Table Of ContentSyphilis
A Short Biography
Andrew P. Zbar
Syphilis
Andrew P. Zbar
Syphilis
A Short Biography
123
AndrewP. Zbar
University of Melbourne
Melbourne, VIC,Australia
ISBN978-3-031-08967-1 ISBN978-3-031-08968-8 (eBook)
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To the spirit of Paul Ehrlich (1854–1915)
who towered above others through his
industry, the fertility of his mind and in how
he conducted himself against prejudice.
Foreword
Andrew Zbar opens his treatise with a question: Why write a book about syphilis?
Initially,Ithoughtthiswasmerelyrhetorical,togetthenarrativerolling.Butas
the story of syphilis unfolds I realized this is a genuine enquiry, directed towards
himself, and asked on behalf of the reader. The book itself becomes the answer.
Andyetitismorethanabook;theauthorhaselevatedthesubjecttobeworthy
of a ‘biography’, which, on the face of it, is a huge anthropomorphic leap for a
bacterium, let alone a disease. Biographies are often written about great men and
women, however, a quick scan of any reputable bookshop shelf will reveal that
many, perhaps most, of the subjects of biographies are nowhere near as famous as
syphilis. There are other biographies that hone in on the darker side of humanity
and have as their subject true monsters—again syphilis is not out of place here.
This is a ‘short’ biography and cannot rival, in girth at least, those Winston
Churchill door-stoppers that thump onto desks every couple of years. But it is a
thoroughandincisiveexposéofatrulyremarkablelife-formthathasinfluencedand
even devastated the lives of any number of people who wind up the subject of a
publishedbiography.Syphilismaynotbeaperson,butitisanintimatecompanion
ofhumanity,inmanywaysunchanging,yetcapriciousenoughtofightbackwhenit
seems not far from being silenced. While, personally, we would not choose the
intimate company of the subject of this biography, we can enjoy vicariously many
happy hours amongst these pages.
Zbarstartswiththeoriginsofthediseasethathasalonghistoryofcontroversy.
He deftly avoids getting bogged down with the ‘who brought it back from where,
and then gave it to whom’ argument. Huge volumes of toner have been consumed
arguingabouttheancientEuropean(orevenolder,African)originofthediseaseas
an alternative to the often-quoted arrival of syphilis from the Americas more than
five centuries ago. Instead we first join the author on this journey in the company
of the well-connected Girolamo Fracastoro. It was this Italian poet/physician who
vii
viii Foreword
put the disease on the map, both metaphorically and literally, (achieving the latter
by placing the blame at the feet of the French in the timeless xenophobic way we
like naming diseases—the morbus Gallicus).
Next,weareinvitedtoseethemanyguisesofsyphilisthroughahistoricalprism
usingmagnificentdescriptionsfromthepast.Theillustrationsarecarefullyselected
butitisthewrittenrecordthatbringsthediseasetolife.Syphilis,asthedescriptions
attest, is truly versatile, ‘malignant, occult and insidious’. With every scientific
discoveryof medical importance, there isoften great hopeand ambitiousplans for
disease eradication. Syphilis has had its share of pharmaceutical over-reachers,
where a little knowledge quickly turns into arrogant bravado. And after hubris,
failure often follows at great cost to reputations, but much more important to the
poorpatientswhohavefollowedtheseleadersdownaroadofquackeryoftenoutof
desperation and blind hope. But in the middle of the last century, there arrived a
great white powder to usher in the antibiotic era, and luckily for us penicillin
remains the first choice of treatment for many serious illnesses including syphilis.
In the fifth chapter, we are shown the impact of syphilis on the arts both at a
personal and cultural level. In the recording of stories about infectious diseases
throughtheages,theword‘romance’hasoftenbeenhitchedtotuberculosis,though
giventhemodeoftransmissiononemightthinkthatsyphilisisabetterfit.Intruth,I
thinkweshouldleavethe‘R’wordwellawayfrombothofthem.Andyetsyphilis
has inspired a tremendous wealth of writing, from literature to satirical scorn, and
portraiture, from epic canvasses to humorously vulgar cartoons making for a great
and terrible record of a dreadful scourge.
Finally, there is, what will for many be the most important biographical details
ofthedisease—thepoliticsofsyphilis.Thereisapowerfulnaturalforcethatdraws
infectious diseases physicians, microbiologists and epidemiologists to calamitous
infectionsespeciallyiftheycauselargeoutbreaksofgreatmorbidity.Itcanappear,
totheunbiasedobserver,atleastabituncaring,however,overwhelminglythestudy
of infectious diseases is undertaken with best intentions and by good people. But
Tuskegee is now synonymous with one of the most heinous cases of medical
malfeasanceinhistoryandnowhasapermanentplaceinmedicalethicspedagogy,
toremind us,emphatically,whatnottodo.Itwasaterribleironythatthosewhom
thefoundersofthatInstitutesetouttobestserve,werethemostbesetvictimsofthis
wrongdoing. The story has been often told but in this chapter the misadventure is
clearlylaidbare underfourappositeheadingscalledthe‘Medical’,the‘Folkloric’,
the ‘Factual’ and the ‘Racial Tuskegee’. Throughout the author takes a cool
historian-scientistapproach; butwe can sense (andwe share) his patent disgust.
Foreword ix
Sowheredoesthisbookgointhelibrary?History?Science?Medicine?Itactually
doesn’treallymatter,what’simportantisthatthequestionthatopenedproceedings
hasbeenanswered:Whywriteabookaboutsyphilis?Becauseitisfascinating.
(…and by the way, it goes in the Biography section.)
Adam Jenney, M.B.B.S., Ph.D., F.R.A.C.P., F.R.C.P.A.
Head, Microbiology Unit
The Alfred Hospital
Monash University
Melbourne, Australia
Preface
Why write a book about Syphilis?
Ifwearetoexamineanyinfectiousdisease,thematerialaspectsofitsidentification,
its growth in culture, the clinical manifestations, its fastidious microbiological
needs and habits and its treatment, are the domain of the scientist and the doctor.
That too today along with the molecular information of its genetic backbone that
has sequenced its unique genome. But the historical fingerprint of any disease like
Syphilis can be found in its communicability, something more defining that lies
outside the organism itself. Although it emerged in its most virulent form in the
Renaissance,itisperhapsmoreimpressionablyalignedwiththeVictorianera(like
another disease Tuberculosis) and it is through this association that it has become
inculcated into the romantic literature and with its veil of secrecy, transcended
social class.
This book is aimed at the presentation of more than the history of Syphilis as a
distinct bacterium. I have entitled it a biography in order to render it more of an
intimate account of its emergence and impact and to establish that connection
between the organism itself and the social responses it provoked. Both most
assuredly contribute to its definition. Chapter 1 examines the origins of European
Syphilis,stillsomewhatshroudedinmysteryandfirstlamentedinthepoetryofthe
Renaissance physician Girolamo Fracastoro (1478–1553). Chapter 2 considers the
protean manifestations of disease and focuses on bizarre neuropsychiatric expres-
sionsoflateSyphilis.Chapter3relatesthehistoryofthelaboratorydiagnosisofthe
disease and the quest for definitive anti-Syphilis therapy chronicling those who
hitched their medical wagon to the curative properties of mercury, a drug-metal
rooted in the era of alchemy and wizardry. Chapter 4 illustrates the impact of
Syphilisonliteratureandinthearts,detailingthequirkynotablehistoryofsomeof
its more renowned victims, both assured and presumptive. Chapter 5 deals with
thosewhoseprime interest inSyphiliswasacademicbutwhoseambitions clouded
theirgoalsleadingthemtobehaveinthemostunethicalmannerinordertoachieve
their aims.
xi
xii Preface
The Canadian physician Sir William Osler, (1849–1919) oneofthefoundersof
JohnsHopkinsHospitalinBaltimoreandoneofthemosthighlycitedofphysicians
hadoftbeenquotedassayingKnowsyphilisinallitsmanifestationsandrelations,
andallotherthingsclinicalwillbeaddeduntoyou.Thestatementisastruetoday
asiteverwas,justnotasrelevantinanagewheretheprevalenceofdiseaseisone
wherethereisadiminishinglawofreturns.1Syphilismaynothavekilledasmany
people as the ‘white plague’ Tuberculosis but for the French medical historian
Claude Quétel it has caused the blackest ink to flow.2 As a disease, many of its
representative specimens may now sit in museums calling to us with 500 years of
collective memory but still it endures.
Melbourne, Australia Andrew P. Zbar
1American,Canadian,EnglishandAustralasianmedicineholdsasoftspotforOslerparticularly
ashetookupapostafterBaltimoreastheRegiusChairofMedicineatOxfordandthenreceiveda
baronetcy.Oslerthroughhisaphorismsandpronouncementswas,onemightsuggestpreoccupied
with his importance and hisverbal legacy donating hispersonal library to McGill University in
MontrealontheprovisothattheydubittheBibliothecaOsleriana.Asafoundingmemberofthe
AmericanAnthropometricSocietythelastthingOslerdidwastowillhisbraintothegroup(now
heldattheWistarInstitutePhiladelphia)whereitresideswiththebrainsofthephysiciansWilliam
PepperandPhillipLeidy,thepalaeontologistsJosephLeidyandEdwardDrinkerCopeand(until
thebrainwasdroppedbyatechnician)thepoetWaltWhitman.
2ClaudeQuétel.TheHistoryofSyphilis.JohnsHopkinsUniversityPress.1990;p2.
