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In the late 15th century, doctors had believed that syphilis was contracted because god wanted them to have syphilis. Some people made the connection that it came from the genital (Syphilis: Origin, 2019)

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From whence came the poxiest of poxes? Averill and Marissa dive into the debates surrounding the origin of syphilis, with historians, paleobiologists, forensic anthropologists, and Shakespeare all weighing in.
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Transcript for Syphilis: Origin Story. Or, Early Modern Europeans Don't Know Where It Came From, Current Scholars Don't Know Where It Came From, and a Lot of Poxy Penises and Vulvas Suffered in Between

By Averill Earls

Averill: We want to give a big THANK YOU to all of our patreon supporters, but especially our "Auger" and "Excavator" level patrons. Colin, Eric, Peggy and Lauren - yall rock, and your good faith and donations help keep this podcast going. Listener, if you are not yet a patron, you can go to patreon.com/digpodcast to learn more.

Marissa: Fair warning: the history of the body requires a relative level of explicitness. Today's episode is about syphilis. Syphilis is an STD, and it has some pretty gruesome effects, so you may want to listen to this one where little or prudish ears cannot overhear. In other words: this episode is "NSFW."

Averill: Unless your workplace is a hospital, in which case, this is probably all par for the course.

Averill: In 1496, Joseph Grunpeck, private secretary to the Holy Roman Emperor Maximilian I, was one of the first to write about a seemingly new disease that was ravaging the bodies of Europeans. "The Roman tongue calls it the French Evil... That which comes from France is called Scorra from the word Scor...which is much talked about as impure, pimply, or stinking. It could be called Thimius when the warts break open and the blood comes out of them, but when the warts are dry, it could be called Condiloma...As I think upon the great misery, sorrow, fear, and need which we feel daily, with which the Almighty Eternal God (even I admit it) punishes us every hour and every moment, I cannot hold back the tears. I find in the old histories and stories great plagues and punishments, which were laid upon the human race to account of their sins-great pestilences, shedding of blood, and famines; but they are indeed not to be compared with that which fills the present time, in which we are now living." The French Evil, the French disease, the great pox - what scholars today have identified as the conceptual precursor to syphilis - seemed to Europeans like Grunpeck to come out of nowhere. Already in 1496, just two years after the first documented epidemic of the disease in Europe, Grunpeck was so horrified by the disease that he wrote an entire treatise on the subject. He'd return to it seven years later. If the disease acted then the way it does now, it is likely Grunpeck in 1503 would have seen an even darker side to the great pox when he wrote: "Some are covered from the head to the knee with a rough scabies dotted with black and hideous lumps, which spares no part of the face (except the eyes), the neck, the chest, or the pubis. They had become so filthy and repugnant that... they hoped to die... others, by contrast, moaned and wept and uttered heartrending cries because of the ulceration of their male organs." Early modern Europeans hardly knew what to make of the French disease when it reached epidemic proportions at the end of the 15th century; five hundred years later, scholars are just as baffled by the emergence of the disease in Europe at that precise historical moment. Today we're digging into the origins and earliest discussions of syphilis, to find its historical debut and significance in the minds and ravaged genitals of early modern Europeans.

I'm Averill Earls

And I'm Marissa Rhodes

And we are your historians for this episode of Dig!

Averill: Before we begin, I do want to say that there is a ton written on the history of syphilis. Medical doctors, paleopathologists, historians, paleobiologists, forensic anthropologists, comp literature...ists - just about every field I can think of that looks at the past in some way has its own angle on the syphilis discussion. I did my best to read a decent sampling from each of these, but there was no way I could even dent the field in its entirety in my lifetime... let alone in the month or so I had to prepare this episode. It's actually a fascinating topic, and I tried to give this episode a decent blend of the medical/biological and socio-cultural historical.

Marissa: From the historians point of view, the key issue at stake is not necessarily when the disease first plagued humankind, but how people remembered it, dealt with it, experienced it, etcetera, in specific moments and in the long duree of the disease. Kevin Siena, editor of Sins of the Flesh, which includes essays covering just about every angle of thought about syphilis as a historical construct, points out pretty poignantly that syphilis was not "syphilis" as we know it until fairly recently. When it first emerged as an epidemic in Europe, right around the end of the 15th century, it was not distinguished from other sexually transmitted diseases. It, and diseases like gonorrhea, were rolled into one, and known simply as "THE venereal disease," until the 18th century, when physicians like William Cullen began differentiating it from the "lesser" venereal diseases. This complicates how we can and should think about syphilis as a historically contingent disease. The "French pox," then, was not always or only the symptoms created by the bacteria that we've since identified as causing syphilis.

Bartholomaus Steber, syphilis treatment, Vienna, 1498 | Public Domain / Wikimedia Commons

Averill: This point will be important to remember when we get deeper into the GREAT ORIGIN DEBATES.

Marissa: The origin debates involve scholars from all those aforementioned disciplines and probably more. Historians have, of course, had something to say about origins, even if they're not relying on carbon dated bones as evidence. The emphasis that scholars have placed on the "first" documented outbreak of syphilis during the Italian Wars of 1494-6, and the intentional connection of that event with Columbus's return from the Americas, is just one way that our discipline has been involved in the conversation. But there are also historians who are hesitant to even engage with the "origin" debate, insisting that our role in writing the history of syphilis is to query how people treated it, how they thought about it, how they talked about it, and their socio-medico-legal responses to it, rather than trying to put a finger on patient zero.

Averill: There are some interesting parallels to the history of HIV/AIDS in the 1980s and beyond which we don't have time to get into here, but which others, like Richard Davenport-Hines and Claude Quetel, have written on extensively, and which we encourage you to look into. Maybe/hopefully that's a topic we can come back to in another episode in the future.

Marissa: Most agree that the conversation of origin is interesting - was it the revenge of the colonized indigenous peoples of the Americas? Was it always present in Eurasia, but only distinguished from similar diseases starting in the 15th century? Or was it something entirely new, the result of peoples who'd not been in contact for hundreds, thousands of years, finally converging in the "Columbian exchange"? - but while interesting, these are not the core issues that historians tend to focus on when studying syphilis.

Averill: For the most part, it's been the hard-science centered disciplines that have taken up those queries. The history of the debate is fascinating in and of itself. For decades after Europeans started documenting and studying syphilis, they blamed each other for its emergence, they blamed women and indigenous peoples of the Americas for its spread, and they moralized the disease itself from the first genital wart to the last breath of the decayed syphilitic body. Conversely, in a postcolonial world, an origin story which has the Europeans bringing syphilis to the Americas along with every other devastating epidemic ends up being par for the course in the shit show of imperialism. So there are and always have been serious implications for "discovering" the origins of this disease.

Marissa: While the co-authors of articles like "The Science Behind Pre‐Columbian Evidence of Syphilis in Europe" contend that modern debates about the origins of syphilis are not morally motivated the way they were when it was a blame game between European countries, even "objective" science is shaped by the scientists themselves. They decide what questions to ask, what tests to run, etcetera. Some scientists discuss their data as if it is above the flaws of humankind. But just as in the humanities and social sciences, every scientist is part of her investigation, and is subject to biases. That doesn't make results or interpretation of data sets less interesting or important, it's just something to be aware of. Don't be afraid to ask your own questions and be skeptical, even of us so-called experts.

Averill: Exactly.

Marissa: In its earliest appearances in the historical record, the disease was just known as a "great pox" or "the French/Italian/German/Spanish/Christian disease" (depending on who your enemy was. In 1530 the poet and physician Girolamo Fracastoro reflected on a great pox which had been pimpling European penises for several decades in a three-volume treatise called "Syphilis sive Morbus Gallicus." The "French disease" was thus called "syphilis," and given a mythological origin story. In this tome, Fracastoro writes about a shepherd called Syphilus. Syphilus was tending the sheep of King Alcihtous, a mythological Greek character, when he angered the god Apollo by choosing to worship his king instead of the gods. Because Greek gods were overly invested in the attention of mortals, Apollo got pissed and cursed Syphilis with a disfiguring disease.

He first wore buboes dreadful to the sight

Felt strange pains, and sleepless passed the night.

From him the malady received its name

The neighboring shepherds catch'd the spreading flame.

In the story, the disease spread quickly, affecting everyone around him, even the King. To mitigate the curse, a tricksy nymph told the people to sacrifice Syphilus and some other things, probably some goats, and then she gave them the Guaiac tree, whose flowers were used as a treatment for the disease. We will come back to the Guaiac tree in a little bit, because though this was a just a fabricated Italian physician's tall tale, it actually feeds in to a long standing debate about the origins of the disease.

Averill: Syphilis is caused by the bacterium Treponema Pallidum. It is the only of the Treponema bacterium family to be transmitted through sexual contact. The other manifestations of the bacterium are transmitted through bodily contact and by sharing water vessels. All produce similar, though varyingly horrifying, symptoms. Pinta is purely a dermatitis infection, producing painful papules, usually around the extremities, neck and face, and if left untreated, progressing to lesions. Yaws and bejel [be-gel] also start as painless spots that can progress to painful lesions, but if left untreated can also attack bones and the soft palate.

Marissa: Syphilis, like yaws or bejel, starts as a painless sore called a chancre [SHANG-ker], typically in the rectum, mouth or on the genitals. But after that, syphilis is one of these diseases that can have really varying symptoms, which is probably one reason early modern physicians had trouble distinguishing it from other common diseases like leprosy. But today doctors have mapped five manifestations of the disease.

A chancre | Wellcome Collection

Averill: The first is the painless chancres [SHANG-ker], which you may or may not know you have, because sometimes they pop up inside of your rectum or vagina. Those go away after a few weeks, and then you are infected. Syphilis today, of course, is curable at this early stage (get checked early and often, people) with a dose of penicillin. Fifteenth-century folks were not so lucky. So those who contracted the venereal form of syphilis were likely to progress through the disease until it killed them.

Marissa: According to the Mayo Clinic, secondary syphilis starts within a few weeks of the original chancre healing. This stage is much easier to discern, because it manifests as a rash that will start around your middle, but will eventually spread to your entire body, right down to your palms and the soles of your feet. It might be itchy, it might include genital warts, it might include hair loss, muscle aches, fever, a sore throat, or swollen lymph nodes. The Treponema bacterium causes inflammation, so that can manifest in myriad ways, depending on the infected person. These symptoms might resolve themselves, only to come back over the course of an entire year, or they may clear up after a month and progress into latent syphilis, which is where things get bad. The good news for us is that secondary syphilis is also curable with antibiotics, as long as you catch it while it is still in this early stage. Still bad news for the early moderners.

Facial symptoms of tertiary syphilis | Wellcome Collection

Averill: If your infection goes untreated after secondary syphilis sets in, it will go into its latent stage. This is kind of terrifying, because latent syphilis has no symptoms. It can last for years, even decades. It is most likely that latent syphilis will just be in you forever, without ever manifesting symptoms again, and you'll just be left with the scars from your secondary stage pox. But today, in about a third of cases left untreated, syphilis will progress to the tertiary stage. Again, like the secondary stage, the symptoms will vary from person to person, but the inflammation may attack your brain, nerves, eyes, heart, blood vessels, liver, bones, and/or joints. The inflammation will cause tissue to degrade, effectively rotting, sometimes from the inside out, and sometimes from the outside in. Some of these symptoms are like those Marissa discussed in her leprosy episode. The flesh rots, and like any other decay, stinks like putrefaction. [I imagine this is like leaving a chicken carcass or hamburger packaging in the trash in the middle of July. Gross. Rotting meat. But I am just guessing, because I've never encountered anyone with late-stage syphilis. If any of you have, let us know! We want to know what syphilis... smells like?] One of the more visible signs of tertiary syphilis is the degradation of the soft tissue like the nose and ears, which may collapse, leaving the infected with breathing and hearing issues until the disease kills them.

Marissa: Like other venereal diseases, syphilis can also be passed from an infected mother to her baby in utero. The newborn might not have any symptoms at birth, but may later experience the soft palate and tissue collapse, leaving them deaf, or with collapsed noses.

Averill: Though we of course know today that syphilis is transmitted sexually, physicians in the late 15th century did not automatically associate sex with the contraction of the pox, despite its manifestation first on the genitals, but in a roundabout way, some did make the connection. As suggested in that long quote I read you at the top of the episode, from Joe Grunpeck, early modern Europeans believed that disease-all disease-was first and foremost God's doing. We're talking about pre-Enlightenment era people, in an age when God was all powerful, the Church pretty much ran everything, and every pestilence and plague - including The Plague itself - was issued by God as punishment for human sin and immorality. So within that line of thinking, something like venereal disease could be construed as being linked to immoral behavior. Some physicians did contend that the French pox was likely connected to lustful sin, because leprosy, having similar symptoms, was already linked to lustfulness (and sometimes early modern Europeans thought that leprosy was diffused through sexual contact, hence the categorization as lustful). As Kevin Siena notes, "in early modern Europe, all diseases were interpreted in providential terms: outward signs of illness stood for internal moral failure."

Marissa: Early modern Europeans ascribed to the humoral theory of the body. I go over this in detail in my leprosy episode, which we released a couple of weeks ago, so feel free to zip over to the transcript to get a full breakdown. For our purposes here, let's just cover the basics. Central to the humoral theory of the body are the four humors: yellow bile, black bile, blood, and phlegm. Every person had a particular humoral "constitution," and a healthy person required the proper balance of their humoral fluids. So after the GOD-WILLS-YOU-TO-BE-POXXED causation, early modern Europeans looked to the humoral balance of the body to explain all ailments, temperaments, and pretty much everything body-related. Each of the humors were connected to temperatures and natural elements. Yellow bile = hot, dry, fire, summer. Blood = hot, wet, spring, air. Phlegm = wet, cold, water, winter. Black bile = dry, cold, earth, autumn. You had to keep these liquids balanced. If you had a fever or other inflammations, doctors would probably diagnose you with an excess of blood, and put the leeches to you. But mostly they'd recommend changes to your diet and to your exercise habits, or maybe some herbal remedies intended to restore those balances.

Averill: Early physicians, working from this cosmological-medical POV, related the French pox to a range of different causes. According to historian Jon Arrizabalaga, those included divine punishment, corrupted air, harmful star constellations (duh), and bad life regimens. Few thought sex was the problem. And actually, because sex was considered a healthful, humorally-balancing act, some doctors prescribed having more sex (with a spouse, presumably) to try and restore health. So... sorry, wifeys. The few who did associate early iterations of the French disease with sex are not insignificant, of course. Those who made the connection typically cited the location of the disease's initial manifestations. The Valencian Almenar, for example, rejected the hypothesis that the disease started in the genitals simply because the genitals are hot and stinky. If that were the case, he shot back, all diseases would start in the genitals, and they most definitely do not. He and a handful of others acknowledged that the disease likely started in the genital region because it was being transmitted via genital to genital contact.

Marissa: Others took the lustful theological causations of the disease to their logical conclusion. If the French pox was a cosmological lustful infection, then surely cause might be lustful acts. This, as we'll actually get into in Ave's next episode, as part of our upcoming Sex series, was important in shaping the way that syphilis was gendered. Women, particularly but not only women who sold sex, were often saddled with the responsibility for spreading syphilis. Humoral doctors said that the womb - cold and dry - was less susceptible to the effects of syphilis, but could carry it and then infect tons of men before being affected itself. All the poor penises, being hot and (wet?) were very sensitive to the great pox, and would get it the very first time it brushed against a poxy vulva.

Averill: So early physicians argued for decades about what the great pox was, how it was caused, and made all kinds of (largely ineffective) recommendations about how to treat it - including having more sex. By the turn of the century, though, most agreed that it was venereal, and recommended washing their genitals with abrasive powders, wipe them down with a clean linen shirt or cloth, or hot water or white wine. These... innovations ... would be the primary preventatives for the next 300 years, which is where we'll get horrific stories of women washing their vaginas out with acidic solutions. And bleach. Yuck. But either way, the prevalence of syphilis really freaked Europeans out. There is tons of literature, artwork, and other cultural products that reflect the anxiety syphilis created among Europeans. We've got so much to cover, we'll only discuss a couple of Shakespearean examples before we move on to the Origins debates, because those are sort of the crux of this episode. But once you think about all the 16th, 17th, 18th, and 19th century literature you've read in your lifetime, you'll probably start to realize just how widespread the French pox became in popular imagination - as a marker of immorality, depravity, decay, sin, or womanly guiles. It's kind of everywhere.

Marissa: Shakepeare mentioned the pox in 55 lines of "Measure for Measure," 61 lines in "Troilus and Cressida," and 67 lines in "Timon of Athens." It was even the inspiration for a couple of sonnets. Sonnet 55 (the "canker") quipped: "The expense of spirit in a waste of shame/is lust in action; and still action." By the time he wrote Henry V, it was almost a staple of his world-building. The character Pistol returns home from war, opens a brothel, while disguising his syphilitic sores as war wounds. "Honour is cudhell'd, well, bawd I'll turn and something lean to cutpurse of quick hand to England will I steal, and there I'll steal; and patches will I get unto these cudgell'd scars, and swear I got them in the Gallia wars."

R. Casas, Sifilis | Wellcome Collection

Averill: Generally Shakespeare perpetuated the pox's popular association with France. Even the fanciful Midsummer Night's Dream is marred by the pox. Once character observes "some of your French crowns have no hair at all." Le chapelet was the French term for the syphilitic lesions of the forehead that looked a bit like a crown. This condition is mentioned again in Measure for Measure, Comedy of Errors, and Pericles.

Marissa: The references are numerous. There are a couple of good, short analyses of Shakespearean syphilis, but go back to your favorite plays and see if you can't find some allusion yourself! We'd love you to share them with us - post the weirdest, grossest, or sassiest Shakespeare syphilitic quote in our Pod Squad group.

Averill: Though we have a pretty solid sense of how early modern Europeans reacted to, treated, and moralized about syphilis in the first decades of its proliferation, we don't really, definitively know where syphilis started. Though this is a question scholars have been pondering for centuries, the most recent scholarship that I could dig up on the subject still admits that there are several plausible hypotheses on the origin. All three make some connection to contact between Europeans and Americans in the 15th century - hinging on whether that contact was responsible for the proliferation of syphilis, or if that contact has absolutely nothing to do with the disease manifesting suddenly and unrelatedly at that moment. The three hypotheses are known as the precolumbian, the Columbian, and the "unitarian."

Marissa: The Precolumbian thesis argues that the treponemal bacterium was present on both sides of the Atlantic before Columbus and his successors started ferrying disease back and forth, but that venereal syphilis developed specifically in Europe, and then was carried by Europeans to the Americas. So "precolumbian" just means that syphilis didn't start ravaging Europe because Columbus sailed the ocean blue. It's suggesting that things just got bad around the same time, perhaps 30+ years before. This thesis is pretty unpopular now, since new skeletal studies support different hypotheses.

Averill: According to some of the scholars who've put forward this precolumbian thesis, the treponema bacterium mutates when introduced to different climates. Arid climates, for example, will cause the pinta strain of the bacterium to mutate into yaws. Pinta, a skin disease, was first contracted by humans in southwest Asia who came into contact with bacterium-carrying primates, 15-17,000 years ago. Because a landbridge connected Asia to the Americas until about 11,000 years ago, nomadic humans would have carried that strain of the bacterium into the Americas with them. Yaws, a mutation of pinta, developed first in central and western Africa around 9000 years ago as a result of climate change, which made that region more arid. Archaeologists have identified skeletons with evidence of yaws in the Americas, which suggests that American regions that experienced similar aridization 9000 years ago likely also saw pinta mutate into yaws.

Marissa: According to these scholars, then, when Europeans started encountering the disease through contact with central and west Africans, in trade and then through large-scale enslavement of infected peoples, they carried the disease back to western Europe with them. Yaws remained yaws in regions with similar climates, but would have mutated into different kinds of syphilis in colder and drier climates. It became bejel, or endemic syphilis, in places with poor hygiene. Like yaws or pinta, bejel is transmitted through bodily contact - not necessarily sex. In places with relatively good hygiene, where the bacterium is not permitted to take root on the skin, it would have evolved into the venereal disease that we're talking about today - regular old syphilis.

Averill: The other side of this coin is the Columbian hypothesis - which is, apparently, very popular, and argues that Columbus and his goons contracted syphilis in the Americas and carried it back to Europe. This thesis is staked in part on 15th and 16th century medical texts that map the explosion of the disease in Italy, France, and Spain in the immediate years after Columbus returned from the Americas. Other scholars have challenged this 'evidence' because it may also reflect a shift in the medical community, which was paying more attention to classifying diseases more generally in the late-15th century. Venereal syphilis shares many symptoms with leprosy, for example, so it is possible that there simply wasn't an effort to differentiate between these generalizable diseases.

Marissa: In the 1990s, paleopathologists Bruce and Christine Rothschild examined collections of skeletons from several sites around the globe. They first examined skeletal remains with confirmed cases of syphilis, bejels, and yaws. Then they examined 687 skeletons from archaeological sites in the United States and Ecuador. They found that populations in the south (New Mexico, Florida, and Ecuador) had syphilis, while those to the north (Ohio, Illinois, and Virginia) had yaws. By contrast, examination of 1,000 "Old World" skeletons dated to before contact with the Americas revealed no cases of syphilis. For the Rothschilds, this suggests that syphilis was first present in the Americas, and that it was a mutation of American yaws; then it was contracted by Columbus and his crew, and carried back to Europe.

Averill: The most recent thesis is the "unitarian" thesis, or the "modified Columbian hypothesis," which pieces together data from both the Columbian and precolumbian studies. This builds off of the Rothschilds' work, studying skeletons from both sides of the Atlantic, and goes a step further to suggest that what we know as syphilis today did not exist until the European, African, and American strains of the treponema bacterium collided in those first years of contact, facilitated by the early Atlantic slave trade and the Spanish encounters with the indigenous peoples of the Americas. Studies conducted by forensic anthropologists and paleopathologists have identified the symptoms of various strains of the Treponema bacterium in pre-Columbian American and Eurasian and African skeletons. There is ample genetic evidence to show that early strains of the treponemal diseases, particularly pinta and yaws, existed everywhere, both before and after Columbus made it to the Caribbean. It would have mutated and changed in those isolated settings in divergent but similar ways.

Marissa: More importantly, on the Americas side of the Atlantic, there is skeletal evidence of a "high prevalence of treponemal disease paired with a low age of infection and an apparent absence of lesions attributable to congenital syphilis." According to Molly Zuckerman, Associate Professor of Biological Anthropology at Mississippi State University, "This suggests that a nonvenereal form of

[syphilis]

, similar to modern‐day yaws or bejel, one not passed through the placenta was present." So something akin to the syphilis that would rage through Europe preexisted in the Americas. This is supported in part by the historical record as well as the biological one. The indigenous peoples that the Spanish encountered in the Caribbean were already familiar with treatments for the symptoms of syphilis, which would prove effective on the European disease that took root in the 1490s. The guaiacum, for example, which appeared as a cure proffered by the lovely nymph in Girolamo Fracastoro's poem naming syphilis, is native to the tropical Americas. The word guaiacum is derived from a Taino word for the flowering plant. The Taino lived, before being wiped out by Spanish conquistadors and disease, in the Bahamas, and obviously introduced Europeans to the medicinal uses of the plant before they were largely decimated by enslavement and European diseases.

Averill: So what this hybrid theory postulates is the idea that Columbus and his crew encountered a unique strain of the Treponema bacterium, which had developed in the biomes of indigenous Americans without interference from the Eurasian/Africans for millenia. Those conquistadors transported that non-venereal infection back to Europe, which, according to Zuckerman, "could have responded to dramatically different selection pressures with a new, sexual, transmission strategy." That means that, like the pinta to yaws development in the aridization of central and west Africa, the American disease could have adapted itself into a sexually transmitted infection with extreme side effects. While there were certainly great cities in the Americas in the 15th century, urbanization was nothing compared to that of early modern Europe. According to this hypothesis, then, syphilis was created by the introduction of an American strain of the treponema bacterium to the climate and conditions of early modern Europe.

Marissa: As Mark Rose points out, historians have found complicating evidence in the writings of precolumbian European people to suggest that syphilis did exist in Europe prior to 1492. While ancient Greek and Roman authors were rarely specific enough to be certain, and it is problematic to apply more recent diagnoses on diseases of the past, it's important not to discount any one of these hypotheses entirely. Crusaders brought "Saracen ointment" back from the middle east, a medicine that contained mercury, for treating "lepers." Mercury wasn't actually an effective medication for leprosy, but was a very popular treatment for syphilis, well into the 19th century. Thirteenth- and fourteenth-century A.D. references to "venereal leprosy" may also indicate syphilis because leprosy is not sexually transmitted. That European physicians didn't start describing syphilis as syphilis until the 16th century does not mean that it didn't exist. While biological anthropologists and other scientists have studied a thousand, or even several thousand skeletons and found no signs of syphilis pre-Columbus is not evidence that it wasn't there. As I note in my episode on leprosy, thousands were buried near leper hospitals, and because many of the manifestations of syphilis resemble leprosy, it is very possible that among those unstudied skeletons are syphilitic victims. Of the bodies excavated, for example, 20-30% of the skeletons do not have the symptoms of leprosy, and so they think either they were misdiagnosed or possibly they had the lesser version. There are two different versions and one is no big deal. Or they could have had a different disease all together, one that doesn't leave the skeletal evidence that leoprosy does, so it's possible that some were syphilitic.

Averill: Now I am not a scientist, and I don't have access to any of the data upon which Molly Zuckerman or the Rothschilds are basing their conclusions, but I also have to wonder how quick these "hard" scientists are to dismiss the historical records, or the fallibility of their own interpretation of data. In 1997, a French scholar concluded that a fourth-century fetus exhibited the symptoms of congenital syphilis. Bruce Rothschild dismissed the French scholar's interpretation, preferring his own instead. Of course a 4th-century fetus with congenital syphilis would have been one data point to destroy his career-making Columbian thesis, but still, his examination of the skeletal remains produced different results. ""The character of the pathology appeared to me to be calcified membranes/tissues, rather than periosteal reaction," he says. "The skull lesions are unlike those of treponemal disease (e.g., congenital syphilis) and the dramatic forearm calcification is unlike anything we have previously witnessed in over 500 cases of adult syphilis, nor in the periosteal reaction that characterizes yaws and bejel-disorders in which children (though probably not fetuses) are frequently affected."

Marissa: While we have no concrete answer to the origin of syphilis, we do have lots of documentation about what the English called the "French pox"-and what the French called the Neapolitan Pox, the Russians the Polish disease, the Poles the German disease, and the Turks the Christian disease. Because we (meaning me and Averill, but probably also Anglo-Americans more generally) rely primarily on English-language sources, we are more accustomed to hearing it called the French disease more than anything else. The Italians, Germans, and British all referred to it as the French disease at some point, as well as "the great pox," "the pox disease," "pustule" (pox), the "bad pox," "bad verrucae," "the disease of tavelle," among other descriptive titles. Presumably this assignation of blame mostly centered in rivalry; the French were frequently at war with English, German, or Italian enemies throughout the early modern period (and beyond!) But undoubtedly the shoe fit, as it were, because the first major documented outbreak of the great pox was among French troops who laid siege to Naples from 1494-95.

Averill: As you'll recall from 5th grade social studies, Christopher Columbus was probably Genoese, maybe Spanish (his family mausoleum was in Seville), but the 87 men who made up the crew of his three ships were mostly Spaniards. Believing that the infection made its way from either Lisbon or Barcelona in March 1493 to Naples, Italy by February of 1495, when Charles VIII and his troops arrived at the city with the intention to siege it into submission is not all that far fetched. Charles marched with 25,000 men, mercenaries from all over Europe, through the Italian peninsula, and Naples had only a defense of about 1,000 troops, also mercenaries, including Spanish men. It's possible that the new pox traveled on the genitals of Spanish mercenaries. Naples was taken easily. According to the histories, the pox decimated Charles VIII's troops,

Marissa: Though this incident is usually cited as evidence for the Columbian thesis, we should also point out that this is merely the first documented outbreak. That doesn't mean the disease didn't exist in some lesser form in Europe before the Italian War.

Averill: And actually, I searched high and low for the sources that documented the effects of the disease among French troops. I found a footnote in Matthew Smallman-Raynor's War Epidemics that says "The source of the disease among the French army in Naples is entirely uncertain. According to Garrison (1917), syphilis is supposed to have been communicated to the French soldiers by the Spanish occupants of the city. The latter, in turn, contracted the disease from sailors who had returned from the New World with Christopher Columbus. As noted by Creighton (1965, i. 433), however, there is evidence that the disease may have been present in France before the war with the Italians, and that the French forces may have conveyed the disease to Liguria. In summarizing the conflicting evidence, Creighton observes: 'we have a theory of a Spanish origin, of a French origin, and also perhaps of a native Italian origin-all agreeing that Italy during the state of war from 1494 to 1496 was the theater of its first ravages on the great scale, and the source from which the disease was brought to all the countries of Europe by the returning soldiery." Those who survived the first rounds of incubation apparently returned to their homes with enough time to pass on the disease far and wide.

Marissa: Documented outbreaks cropped up in France and Germany in early 1495, during the Italian Wars; Switzerland was hit later in 1495. After the Italian Wars ended, the pox popped up in Holland and Greece in 1496 (somewhat surprising that it took that long, considering Greece's proximity to Italy, apparently the breeding ground of the disease); in England and Scotland in 1497; and in Hungary, Russia, and Poland in 1499. Europeans ultimately spread the great pox to the rest of the world. The first recorded case in India cropped up in 1498, through Indian contact with Portuguese traders. The Portuguese also carried it to east Asia and west Africa, merchants and sailors making landfall at various ports along the African coast.

Averill: So in about five years, the disease was being documented in just about every European country, and then every African and Asian country with which Europeans came into contact. As those early physicians tried to grapple with the disease, sometimes in conversation, but all too often in intellectual isolation, it took a great deal of trial and error to develop effective preventative measures and treatments. Understanding the venereal transmission was first and foremost in this journey; but prevention was much harder. There are scholars who've suggested that the anxiety the great pox created in Europeans contribute to the religious puritanism, policing of sex and sexuality, and even witch hunts! Now, saying that syphilis created religious conservatism is an overstatement for sure. But it can surely be understood as part of a larger confluence of events that prompted the reshaping of the early modern world starting in 1500. Kevin Siena notes that though early iterations of condoms were being created in the 16th century, few thought to use them to prevent venereal disease transmission. And fun fact: Condum, from the Latin "condo", to sheath, preserve, or thrust into. Use it, or very possibly lose it.

Marissa: In debunking some of the less credible and highly popular theories about the origins of syphilis, Molly Zuckerman discuss the danger of popularizing unverified data and opinions in media like documentaries and popular magazines. One key point of this article they take issue with is accusation of the 'moralizing' of the origin story debate. As we already suggested, these authors (including Molly Zuckerman) take offense at the idea that they (pure, objective scientists) would be investigating this issue and proffering results to make a moral argument. While I've already expressed my annoyance with this typical scientist point of view, they do at least admit that something like syphilis can be and is morally-charged. That is illustrated with no finer a point than a woodcut from Germany in the 15th century that literally moralizes the spread of syphilis. As the authors note, "This illustration ....shows a closed community of syphilitics, three male and one female, being punished by the flagellum Dei (the "whip of God") for their sexual transgressions. The arrows emanating from the hands of Jesus function as agents of infection and signify the martyrdom of the victims, who suffer as a consequence of the fall from Eden. Later reworkings of this illustration place more emphasis on the male sufferer, emphasizing that he, and thus men, overall, are the true victims, whereas women, through their sin, are to blame for the illness. The black spots or "blatterns" (blisters) on their faces symbolize infection with the disease now known as syphilis and are an indicator of moral blight."

Averill: So one thing that I think is really fascinating about syphilis is how it fits into an (admittedly Eurocentric) medicalized periodization of world history. I teach World History since 1500 every fall. I have always taught it by organizing course material into themes, but as I was doing research for this episode, I couldn't stop thinking how perfectly syphilis must help people who teach world history through a single theme of medicine. It's this perfect confluence of when Africa, Eurasia, and the Americas meet up in a violent, gross, horrifying series of events - and what better visualization of that than syphilis itself?

It's also this tangible, pock-marked impact on the imperial metropole. If either the Columbian or hybrid thesis, or some thesis derived from one of those, turns out to be the actual origin story, it's the perfect booyah moment.

I like the hybrid thesis best. I don't think that liking it best makes it more valid, but I feeeeeel like this is the right one. And that's probably the Druid fortune teller in me, so I am probably also right.

A Works Progress Administration poster c. 1940 | Public Domain / Wikimedia Commons

Averill: Before we wrap up, I just want to say that I had to read through a lot of medical journals and jargon to write this episode, and while I am a relatively smart person, I am not a biologist or medical doctor, so I may have some technical stuff wrong. Sorry if that's the case, and feel free to write in with all of your medical expertise, as long as your medical expertise is not from Dr. Oz or WebMD. I too know how to google. I tried to synthesize the medicalese into something podcastable. That said, and on a different note, I will repeat that I am not a medical doctor, so for the love of god, DO NOT send us pictures of spots or oddities on your body that you want diagnosed. Neither of us have the expertise or the desire to see those things. If something looks or feels weird, please consult your actual physician. We will accept, however, your artistic responses to the material of this show. If you want to sculpt us a poxy penis or create an abstract velvet painting of tertiary syphilis, we will take it all.

Marissa: Look for a follow-up episode on women who sold sex and forced institutionalization, coming with our Sex series.

Averill: In the meantime, share your favorite syphilitic Shakespeare - or other 16th/17th/18th century masterpieces - with us by joining the Dig Pod Squad on Facebook!

Marissa: You can also quip your favorite quotes on Twitter - follow & tag us @dig_history

Averill: We hope you've enjoyed this episode! Help us reach new listeners - leave us a rating and review on Apple Podcasts or Google Play, or whereever you're listening.

Marissa: As always, you can find the complete transcript and bibliography for this episode at digpodcast.org

Bye!

Show Notes

Jon Arrizabalaga, John Henderson, and Roger French, The great pox : the French disease in Renaissance Europe (New Haven : Yale University Press, 1997).

Ivana Anteric, Zeljana Basic, Katarina Vilovic, Kresimir Kolic, and Simun Andjelinovic, "Which Theory for the Origin of Syphillis is True," Journal of Sexual Medicine 11 (2014) 3112-8.

George J. Armelagos, Molly K. Zuckerman, and Kristin N. Harper, " The Science behind Pre-Columbian Evidence of Syphilis in Europe: Research by Documentary," Evolutionary Anthropology (12 Apr 2012)

Anne Hanley, "Syphilization and Its Discontents: Experimental Inoculation against Syphilis at the London Lock Hospital," Bulletin of the History of Medicine 91:1 (Spring 2017) 1-32.

George C. Kohn, Encyclopedia of Plague and Pestilence, (Infobase Publishing, 2007).
Hieronymi Fracastorii: the Italian scientist who described the "French disease"*

PH Ricord, " Letter on Syphillis," (Blanchard & Lea; Philadelphia, 1854).

Cari Romm, " A New Skeleton and an Old Debate About Syphilis," The Atlantic (16 Feb 2016)

Mark Rose, " Origins of Syphilis," Archaeology, 50:1 (January/February 1997)

Gregory W. Rutecki, "Shakespearean Syphilis: An Aggressive Disease in Evolution," The Pharos (Summer 2016) 40-46.

ed. Kevin Siena, Sins of the Flesh: Responding to Sexual Disease in Early Modern Europe (Toronto: University of Toronto, 2005).

Naomi Sharp, " The Return of Syphilis," The Atlantic (3 Dec 2015)

Matthew Smallman-Raynor and Andrew Cliff, War Epidemics (OUP, 2004).

Antonio Tagarelli, Guiseppe Tagarelli, Paolo Lagonia, and Anna Piro, "A Brief History of Syphilis by Its Synonyms," Acta Dematovenerol Croat 19:4 (2011) 228-36.

M. Tampa, I Sarbu, C Matei, Benea V, SR Georgescu, "Brief History of Syphilis," Journal of Medicine and Life 7:1 (Jan-Mr 2014) 4-10.

M. Waugh, "Daniel Turner (1667-1741): syphillis and the condum," International Journal of STD & AIDS 21 (2010) 546-48.

Katherine Wright, " Where did syphilis come from?" The Guardian (26 Oct 2013)
Syphilis is a very popular topic on podcasts! Check it out: Stuff to Blow Your Mind Stuff You Missed in History Class Horrific History Podcast
" Syphilis," The Mayo Clinic

Merrill Moore and Harry Solomon, " Joseph Grünpeck and his Neat Treatise (1496) on the French Evil*: A Translation with a Biographical Note," British Journal of Veneral Diseases, 11:1 (Jan 1935) 1-27.

Qtd. in Gregory W. Rutecki, "Shakespearean Syphilis: An Aggressive Disease in Evolution," The Pharos (Summer 2016) 40-46.

Kevin Siena, Sins of the Flesh: Responding to Sexual Disease in Early Modern Europe (Toronto: University of Toronto, 2005) 7. Ee also Cunningham and Grell, Four Horsemen of the Apocalypse, and Arrizabalaga, Henderson and French, The Great Poz.

Arrizabalaga, "Medical Responses," 43.

Arrizabalaga, "Medical Responses," 41.

Arrizabalaga, "Medical Responses," 49.

Qtd. in Rutecki, "Shakespearean Syphilis."

Qtd. in Rutecki, "Shakespearean Syphilis."

Cari Romm, " A New Skeleton and an Old Debate About Syphilis," The Atlantic (16 Feb 2016).

Daniel Turner (1667-1741): syphillis and the condum

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Syphilis: Origin Story. Or, Early Modern Europeans Don't Know Where It Came From, Current Scholars Don't Know Where It Came From, and a Lot of Poxy Penises and Vulvas Suffered in Between

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From whence came the poxiest of poxes? Averill and Marissa dive into the debates surrounding the origin of syphilis, with historians, paleobiologists, forensic anthropologists, and Shakespeare all weighing in. Transcript for Syphilis: Origin Story.

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In a five year span, syphilis had spread  France, Switzerland, Germany, England, Scotland, Scandinavian countries, Britain, Hungary, Greece, Poland and Russia (Syphilis, 2012). Since it happen in Europe, it is easier to pass since due to the smaller size in comparison to the US as well as more trading occurring there.

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At the time,  guaiac tree was the most popular treatment for syphilis. It however had caused sudoration, diarrhea and the increase in urinary debt as adverse effects (Brief History of Syphilis, 2014)

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The spread of syphilis occurred when Europeans had intercourse with natives of the New World and then when they went back to the Old world had intercourse with sex workers (“Columbian Exchange,” 166). If they control the urge, they would have never gotten it.

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The population that was greatly impacted was the Old World.