This is the start of an occasional series on Palaeopathology
(the study of ancient diseases) which I enjoyed studying as an undergraduate. I
expect a large amount of sympathy for the many grotesque images I have had to
endure in the quest for knowledge, especially considering the nature of Part One-
an Introduction to Venereal Syphilis.
Venereal Syphilis is an infectious disease that is a member
of a group of disorders called Treponemetoses, caused by the bacterium, Treponema pallidum subspecies pallidum. The infection occurs in three
stages: the primary stage where a painless lesion occurs at the entry site of
infection, the secondary stage as a skin rash develops (along with mucous
membrane lesions) and finally the tertiary stage, marked by the infection spreading
to the organs in the Central Nervous System, as well as the heart and skeleton.
In 20-30% of cases tertiary symptoms can manifest 5-20 years after the original
infection. Without our good friend the humble antibiotic, the numbers of cases reaching
this stage in history were immense. Luckily for Palaeopathologists, the fact
that symptoms can be found on the skeleton allows for the analysis of historical
diseases including disease history, geographical spread and the ability to
predict similar infection courses in the future.
The most frequent symptoms of Venereal Syphilis found on the
skeleton are bi-lateral lesions most commonly occurring on the tibia and skull (frontal,
parietal and nasal-palatial regions). If the infection advances to the Central
Nervous System then Neurosyphilis can occur. This infection of the brain and
spinal cord can cause many debilitating effects when living, such as headaches,
numbness in the extremities and seizures. In historical cases, indirect
evidence of this type of disorder can be found as a Charcot’s joint, which is
caused by repeated trauma occurring at the joints, due to a lack of pain
perception.
Analysis of the skeletal symptoms of Venereal Syphilis has
been used in attempts to deduce the mysterious emergence of the disease. The earliest known reports of Venereal
Syphilis came from Naples in 1495, when a ‘plague’ broke out among the
French King, Charles VIII’s troops. It is thought that when they later disbanded
the disease was spread throughout Europe. How and when Venereal Syphilis
arrived in Europe is a matter of great controversy with two opposing schools of
thought contesting a different historical background. The first believes that
there is an association with the timing of Christopher Columbus’ return voyage
to Europe from North America, with the bacteria transported aboard ships. The
other believes there is evidence for Venereal Syphilis being present in the Old
World before the voyage in 1493. The difficulty in evaluating the history of
the disease is that the remaining evidence of Syphilis found on the skeleton
can often be mistaken for other disorders (such as Tuberculosis) and there has
been recent controversy over non-peer reviewed research on supposed syphilitic
skeletal remains found in pre-1493 Europe, being represented in the media.
Recently, the Columbian hypothesis has been refined with the
belief that the Columbus voyage transported a Treponemal bacterium that was
nonvenereal, and which later adapted under new selective pressures in the Old
World to become Venereal Syphilis. While this theory is intriguing, a problem
arises due to the short time in which the bacterium would have had to adapt and
become sexually transmitted in this new environment (especially if the first
known case was in Naples, 1495). Phylogenetic studies on treponemal disease may
be the next step in illuminating the history of this interesting disease, going
beyond the limitation of osteological observation.
This is just a brief overview of a few of the skeletal
symptoms and the controversial emergence of one of the most virulent diseases
in history. I encourage you to research further and increase your disgust, but
be warned- what has been seen on google images can never be unseen!
Further Reading:
Armelagos, G.J., Zuckerman, M.H. and Harper, K.N. (2012) The
science behind pre-Columbian evidence of syphilis in Europe: research by
documentary. Evolutionary Anthropology, 21(2),
pp.50-57.
Salazar, J.C., Hazlett, K.R. and Radolf, J.D. (2002) The
immune response to infection with Treponema
pallidum, the stealth pathogen. Microbes
and Infection, 4(11), pp. 1133-1140.
Sequeira, W. (1994) The neuropathic joint. Clinical and Experimental Rheumatology, 12(3),
pp. 325-337.
Credits: <a href="http://www.flickr.com/photos/26312642@N00/2524462429/">an untrained eye</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-nc/2.0/">cc</a>
<a href="http://www.flickr.com/photos/47353092@N00/392924423/">AJC1</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-nc/2.0/">cc</a>
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