam. Analisa a construçäo histórica do Brasil através da sífilis, do sexo, da raça e vice-versa. Em outras palavras, o trabalho é sobre sífilis, sexualidade, raça `e` o Brasil ou a brasilidade.(AU)