For 20 years syphilis has been a nasty sexually transmitted disease we didn't have to worry about because condoms easily prevent its transmission. But with some men reverting to unsafe sex syphilis has returned to gay communities around the world. What is known about the history of this venerable venereal disease? American author Deborah Hayden recently compiled a list of great nineteenth and twentieth century syphilitics, subject to biographical and diagnostic debate. However, Hayden considers that this insidious bug probably originated on cockroaches before it spread to humans around 13,000 BCE. It ended up in Europe and the Americas. There is debate over the origins of syphilis, and one hypothesis notes that there were possible signs of skeletal pitting before Columbus returned from European discovery of the New World. (This hypothesis is referenced below.) Another hypothesis is related to a North American origin for the infection. According to some epidemiologists, Christopher Columbus' vessels were the vector of infection when they returned to Spain in 1493, after some of his sailors had sex with infected women on the Carribean island of Hispaniola. Several sailors returned to Italy, or served as mercenaries when Italy was convulsed by civil war, foreign invasion and typhoid in 1495. From there, it spread across France, Germany, Russia, China and Japan as mercenaries returned to their countries of origin and infected wives and sex workers en route. Syphilis itself is known as treponema pallidium, its a parasitic micro-organism discovered in 1905 when Fritz Schauddin viewed it under a microscope for the first time. In those days, untreated, it could provide long-term debilitating illness, or remain latent and asymptomatic after initial sores appeared and subsided. However, it could also become tertiary syphilis, which led to dementia, pain surges and cardiovascular weakness. Fortunately, the drugs salvarsan (1909) and penicillin (1943) proved able to treat the early onset of the disease, which diminished in importance as it became treatable. There is one horrific incident related to untreated syphilis that should be recounted. In the United States, several medical practitioners in Alabama treated Macon County African-American men with a placebo, leading to multiple deaths from untreated tertiary syphilis. Understandably, the African-American community was outraged at the breach of medical ethics and informed consent, which had been allowed to continue for thirty years before it was exposed and Presidnt Bill Clinton isssued a formal public apology. Deborah Hayden chronicles many famous syphilitics, primarily from the nineteenth and twentieth centuries. Most contracted syphilis from unprotected heterosexual sex, even Abraham Lincoln, Oscar Wilde and Friedrich Nietzsche, who were exposed during their early lives. None of the aforementioned, or any of the other historical subjects, caught it from gay sex. If I have qualms about Hayden's work, it is related to the ease with which she argues that sex workers acted as the vector of syphilitic infection in the case of her (predominantly) male subjects, as Mary Todd Lincoln, Constance Wilde and Karen Blixen are the only possible female vectors cited. I have some difficulty with this assumption. Granted, nineteenth-century sex workers didn't have the advantage of collective self-organisation and occupational awareness that accompanied the rise of modern sex workers rights movements during the HIV/AIDS epidemic of the late twentieth century. However, Hayden fails to note that criminal penalties for sex work might have discouraged sex workers from medical consultation and sabotaged any pro-health occupational cultures within their social networks. We simply don't know that this was the case, without medical histories of collective sex worker organisation. Did all medical practitioners buy into stigmatising stereotypes about sex workers as alleged reservoirs of disease, for that matter? This deserves further historical analysis. In the case of Oscar Wilde, he may have eventually died from tertiary syphilis, contracted while he was an Oxford student in his twenties. Hayden argues that his "Portrait of Dorian Grey" might have been a self-portrait of his own awareness of the encroachment of syphilis in his life. However, not all of the alleged 'great syphilitics' were philosophical, arts or letters celebrities. Hitler may have had tertiary syphilis as well. If so, it was poetic justice, given the enormity of his evil. I felt distinctly queasy when Hayden discussed a remote possibility that a "Jewish prostitute" might have infected him. Hayden might care to read Sander Gilman's excellent historical observations of anti-Semitic stereotypes about Jews as vectors of disease before she makes any other such statements. In any case, biographical opinion is divided over whether Hitler had tertiary syphilis at the end of his life. His behaviour fits its symptomology, however. Hayden's book is a sobering reflection of what this familiar but forgotten malady can do to those infected. While all of her subjects became infected through heterosexual sex, her list of possible victims is a depressing list of cultural greats. Beethoven, Schubert, Baudelaire, Flaubert, Maupassant, Van Gogh and James Joyce are listed amongst its casualties. If that lends romantic tragedy to their plight, then it should not. Consider their suffering, illness and ends and what else they might have achieved had they lived longer. Recommended Reading: Deborah Hayden: Pox: Genius, Madness and the Mysteries of Syphilis: Basic Books: New York: 2003. See also Hayden's website, related to her book: http://www.poxhistory.com Educational Broadcasting Corporation, (2002). Secrets of the dead: The syphilis enigma. http://www.pbs.org/wnet/secrets/case_syphilis/ WebSand, (2002). The History of Syphilis and its treatment. http://www.allsands.com/Health/Advice/syphilishisto_zkq_gn.htm Craig Young - 2nd February 2005