(Updated 8 February 06)
Syphilis is caused by a bacterium (a “spirochete”) called Treponema pallidum
Three lectures on Syphilis
- The Columbian Exchange
- Syphilis as a precursor for HIV/AIDS
- The Tuskeegee Study
The Columbian Exchange
- Diseases
- Syphilis, (controversial)
- Smallpox, measles, etc. (certain)
- Ecological and Sociological
- potatoes and Maize
- horses
The New World in 1490
- Was it “new?”
- human settlement ca. 30,000 BC
- Isolation from Old World since about 10,000 years ago
- General lack of large animals (died out in ice ages)
- dinosaurs dies out much earlier, ca. 60,000,000 yrs. ago
- All useful domesticatable animals died out between 40,000 and 10,000 years ago
- horses, camels, mammoths, mastodons, giant sloths, saber-toothed tigers, woolly rhino, etc.
- result, no plow animals
“Conquistador y Pestilencia”
A plague of conquerors and a plague of their diseases.
Smallpox: a viral disease
- Endemic smallpox has mortality of about 3-10%
- Epidemic smallpox is about 30% fatal for naive populations
- e.g. Iceland in 1707, 18,000 deaths out of a total population of 50,000
Transatlantic crossing of Smallpox
- normal cycle time of about 1 month
- crossings by sailing ship take longer
- must require a reinfection on shipboard
- but most Europeans were immune.
- still curious how it made it
- reached Santo Domingo by 1519
Santo Domingo 1519
- about 1/3 to 1/2 of the native population died
- no Spaniard died
- a few got sick
- probably a mixed epidemic of smallpox and measles (another viral disease)
- then on to Puerto Rico, Antilles, and Mexico
Cortez and Montezuma
- Cortez invades Mexico
- small force
- Marches on Aztec capital
- Trounced by Aztec army
- Aztecs fail to follow up
- Cortez gets allies from Aztec enemies
- Defeats a greatly weakened Aztec army
What happened?
- Some religious iconography suggests that Cortez is “of the gods”
- Smallpox breaks out in the Aztec camp (not the Spanish) and decimates the army and kills the chief (Montezuma)
- Power struggle and culture shock ensues
- No organized resistance to Cortez
Effects of Introduction into Mexico
- estimates say that population of central Mexico fell from 25 million to 17 million in a decade
- had reached the Incan empire in Peru by the mid to late 1520’s
- Note: the epidemic PRE-dated the conquest of the Incans by Pizzaro — cause and effect?
The Crisis of Incan Succession
- Huayna Capac (great Incan emperor) dies of smallpox
- so do many others in royal family
- also many in bureaucracy
- He had named his son Ninan Cuyoche as heir
- Priests said Ninan’s omens were “unfavorable”
The crisis worsens
- Nobles risk everything and find another candidate
- alas he died of smallpox before he could be crowned
- Nobles returned to Ninan Cuyoche after all
- alas he too died of smallpox before coronation
- Two other sons began a great civil war of succession that divided the empire
Conquest of the Incas by Pizzaro
- Pedro Pizzaro arrived after the civil war weakened the empire
- First came the death followed by horrid disfigurement unknown in the Americas
- Then came the Spaniards
- horses, steel swords, guns, and immunity to Smallpox
- No choice but to surrender
- But more complicated than that!
Aztec and Incan Plagues
- Effect of plague on Aztecs was decisive because it arrived WITH the Spaniards
- Less of an effect on the Incans because it arrived BEFORE the Spaniards
- In both (and all other) cases, cultural dislocation led to surrender of power and culture (religion) to the Spaniard influence
Effects on North America
- Central and South America well documented
- priests
- tax collectors
- military outposts
- slavery
- Effects on North America only now becoming known
What about New England?
- Verrazzano (1532) Sailed North from NC to RI
- Dense population, smoke from cooking fires even 100 miles away!
- Remarkably healthy race!
- By 1600, a lively British trade (200 English ships alone!) with densely populated coast.
Plagues and Peoples
- By 1616, both sides has taken hostages
- One group of French sailors threatened “God’s wrath”
- A plague broke out (hepatitis A?) that raged for 3 years and probably killed 90% of the population of Northern New England!
- A smallpox epidemic in 1637 decimated Southern New England
Estimates
- Range from 1/3 of the population to 90% or more of the population destroyed.
- Clear change in culture
- May be less because few large cities
- is that true?
- DeSoto (tour of FL, AL, and GA) described large city
- not there 70 years later
DeSoto’s March
- Landed near modern Tampa
- Marched through Fl, GA, NC, SC, TN, AL, MS, AK, TX, and LA.
- He was a slaver
- Died along the way, but left a trail of disease and death behind.
Along the Mississippi
- DeSoto (1540s)saw many great cities, with moats and walls. The region was thick with population
- LaSalle (1680s) found it almost deserted
- Probable cause, disease carried by spanish pigs!
- Caddoan populaton (Texas) fell from ca. 200,000 to about 8,500 in that time. 100 years later, it was ca. 1,400
The Columbian Exchange
- Diseases
- Syphilis (controversial)
- Smallpox, measles, etc. (certain)
- Ecological and Sociological
- potatoes and Maize
- horses
Syphilis: Was it part of the exchange? I will take the position “yes”
“The Bones”
- First appear in Europe ca. 1493
- no prior record of such symptoms
- not even in Greece, China, India, Japan
- no prior record of such symptoms
- No evidence of bone lesions (characteristic of one form of syphilis) before 1493
- But there is evidence in the Americas from much earlier
“Eyewitness”evidence
- Columbus’ son’s book
- report of Fra Ramon (supposedly from ca. 1495)
- Great Arawak Indian hero “had pleasure” with many women, but then needed many bathhouses to scrub himself clean of “French Disease”
- Myths change slowly
- Unlikely something newly invented
- Great Arawak Indian hero “had pleasure” with many women, but then needed many bathhouses to scrub himself clean of “French Disease”
A Historians’ evidence: LasCasas
- Talked to sailors whose relatives were on the ships
- Asked the Natives in the New World
- they said it was as old as beyond memory
- it was milder in the natives than in the Spaniards
- suggests it was established already
A second historian: Oveido
- in Spanish court in 1490’s and knew Columbus before the voyages
- went to New World in 1513
- Called it “the Disease of the Indies”
a third “historian — Diaz de Isla
- (writing in 1539)
- Claims he treated Columbus’ crew for syphilis
- He was the greatest syphilographer of his time
- was he telling the truth or blowing his own horn?
Evidence against Columbian Origin of Syphilis
- Similarity of syphilis and yaws
- both from spirochetes (Treponema pallidum)
- could just be a venereal form
- central heating and insulation were making Yaws hard to spread and it may have needed a new way
- Poor discrimination of diseases
- was it formerly part of leprosy?
- Syphilis then differs from syphilis now
Summary
- New World origin of syphilis
- the bones
- the contemporary witnesses
- the lack of descriptions in the orient
- Old World origin
- too much difference between then and now
- absence of evidence not evidence of absence
Epidemiology of syphilis
- Slow spread from 1493
- In 1494-5 Charles VIII of France invaded Italy and France
- Both Italy and France had epidemics by 1495-6
- Reached Germany by 1495 (also Switzerland)
- Greece, Holland, and England by 1496
- N. Africa and Middle East by 1498
- Russia and Hungary 1499
- India by 1498
- Canton (china) by 1505 (probably via Portuguese Sailors)
- In early times, no shame associated, so many blunt, detailed records
The changing Face of Syphilis
- 1494-1516
- first small genital ulcers
- then bad rash
- then spread through body (esp. mouth)
- large gummy tumors, agonizing muscle pain
- then deterioration and death (common)
- 1516-1526
- bone inflammation and degeneration
- sometimes hard genital warts or corns
- 1526-1540
- general decrease in symptoms and sequellae
- 1540-1560
- decrease in the more spectacular symptoms
- Gonorrhea symptoms become dominant
- 1560-1610
- continued decline in symptoms
- add “noise in the ears”
- this is the modern form we know today
Old Treatment for syphilis
- Mercury (“Unguentum Saracenum”)
- effective against “scabies” — which also makes sores, so why not try here
- the slobbering resulting from mercury poisoning also fit “humoral theory” — purge the phlegm
- it actually worked!
- Gaiacum wood (probably did nothing)
Modern Syphilis
- Three stages
- Primary: usually a simple genital ulcer
- Secondary: rash, fever, swollen glands, general malaise. Sometimes so mild it is unnoticed.
- Latent period — can last for many years. Bacteria are growing within body tissues
- Tertiary: bacteria multiply in various tissues
- effects depend on where they grow best
- took a long time before it was clear that all the diseases were actually syphilis (cf. TB)
- originally thought to have different spectrum of symptoms based on race
Modern Treatments
- Mercury rubs (with bismuth to counteract Mercury poisoning)
- Dr. Erlich’s Magic Bullet Salvorsan
- and Arsenic derivative
- not a cure, but could arrest the disease
- made a person non-infectious
- Penicillin