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History of Syphilis

Edward Worth owned not one but two editions of Luigi Luigini’s three-volume collection of treatises on syphilis, De morbo Gallico: the first edition, published in Venice by Jordanus Zilettus in 1566-67 and Hermann Boerhaave’s 1728 Leiden edition entitled Aphrodisiacus, sive De lue venerea. Luigini attempted to bring together treatises by fifty-nine authors on the new ‘French Disease’. In the words of its first publisher, the purpose of the collection was ‘the best way of making it possible for every scholar to read so many authors and achieve knowledge of, and the cure of, the French Disease’ and Boerhaave’s edition did little to change it beyond adding some medical remedies, reordering the texts and making the textual emendations more obvious.

Luigi Luigini, De morbo Gallico (Venice, 1566-7), title page.

That the disease was new was agreed on by Luigini’s commentators who not only pointed to gruesome symptoms and sixteenth-century cures but were keen to pinpoint the start of this new affliction: the siege of Naples by French troops under Charles VIII in 1495. Giovanni Battista da Monte (1498-1551), an author whose text ‘De morbo Gallico’ published at Paris in 1555 was likewise owned by Worth, outlines the genesis of the disease as follows in his section in Luigini:

‘His next Enquiry is, how it came into Italy; and here he tells us, that in the Year 1492 Columbus, with his Spaniards, went out upon the Enquiry after the Western Islands, where he found this Sickness to be, as it were, Endemick, as the Lepra in Aegypt: Whence returning in 1496, his Company, many of them, being tainted by their Commerce with the Natives, brought the same into their own Country, and therewith infected the Spanish and Italian Courtezans, at the Time when the French Army were making Spoil thereof: Who falling in the Way of such as the Sailors had now lately conversed with, the Distemper was propagated, by Degrees, to a vast Number of People, who quickly spread it into other Parts of Europe.’†

If da Monte’s dates are slightly out, his chronology of events is clear. What was apparent to da Monte, writing in mid-sixteenth-century Italy was that the disease was new and that it spread quickly, in a virulent fashion. By May 1496 it had spread across the Alps to Lucerne and Zurich and by the summer it was in Frankfurt and Nuremberg. Both these characteristics were agreed by most contemporary commentators, medical and lay alike, and both characteristics give strong evidential support for the Columban theory of the origin of syphilis.

But not all writers agreed. As the opening passage of another work collected by Worth, François Calmette’s Riverius reformatus: or The modern Riverius (London, 1706) makes plain, advocates of galenic medicine were loath to accept that there was any disease unknown to either Hippocrates or Galen:

‘Most Authors are used to derive the Origin of the Pox from the Year 1494; at which time Charles VIII of France was at War with Alphonsus of Spain; the Contagion being communicated by the Spaniards to the French, that besieged Naples. Some will have it, that the Soldiers of Columbus brought it among other Merchandises from America, and that first in Spain, and afterwards in Italy it was suddenly propagated with a great increase: But if the matter be more nearly examin’d, it will appear that the Pox has been known long before the time of Columbus: For Moses himself speaks in Leviticus of some Running of the Seed, and forbids them, that had it, as being polluted, to Eat with the rest. And in the First Book of the Histories of Herodotus, you may read, that the Scythians, for prophaning the Ascalonian Temple of Venus Urania, were afflicted with a Woman’s Distemper; the Goddess thus revenging the Injury done her. I will not deny that Hippocrates and Galen might have been ignorant of this Distemper; tho’, that we meet every where in the Works of both, with most of the Symptoms, seems to confirm the contrary Opinion: For what else is the Gonorrhaea, of which they so frequently make mention? What mean those ulcers, those sore and angry Pimples? Nothing but a Venereal Contagion…’

Calmette, Riverius reformatus (London, 1706), pp 466-7.

This theory, that the treponema virus was present in Europe prior to Columbus’ adventures in the New World, has been expanded on by later writers who argue against the Columban origin theory. They point to the presence of star-shaped scars on skulls of European skeletons prior to 1492 and to the presence of other forms of treponema elsewhere: yaws, a non-venereal syphilistic infection which originated in Central Africa and bejel, a mild version of it found in Egypt and Mesopotamia. The unitarian theory (as opposed to the Columban) theory argues that these three forms of treponema were present in Europe prior to the voyages of Columbus and that the bacterium mutated into a more virulent form in the 1490s. An alternative theory, cited by Brown (2006), is a slight variation on this: treponema infection in Europe combined with imports from overseas to start the virulent outbreak in the early sixteenth century.

Most modern commentators agree with those of Luigini on the origins of the disease. It cannot be proven that the ‘syphilitic symptoms’ on European medieval skulls were the result of infection by treponema pallidum since they might equally (and more likely) be read as being signs of leprosy. Equally, when they are placed against a census of syphilis symptoms in skulls in the pre-conquest Americas it becomes clear that syphilis was either negligible or non-existent in the former and endemic in the latter. Thirdly, the virulence of the outbreak in the 1490s and early sixteenth century, commentated on by all commentators, is another indication that the bacterium had struck epidemiological gold: a population that had no time to develop resistance to it. Finally, the testimonies of the commentators themselves, so lovingly compiled by Luigini, all point unerringly in the same direction.

But if Calmette was attempting to maintain the good name of galenic medicine in the face of a new challenge, the above passage also highlights some of the difficulties associated with the disease: its symptoms might so easily be confused with those of other diseases. Here Calmette appears to think that biblical leprosy was the same as venereal syphilis and he makes the common mistake that gonorrhoea was a type of syphilis (in fact it was on in 1879 that it was recognised that gonorrhoea was a specific disease in its own right). Another problem lay in the changing nature of the new disease. All writers were agreed that in its initial outbreak the virulence was the disease had been seen at its height. However, by the mid sixteenth century symptoms, though gruesome, were not quite as gruesome as before. This is commented on by Antonio Musa Brasavola (1500-1555), whose work on the French Disease, published at Venice in 1553, was collected by Worth.

Brasavola title page

Brasavola was enabled to disagree with his mentor Nicolas Leoniceno precisely because, as he said himself, the ‘Disease having varied since that Time’ proved that both their treatments for it had been correct – at the time. Such medical quandaries could not be easily resolved. It was only at the beginning of the twentieth century, in 1905-6, that the venereal syphilis treponeme was actually isolated and the Wassermann diagnostic text invented.

Given the means of transmission and it’s appearance during the French invasion of Italy it was inevitable that syphilis would have a major social impact. The horrific nature of the disease, particularly in its initial outbreak in the early sixteenth century, ensured that the blame game was entered into with much gusto. As Qualtiere and Slights (2003) point out, though it might not kill as many people as plague, it was regarded as a disease which ‘threatened the social fabric of Europe’. It was understood by most to be a judgment of God on licentious behaviour and a number of European countries responded by closing brothels. As Fabricius (2008) has shown, it proved a fertile theme in the drama of the age and countless reformation and counter-reformation sermons focused on it as a sign of God’s wrath. Harrison (2004) reminds us that it was even taken to be a harbringer of the apocalypse.

† All translations from Luigini’s compilatory work of tracts on syphilis are taken from the English translation of Boerhaave’s 1728 edition, undertaken by Daniel Turner and printed at London in 1736. As Worth died in 1733 this English translation of the Aphrodisiacus is not in the Worth Library.

Selected Reading
Adler, M. W. (1980), ‘The terrible peril: a historical perspective on the venereal diseases’, British Medical Journal, pp 206-211.
Arrizabalaga, Jon, Henderson, John and French, Roger (1997) The Great Pox. The French Disease in Renaissance Europe (Yale).
Brown, Kevin (2006), The Pox. The Life and Death of a very Social Disease (Stroud).
Crosby Jr, A.W. (1969), ‘The Early History of Syphilis: A Reappraisal’, American Anthropologist, New Series, 71 no. 2, pp 218-27.
Fabricius, Johannes (2008), Syphilis in Shakespear’s England (London).
Harrison, Mark (2004), Disease and the Modern World. 1500 to the Present Day (Cambridge).
Hays, J.. N. (2009), The Burdens of Disease. Epidemics and Human Response in Western History (London).
Luigini, Luigi, De morbo Gallico omnia quae extant apud omnes medicos cuiuscenque nationis … in unum … corpus redacta. … (Venice, 1566-67). 2o. Worth also had the later edition, edited by Hermann Boerhaave: Aphrodisiacus, sive De lue venerea; in duos tomos bipartitus, continens omnia quaecumque hactenus de hac re sunt ab omnibus medicis conscripta. … Ab … Aloysio Luisino … novissimé collectum (Leiden, 1728).
Qualtiere, L. F. and Slights, W. E. (2004), ‘Contagion and blame in early modern England: The case of the French pox’, Literature and Medicine, 22, pp 1-24.
Quétel, Claude (1990), The History of Syphilis (Baltimore).
Siena, K. P. (1998), ‘Pollution, Promiscuity, and the Pox: English Venereology and the Early Modern Medical Discourse on Social and Sexual Danger’, Journal of the History of Sexuality 8, no. 4, pp 553-74.
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