Metagenomic and paleopathological analyses of a historic documented collection explore ancient dental calculus as a diagnostic tool.

Dental calculus is a microbial biofilm that contains biomolecules from oral commensals and pathogens, including those potentially related to cause of death (CoD). To assess the utility of calculus as a diagnostically informative substrate, in conjunction with paleopathological analysis, calculus samples from 39 individuals in the Smithsonian Institution's Robert J. Terry Collection with CoDs of either syphilis or tuberculosis were assessed via shotgun metagenomic sequencing for the presence of Treponema pallidum subsp. pallidum and Mycobacterium tuberculosis complex (MTBC) DNA. Paleopathological analysis revealed that frequencies of skeletal lesions associated with these diseases were partially inconsistent with diagnostic criteria. Although recovery of T. p. pallidum DNA from individuals with a syphilis CoD was elusive, MTBC DNA was identified in at least one individual with a tuberculosis CoD. The authenticity of MTBC DNA was confirmed using targeted quantitative PCR assays, MTBC genome enrichment, and in silico bioinformatic analyses; however, the lineage of the MTBC strain present could not be determined. Overall, our study highlights the utility of dental calculus for molecular detection of tuberculosis in the archaeological record and underscores the effect of museum preparation techniques and extensive handling on pathogen DNA preservation in skeletal collections.

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.

Serología y lucha antivenérea en el Instituto de Transfusión Sanguínea de Valencia (1937-1938): María Hervás Moncho / Serology and venereal control at the Blood Transfusion Institute of Valencia (1937-1938): María Hervás Moncho

ABSTRACT: During the Spanish Civil War, military transfusion services appeared for the first time. In Barcelona and Valencia –two of the main strongholds of the Republican rear– blood transfusion institutes were set up during the struggle. The one in Valencia had, as an annex, a serology laboratory run by María Hervás Moncho (1894-1963). Hitherto unknown to historiography, this Valencian doctor had spent a long training period at the Pasteur Institute in Paris during the 1920s under the tutelage of the prestigious immunologist Alex-andre Besredka (1870-1940). The aim of this paper is to rescue the figure of María Hervás Moncho from historiographical oblivion, and to analyze her work as the leader of the laboratory of the Institute of Blood Transfusion in Valencia. Hervás was particularly interested in increasing the sensitivity of serological tests used in the diagnosis of syphilis in order to reduce the incidence of false negatives and, therefore, of possible post-transfusion infections. In order to achieve our purpose several archival, hemerographical and bibliographical sources, both manuscript and printed, have been consulted. These are enumerated in the introduction

RESUMEN: Durante la Guerra Civil Española aparecieron por primera vez los servicios militares de transfusión. En Barcelona y Valencia –dos de los principales bastiones de la retaguardia republicana– se habilitaron durante la contienda sendos institutos de transfusión sanguínea. El de Valencia disponía, anexo, de un laboratorio de serología dirigido por María Hervás Moncho (1894-1963). Desconocida por la historiografía, esta médica valenciana había realizado durante la década de 1920 una prolongada estancia de formación en el Ins-tituto Pasteur de París bajo la tutela del prestigioso inmunólogo Alexandre Besredka (1870-1940). El objetivo de este trabajo es rescatar del olvido historiográfico la figura de María Hervás Moncho, analizando su trabajo al frente del laboratorio del Instituto de TransfusiónSanguínea de Valencia. Hervás estaba especialmente interesada en aumentar la sensibilidad de las pruebas serológicas empleadas en el diagnóstico de la sífilis al objeto de disminuir la incidencia de falsos negativos y, por tanto, de eventuales contagios post-transfusio-nales. Para alcanzar los objetivos planteados se han consultado diversas fuentes archivísticas, hemerográficas y bibliográficas, tanto manuscritas como impresas, que se especifican en la introducción.

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.

Organización de los Servicios de Salud en Portugal a Principios del Siglo XX: el Caso de la Sífilis / Organization of the Health Services in Portugal in the Beginning of the 20th Century: The Syphilis’s Case

La lucha contra las enfermedades venéreas como la sífilis se viene dando desde el siglo XVI, desarrollándose significativamente en el siglo XIX, especialmente tras el armisticio de 1918. El gran impacto social sobre todo debido a las malformaciones que causaba la sífilis congénita, poco tiempo después de terminar la primera guerra mundial fue creada la Unión Internacional Contra el Peligro Venéreo [Fragmento de texto] (AU)

Preparados curativos aplicados por sanitarios al sifilítico: un recorrido histórico (s. XVI-XXI) / Preparations applied by nurses to syphilitics from 1500 to the present day

La sífilis enfermedad infecciosa, cuyo agente causal es la bacteria Treponema Pallidum, presenta una evolución tórpida, con períodos de exacerbación y latencia, siendo su transmisión por vía placentaria o contagio directo. La enfermedad posee varios estadios, denominándose el primero la sífilis primaria o primitiva, momento que comienza la infección con la aparición de un chancro, si el tratamiento es efectivo, en torno a 4-6 semanas el chancro cicatriza [Fragmento de texto] (AU)

THE HISTORY OF SYPHILIS IN THE XVI CENTURY AND THE PIVOTAL ROLE OF LUIGI LUIGINI IN THE RENAISSANCE / [LA STORIA DELLA SIFILIDE NEL XVI SEC. E IL RUOLO CENTRALE DI LUIGI LUIGINI NEL RINASCIMENTO]

Syphilis is the prime example of a "new disease" which triggered a transnational (European) discussion among physicians. It appeared between the end of the Middle Ages and the beginning of the Modern Times (at the beginning of the sixteenth century), a time in which medicine was changing from a dogmatic to an experimental discipline. The main changes were in the field of anatomy: in 1543, the same year of the astronomy-disrupting work by Nicolas Copernicus, the new less dogmatic and more empirical approach to anatomy by Andreas Vesalius was published. Nevertheless, in the Renaissance, medicine remains a tradition-bound discipline, proud of its millennial history and its superiority over the empirical, non-academic healers. When syphilis appeared in Europe, several explanations were elaborated. In the mid-16th century, an Italian doctor Luigi Luigini (born in 1526) published in Venice a collection of all the works on syphilis that appeared until 1566. He wanted to entrust to colleagues, contemporary and future, a compendium of all that was known about the "new" disease (the Latin term Novus means both "new" and "strange"). According to the most authors of the collection, the disease is in fact "new" and "strange". Some authors of the collection find it impossible that authorities like Hippocrates and Galen overlooked it. Luigini's work shows the authors' effort to absorb syphilis in the corpus of academic medicine and affirm the authority of academic physicians against the empirical healers.

Aldred Scott Warthin: Ann Arbor's Erudite, Outspoken, and Academically Transformative Early 20th Century Pathologist.

CONTEXT.­: Aldred Scott Warthin, MD, PhD, was professor of pathology and director of the pathological laboratory at the University of Michigan during the first third of the 20th century. OBJECTIVE.­: To explore the life and accomplishments of Dr. Warthin and his impact on academic anatomic and clinical pathology. DESIGN.­: Available primary and secondary historic sources were reviewed. RESULTS.­: After studying music, biology, and botany, Warthin attended medical school at the University of Michigan, graduating in 1891; he remained in Ann Arbor for 40 years, almost single-handedly transforming a rundown department into a top academic department. He was a dedicated teacher who produced 2 important pathology textbooks. His research interests were diverse. In 1913, he published one of the first papers unambiguously documenting heritability of cancers; subsequent research on one of his cancer families resulted in the description of Lynch Syndrome. He published extensively in the fields of surgical pathology and experimental pathology. He was a recognized expert on syphilis and pathology of aging. CONCLUSIONS.­: Warthin's name is eponymously associated with Warthin-Finkeldey giant cells in measles, Warthin's tumor of the parotid, and Warthin-Starry stain for the diagnosis of syphilis as well as Warthin's sign in the clinical diagnosis of pericarditis.

80th Anniversary of the Publication of Endemic Syphilis in Bosnia: Survey by the School of Public Health in Zagreb.

Certain regions of Bosnia and Herzegovina were prominent European sites of endemic syphilis. In 1934 and 1935 the School of Public Health in Zagreb, later the Andrija Stampar School of Public Health, conducted two surveys on endemic syphilis in Bosnia and Herzegovina. The surveys were well-described in the monograph published in 1939 by the School, under the title Endemic Syphilis in Bosnia: Survey by the School of Public Health in Zagreb ("Endemski sifilis u Bosni anketa Skole narodnog zdravlja u Zagrebu"). This paper provides a description of the publication for the first time, presents the most important data from it, and explores its significance from the historical perspective.

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.

Ancient Bacterial Genomes Reveal a High Diversity of Treponema pallidum Strains in Early Modern Europe.

Syphilis is a globally re-emerging disease, which has marked European history with a devastating epidemic at the end of the 15th century. Together with non-venereal treponemal diseases, like bejel and yaws, which are found today in subtropical and tropical regions, it currently poses a substantial health threat worldwide. The origins and spread of treponemal diseases remain unresolved, including syphilis' potential introduction into Europe from the Americas. Here, we present the first genetic data from archaeological human remains reflecting a high diversity of Treponema pallidum in early modern Europe. Our study demonstrates that a variety of strains related to both venereal syphilis and yaws-causing T. pallidum subspecies were already present in Northern Europe in the early modern period. We also discovered a previously unknown T. pallidum lineage recovered as a sister group to yaws- and bejel-causing lineages. These findings imply a more complex pattern of geographical distribution and etiology of early treponemal epidemics than previously understood.

The Reemergence of Syphilis: Clinical Pearls for Consideration.

Despite the near-eradication of syphilis in the United States in the late 1990s, new infections have surged over the past 20 years. Dubbed, "the great imitator," syphilis infections often can be misdiagnosed and resultantly untreated. This leads to people inadvertently infecting others. This article reviews the history of syphilis, including the unethical studies undertaken in the past; current epidemiology; treatment guidelines; and strategies to reduce new infections.

Sick skin. The history of the dermatological representations in Olavide Museum

This article presents a review of the history of dermatology through the visual teaching aids employed, including both two-dimensional illustrations in texts such as the dermatological atlases, and three-dimensional representations through moulages. We will examine the Olavide Museum and its contextualisation within 19th century dermatology, concluding with an analysis of a pathology within the institution’s systems of representation. The guiding thread throughout this study will be the emotion of disgust in relation to disease. We aim to show how disgust does not invariably respond to an atavistic mechanism but rather can be influenced by our knowledge, our methods of observation and our ability to "transform" reality

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