
Syphilis (historically called lues) is a sexually transmitted disease (STD) that is caused by a spirochaete bacterium, ''Treponema pallidum''. Syphilis has many alternate names, such as: Miss Siff, the Pox, and has been given many national attributions, ''e.g.'' the France disease or the English disease. The route of transmission for syphilis is almost invariably by sexual contact; however, there are examples of direct contact infections (see yaws) and of congenital syphilis (transmission from mother to child in utero). The signs and symptoms of syphilis are myriad; before the advent of serological testing, diagnosis was more difficult and the disease was dubbed the "Great-Imitator" because it was so often confused with other diseases. In the United States, about 36,000 cases of syphilis are reported each year, and the actual number is presumed to be higher. About three-fifths of the reported cases occur in men. Syphilis can be treated with penicillin or other antibiotics. Statistically, treatment with a course of pills is dramatically less effective than other treatments, because patients tend not to complete the course. The oldest, and still most effective, method is to inject procaine and penicillin into each buttock (the procaine is added to make the pain bearable); the dose must be given half in each buttock because the amount given would be painful if given in a single injection. An alternative treatment is to administer several capsules of azithromycin orally (which has a long duration of action) under observation. This latter course, however, may be falling on hard times, as strains of syphilis resistant to azithromycin have developed and may account for 10% of cases in some areas in 2004. Other treatments are less effective as the patient is required to take pills several times a day. If not treated, syphilis can cause serious effects such as damage to the nervous system, heart, or brain. Untreated syphilis can be ultimately fatal. == History == There are two schools of thought on the origin of Syphilis- the Colombian and pre-Colombian thesis. There is ongoing debate in anthropological and historical fields about the validity of either theory. The pre-Colombian theory holds that syphilis symptoms are described by Hippocrates in Classical Greece in its venereal/tertiary form. Some passages in the Bible could refer to syphilis, especially Exodus 20:5 where the sins of the father are visited unto the third and fourth generation. There are other suspected syphilis findings for pre-contact Europe, including at a 13th century-14th century century Augustinian friary in the northeastern England port of Kingston upon Hull. The anthropological evidence is contested by those who follow the Colombian theory. The Colombian theory holds that syphilis was a new world disease brought back by Columbus. Although this evidence has been derided as "weak and circumstantial" the first well recorded outbreak of what we know as syphilis occurred in Naples in 1494. There is some documentary evidence to link Columbus' crew to the outbreak. Supporters of the Colombian theory find syphilis lesions on pre-contact Native americans. Again, all the anthropological evidence is heatedly discussed on both sides of the Colombian/pre-Columbian debate. (Baker, et al.) Alfred Crosby has argued that neither side has the full story. Syphilis is a form of Yaws, which has existed in the Old World since time immemorial. Crosby argues that syphilis is a specific form of Yaws that had evolved in the New World and was brought back to the old, "the differing ecological conditions produced different types of treponematosis and, in time, closely related but different diseases". (ref:225 Crosby) The epidemiology of the first syphilis epidemic indicates that the disease was either new or a mutated form of an earlier disease. The disease swept across Europe from the early epicenter at Naples. The early form was much more virulent than the disease of today, the incubation period was shorter, only a few months, and the symptoms were more severe. In addition, the disease was more frequently fatal than it is today. By 1546, the disease had evolved into the form we know now. Syphilis had many different names. ''Great pox'' was used during the 16th century to distinguish it from smallpox. Great pox produced a similar rash in its early stages to small pox, but other than that it has no relation to the ''Variola'' virus. However the name is misleading, as small pox was a far more deadly disease. Because of the outbreak in the French army, it was first called ''morbus gallicus'', or the French disease. In that time it is noteworthy that the Italians also called it the "Spanish disease", the French called it the ''la maladie anglaise'' - the English disease and "Italy" or "Neapolitan disease", the Russians called it the "Poland disease", and the Arabs called it the "Disease of the Christians". The name "syphilis" was first applied by Girolamo Fracastoro in 1530 from the name of a shepherd in a poem by Leonardo da Vinci. A number of famous historical personages, including Charles VIII of France, have been alleged to have had syphilis. Guy de Maupassant and Friedrich Nietzsche are both thought to have been driven insane and ultimately killed by the disease. Al Capone contracted syphilis as a young man. By the time he was incarcerated at Alcatraz, it reached its third stage, ''neurosyphilis'', making him confused and disoriented. The painter Paul Gauguin is also said to have suffered from syphilis. Syphilis has been cited as the cause for various medical symptoms afflicting Adolf Hitler in his later years. The insanity caused by late-stage syphilis was once one of the more common forms of dementia; this was known as the general paresis of the insane. See also: List of notable people identified as probably syphilitic ==Stages of syphilis== Different manifestations occur at each stage of the disease. ===Primary syphilis=== [[Image:Penis syphilis.png|thumb|70px|Chancres on penis due to primary syphilitic infection]] ''Primary syphilis'' is manifested after an incubation period of 10-90 days (the average is 21 days) with a primary sore. During the initial incubation period, individuals are asymptomatic. The sore, called a ''chancre'', is a firm, painless skin ulceration localized at the point of initial exposure to the bacterium, often on the penis, vagina or rectum. Local lymph node swelling can occur. The primary lesion may persist for 4 to 6 weeks and then heal spontaneously. ===Secondary syphilis=== [[Image:Vaginal syphilis (disturbing image).jpg|thumb|50px|left|Secondary syphilis manifested on labia]] ''Secondary syphilis'' is characterized by a skin rash that appears 1-6 months (commonly 6 to 8 weeks) after the primary infection. This is a symmetrical reddish-pink non-itchy rash on the trunk and extremities, which unlike most other kinds of rash involves the palms of the hands and the soles of the feet; in moist areas of the body the rash becomes flat broad whitish lesions called ''condylomata lata''. ''Mucous patches'' may also appear on the genitals or in the mouth. ''A patient with syphilis is most contagious when he or she has secondary syphilis''. Other symptoms common at this stage include fever, sore throat, malaise, weight loss, anorexia, headache, meningismus, and enlarged lymph nodes. Rare manifestations include an acute meningitis that occurs in about 2% of patients, hepatitis, renal disease, hypertrophic gastritis, patchy proctitis, ulcerative colitis, rectosigmoid mass, arthritis, periostitis, optic neuritis, iritis, and uveitis. ===Tertiary syphilis=== ''Tertiary syphilis'' occurs from as early as one year after the initial infection but can take up to ten years to manifest - though cases have been reported where this stage has occurred fifty years after initial infection. This stage is characterised by gummas, soft, tumor-like growths, readily seen in the skin and mucous membranes, but which can occur almost anywhere in the body, often in the skeleton. Other characteristics of untreated syphilis include Charcot's joints (joint deformity), and Clutton's joints (bilateral knee effusions). The more severe manifestations include neurosyphilis and cardiovascular syphilis. Nervous system complications at this stage include ''generalized paresis of the insane'' which results in personality changes, changes in emotional affect, hyperactive reflexes, and Argyll-Robertson pupils, a diagnostic sign in which the small and irregular pupils constrict in response to focusing the eyes, but not to light; Tabes dorsalis, a disorder of the spinal cord, often results in a characteristic shuffling gait. Cardiovascular system complications include aortic aortitis, aortic aneurysm, aneurysm of sinus of Valsalva, and aortic regurgitation, and are a frequent cause of death. Syphilitic aortitis can cause ''de Musset's sign'' (a bobbing of the head that de Musset first noted in Parisian prostitutes). ===Congenital syphilis=== Congenital syphilis is syphilis present in utero and at birth, and occurs when a child is born to a mother with secondary or tertiary syphilis. According to the Centers for Disease Control and Prevention, 40% of births to syphilitic mothers are stillborn, 40-70% of the survivors will be infected, and 12% of these will subsequently die. Manifestations of congenital syphilis include abnormal x-rays; Hutchinson's teeth (centrally notched, widely-spaced peg-shaped upper central incisors); ''mulberry'' molars (sixth year molars with multiple poorly developed cusps); frontal bossing; saddle nose; poorly developed maxillae; enlarged liver; enlarged spleen; petechiae; other skin rash; anemia; lymph node enlargement; jaundice; pseudoparalysis; and ''snuffles'', the name given to rhinitis in this situation. ''Rhagades'', linear scars at the angles of the mouth and nose result from bacterial infection of skin lesions. Death from congenital syphilis is usually through pulmonary hemorrhage. ==Testing and treatment== Originally, there were no effective treatments for syphilis. The commonest in use were guaiacum and mercury (element): the use of mercury gave rise to the saying "A night in the arms of Venus leads to a lifetime on Mercury". It was only in the 20th century that effective tests and treatments for syphilis were developed. In 1906, the first effective test for syphilis, the Wassermann test, was developed. Although it had some false positive results, it was a major advance in the prevention of syphilis. By allowing testing before the acute symptoms of the disease had developed, this test allowed the prevention of the transmission of syphilis to others, even though it did not provide a cure for those infected. In the 1930s the Hinton test, developed by William Hinton, and based on flocculation, was shown to have fewer false positive reactions than the Wasserman. Subsequent syphilis tests, such as the Rapid Plasma Reagin (''RPR'') and Venereal Disease Research Laboratory (''VDRL'') test, and others based on monoclonal antibodies and immunofluorescence, are used in place of the Wassermann and Hinton tests today. As the disease became better understood, effective treatments began to be found, beginning with the use of the arsenic-containing drug Arsphenamine from 1910, and later, Neosalvarsan. One treatment that was tried was the use of malaria; the intense fever produced by a malarial attack raising the body temperature sufficiently to kill off the spirochaetes. Though this did leave the patient with a malaria infection, it was considered to be preferable to the long term effects of syphilis. These treatments were finally rendered obsolete by the discovery of penicillin, and its widespread manufacture after World War II allowed syphilis to be effectively cured for the first time. In one of the more shameful episodes of the twentieth century, the Tuskegee syphilis study continued to study the lifetime course of syphilis in a group of black Americans, long after effective treatments for syphilis were available. In the July 17, 1998 issue of the journal ''Science (journal)'', a group of biologists reported the sequencing of the genome of ''T. pallidum''. To this day, the primary treatment for syphilis remains penicillin. Treatment typically consists of benzathine penicillin G or aqueous procaine penicillin G for several days to weeks. Individuals who have allergic reactions to penicillin (i.e., anaphylaxis) can be effectively treated with oral tetracyclines. == Suffering from syphilis == A detailed although somewhat crude description of how one might have suffered from syphilis before modern antibiotics is provided in a limerick (poetry) of unknown origin [http://www.ucolick.org/~randi/aecom/syphilis.txt[1] ]. It begins with a man having a chancre; he goes on to develop secondary syphilis, losing his hair; following which he has all the common complications of tertiary syphilis and finally ends up insane due to neurosyphilis. The limerick also mentions his wife catching it from him and passing it on to his children.
== Syphilis in art and literature ==
In 1530, Girolamo Fracastoro, a physician and poet, wrote a poem from which syphilis derived its name.
There are references to syphilis in William Shakespeare's play ''Measure for Measure,'' particularly in a number of early passages spoken by the character Lucio, whose name, suggesting light and truth, is meant to indicate that he is to be taken seriously. For example Lucio says "[...] thy bones are hollow"; this is a reference to the brittleness of bones engendered by the use of mercury (element) which was then widely used to treat syphilis.
In Charlotte Brontë's novel ''Jane Eyre'', the character Edward Rochester's first wife, Bertha, is characterised as suffering from the advanced stages of syphilitic infection, general paresis of the insane, and there is plenty of corroborative evidence within the text to substantiate this view.
Henrik Ibsen's controversial (at the time) play ''Ghosts (play)'' has a young man who is suffering from a mysterious unnamed disease. Though it is never named, the events of the play make it plain that this is syphilis, an inheritance from his dissolute father. Dr Rank in Ibsen's play ''A Doll's House'' also has inherited syphilis.
The novel Candide by Voltaire describes Candide's mentor and teacher, Pangloss, as having contracted syphilis from a maidservant he slept with; the syphilis has ravaged and deformed his body. Pangloss explains to Candide that syphilis is 'necessary in the best of worlds' because the line of infection - which he explains - leads back to Christopher Columbus. If Columbus had not sailed to America and brought back syphilis, Pangloss states, the Europeans would not have been able to enjoy 'New World wonders' such as chocolate. Pangloss eventually loses an eye and an ear to the syphilis before he is cured.
The artist Kees van Dongen produced a series of illustrations for the anarchy publication ''L'Assiette au Beurre'' showing the descent of a young prostitute from poverty to her death from syphilis as a criticism of the social order at the end of the 19th century.
Also, in Charles Dickens' novel ''Tale of Two Cities'', references are made that allude to the main character, Sydney Carton, having syphilis.
Mention must be made of the anonymous American medical students' description of syphilis in a series of early 20th-century American limericks, using medical terminology to ghastly comic effect. It was first published in ''Journal of the American Medical Association'' January 1942: [http://www.ucolick.org/~randi/aecom/syphilis.txt]
==Related topics==
*a related spirochete bacterium, ''Treponema pallidum, sp. pertenue'', also called ''Treponema pertenue'', is the cause of yaws, a tropical infection of the skin, bones and joints.
*an additional treponematous disease is called ''pinta (disease)'' (''Treponema carateum'').
*Chancre
*Penicillin
*Sexually transmitted disease (STD)
== References ==
* ''From mercury to malaria to penicillin: The history of the treatment of syphilis at the Mayo Clinic'', 1916–1955
* Baker, Brenda: Armelagos, George. ''The Origin and Antiquity of Syphilis: Paleopathological Diagnoses and Interpretation.'' Current Anthropology 29 (1998).
* Alfred Crosby. ''The Early History of Syphilis: A Reappraisal.'' American Anthropologist, Vol 71 (1969).
* McNeill, William H. "''Plagues and People''." Bantam Doubleday Dell Publishing Group, Inc., New York, NY, 1976, ISBN 0-385-12122-9.
* Sacks, Oliver W. "''The Man Who Mistook His Wife for a Hat''" (ISBN 0684853949) — contains a chapter on an elderly woman treated in the early stages of tertiary syphilis from an infection decades earlier.
== External links ==
*[http://colman.net/eadv/index.html "A New Gold Standard For Syphilis?" Poster Presentation for European Academy of Dermatology and Venereology 2004 Spring Symposium]
*[http://www.cbc.ca/ideas/Aids Syphilis and AIDS: Lessons from history]
*[http://www.cdc.gov/std/Syphilis/STDFact-Syphilis.htm "Syphilis fact sheet" from the Center for Disease Control]
*[http://www.medinfo.ufl.edu/other/histmed/clancy/index.html Kipkeepers, Pox and Gleet Vendors: A Rapid History of Syphilis]
*[http://www.nobel.se/medicine/laureates/1927/wagner-jauregg-lecture.html The treatment of dementia paralytica by malaria inoculation (A Nobel Prize lecture, December 13, 1927)]
*[http://www.pbs.org/wnet/secrets/case_syphilis/index.html Secrets of the Dead (PBS): The Syphilis Enigma]
*[http://www.hkmj.org.hk/skin/syphilis.htm The chapter on syphilis from a book on Dermatology and Venerology] — contains some good pictures
*[http://www.poxhistory.com/ POX: Genius, Madness, and the Mysteries of Syphilis]
*[http://www.bcpwa.org/issue6/syph.htm Article on syphilis, cites a "one in four" chance of getting tertiary syphilis] (references outdated now believed incorrect medical data)
Sexually-transmitted diseases
==Limerick== The limerick is amusing, but what's its copyright status? I found it on [http://pagebuild.com/limerick/97declim.htm this web page] dated 1997, but there's no indication of permission to re-use it. -- User:Ortonmc 03:43, 13 Nov 2003 (UTC) :I agree that the limerick is amusing (and horrible) but it doesn't belong here in the encyclopdia. Instead there should be a "dry" summary of short and long term symptoms for men and women. User:Andries 11:52, 4 Apr 2004 (UTC) ::I don't mind the limerick. It shows how much this disease has to do with the culture of the time. User:Ksheka 11:42, May 20, 2004 (UTC) It is claimed to be Victorian in origin (see http://www.simegen.com/pipermail/simegen-l/Week-of-Mon-20010409/002145.html ), which, if true, puts it in the public domain. -- User:The Anome 13:11, 16 Nov 2003 (UTC) ==:Image:Vaginal syphilis.jpg== Can we link to this photo instead of displaying it? User:RickKUser talk:RickK 22:51, Aug 10, 2004 (UTC) :I feel this photo would be better off with a link. Ditto with any other non-work-safe photos. User:Samboy 08:38, 13 Aug 2004 (UTC) :: If you are so concerned about what people at work think about you, then why are you viewing an article about syphilis at work? - User:Ta bu shi da yu 15:11, 13 Aug 2004 (UTC) ::: I, for one, view it in biology classes. It is then not very appropriate for close-ups of human genitalia to be displayed on my monitor, when one is discussing the biological properties of a disease. Ergo, put it in a link.--User:TVPR 08:01, 10 Feb 2005 (UTC) :Why? If you don't like vaginas there are plenty of other syphilis photos where it came from, but since syphilis is a STD I found a vagina more appropriate. Also this is an illness and showing the effects of such things are bound to show things that are not very nice looking. --User:Dittaeva 22:58, 10 Aug 2004 (UTC) ::How, exactly, is a vagina more appropriate than a penis to show the effects of an STD? Are you, perhaps, assuming that women are unclean? You sure as bloody hell sound like it, if I may say so. Respectfully, --User:TVPR 08:01, 10 Feb 2005 (UTC) ::The point is that we want to offer the reader the opportunity to look at "not very nice looking" things without depriving the reader of the opportunity not to look at "not very nice looking things". The best way to do this is to show a link rather than the "not very nice looking" thing itself on the initial page. - User_talk:Nunh-huh''">User:Nunh-huh|''User talk:Nunh-huh'' 23:37, 10 Aug 2004 (UTC) :::That is a point that applies to all articles with images that might be deemed "not very nice looking". I do not think the image looks so awful that it needs to be merely linked. Syphilis is a medical subject and an STD, and this is how many medical pictures look like. The reader does also have a choice not to read articles concerning STDs. Removing the picture will reduce its visibility and likely audience, and in my opinion will reduce the value and quality of the article. --User:Dittaeva 08:29, 11 Aug 2004 (UTC) ::Anyway, I'd still like to know what kind of problems you have with the image, because, as I have already stated there are alternatives out there. Do you not want any "not very nice looking" images inline in articles on medical subjects? --User:Dittaeva 08:42, 11 Aug 2004 (UTC) :::That's the point. We can use the photo by linking to it, instead of putting it directly onto the page where people who don't want to be grossed out don't have to look at it. User:RickKUser talk:RickK 19:26, Aug 11, 2004 (UTC) ::::And you think this should be done for all medical articles concerning subjects (and images) that people might be "grossed out" by? I understand verz well what you want to do, but let me ask you some direct and clear questions since you haven't answered my more general ones until now: 1. What exactly is it about the current picture that makes you want it linked and not inline? 2. Would you be willing to accept a non-genital syphilis picture inline? 3. Do you think it should be policy to link (instead of including inline) pictures that you think will "gross out" people in all articles? I am trying to work with you here, but until now you have just been repeating yourselves. I still do not think it is necessary to merely link this picture that might "gross out" people in an article that should have the potential to "gross out" people without the picture. --User:Dittaeva 22:56, 11 Aug 2004 (UTC) :::::Yes, I think we should be sensitive to our readers. [1] as you were the first to point out, it's ''not very nice looking'' (hereinafter referred to as ''repulsive''). [2] not if it's not "gross". And I would oppose you removing a ''link'' to the current one. [3] It already is more or less the policy. The problem is defining the level of 'grossness' at which it takes effect. Beheading" videotapes seems to be agreed to be over that level, as are "beheading" photographs. A woman spreading her labia to reveal her clitoris with nail polish on is also over that level, while the same woman spreading her labia to reveal her clitoris with the nail polish Photoshopped out is below that level. I think the present photograph of ''condylomata lata'' falls above that level, and that inline inclusion makes people more likely to click away rather than continue to read it. Gross pictures are appropriate for medical texts, and less appropriate for encyclopedias. I'm also uncomfortable with the moralistic overtones of "wanting" to put repulsive photos into STD articles: we're trying to make an encyclopedia, not an army training film: we're here to disseminate knowledge about STDs, not scare people away from sex. - User:Nunh-huh 23:27, 11 Aug 2004 (UTC) ::::::So I suppose it boils down to whether one find it above or under "the level", I find it is under, you and RickK think it is above. The moralistic overtones that you find in me "wanting" what you call repulsive photos probably comes from the excitement of opposing you guys, it is certainly not part of my POV. Anyhow, as I have said before, the archive where I found this picture have many other syphilis pictures, why don't you head over and try to find some that fits under "the level". BTW: I am aware that we are writing an encyclopedia. It would be nice if you linked the above mentioned examples.--User:Dittaeva 22:36, 12 Aug 2004 (UTC) :::::::It's spread about in talk pages and their associated histories: Talk:Nick Berg for the beheading discussion, Talk:Clitoris (and the Village Pump and the English Wikipedia Mailing List) for the clitoris. - User:Nunh-huh 23:02, 12 Aug 2004 (UTC) ::I don't really understand why do people oppose to linking the image : a link allows people who want to look at it to look at it, and people who don't want to see it just won't follow the link, whereas putting the image directly in the article forces them to see it. For me, giving the choice is obviously better, since it doesn't prevent people from seeing the image. Linking would give the choice instead of imposing the picture. User:SeeSchloss 00:26, 14 Aug 2004 (UTC) I've listed it at Wikipedia:Requests for comment. User:RickKUser talk:RickK 23:39, Aug 11, 2004 (UTC) The article is categorized on "Infectious diseases", and this warns enough for the unadvised readers. Nobody is forced to read about syphilis. The article is clearly about biology (science), describing the symptoms of a very ugly disease. "The sore, called a chancre, is a firm, painless skin ulceration localized at the point of initial exposure to the bacterium, often on the penis, vagina or rectum." The readers interested in knowing more about this disease will appreciate the complementary images. A good encyclopedic article should be comprehesive and an image is worth 1000 words. I agree that removing the picture will reduce the quality of this article. --User:Vasile 01:42, 14 Aug 2004 (UTC) :[1] Not all Infectious diseases articles will have repulsive pictures: one does not follow from the other [2] one learns what classification a pages is by viewing it...too late if you're basing your opinion to visit or not on its classification. [3] ''No one'' is talking about removing any images. They will all be there for those who wish to see them to view. They'll have to click their mouse button. - User:Nunh-huh :: The content of the article is mainly medical. I suppose the esthetic principles aplies in science apart of the art. Those images are not art. --User:Vasile 12:34, 14 Aug 2004 (UTC) :Do you think that someone looking for info on "Syphilis in art and literature" should expect to see such pictures ? And should be ''forced'' to see them ? I don't agree. User:SeeSchloss 21:52, 14 Aug 2004 (UTC) :: We discuss about the article "Syphilis". Those pictures are related with chapter 2-"Stages of syphilis". Those pictures are very good in describing different stages of syphilis -the subject of this medical article. In a medical article about syphilis such pictures should be expected. Nobody could be forced to read this or any other article. --User:Vasile 02:37, 15 Aug 2004 (UTC) :::This is not a "medical" text, and this is not simply a "medical" article. Among those pages from which syphilis is one click away are: Al Capone, Bacterium, Edgar Allen Poe, Edward VI of England, Howard Hughes, July 17, Jane Eyre, Honeysuckle, Pastoral, Recluse spider, and Magic bullet. - User:Nunh-huh 04:45, 15 Aug 2004 (UTC) ::::Hopefully, this article may be extended becoming a simple medical article. --User:Vasile 02:42, 16 Aug 2004 (UTC) :::::Hopefully not. In fact, not even a "medical" article would be complete without a historical overview, and not even in medical textbooks would such a section be omitted when discussing syphilis. Of course, a medical textbook wouldn't make mistakes like claiming a penis has primary syphilis or a vagina has secondary syphilis (a ''person'' may have primary or secondary syphilis, a penis can have a chancre, a ''lesion'' of primary syphilis, and a vagina (actually in this photograph I believe it's labia) can demonstrate condylomata lata, a ''lesion'' of secondary syphilis, but genitalia do not "have" either primary or secondary syphilis. Nor would your typical medical text illustrate the ''usual'' (one chancre per customer) with a photograph of the ''unusual'' (three chancres on one penis). - User:Nunh-huh 03:41, 16 Aug 2004 (UTC) ===Alternative resolution=== I am a bit disappointed at you guys, since it seems to me you do not want to resolve this, you'd rather have it your way. So since you are not trying to resolve this any other way than "the link way" I have come up with two other options: 1. Replace image with other image less repulsive: I have found :Image:Penis_syphilis.png at PHIL which you might find less repulsive. I'd rather use that image anyhow because it depicts a penis which is more approriate since more men than women have syphilis. 2. Use very small thumbnail: This should grab more attention than a link, and look less repulsive. I have just as well implemented the changes. I do not object to replacing the vaginal image with a link or removing it completely. --User:Dittaeva 21:13, 13 Aug 2004 (UTC) Out of curiosity, have you seen any non-genital pictures of syphilis sores? --User:Ssd 06:39, 21 Aug 2004 (UTC) :Yeah, there are many extragenital images where the two others came from, maybe we should find one more to include? --User:Dittaeva 13:58, 2 Dec 2004 (UTC) ===From RfC=== I agree with ''Rick'', ''Andries'' and company. The more grotesque elements of this article, including the pictures and the limerick, should be linked to with warning. No thumbnails. I agree with the general policy that non-work-safe images should ''not'' be placed on Wikipedia regardless of the article they belong to. –User:Floorsheim 05:25, 16 Aug 2004 (UTC) :It would be helpful if you and User:Samboy wrote an article on work-safe internet. Okay. Looks like as per Vulva, Clitoris, and Penis, there's general agreement among the community in support of the inclusion of clinical photos. Is it possible to get one that's not quite so hideous as the vagina one, though? My opinion on the limerick remains unchanged. It's crude and has no place in an encyclopedia. User:Floorsheim 12:27, 17 Aug 2004 (UTC) :You can search for syphilis at the source of the vagina image, but I have tried and did not find any "less hideous" and equally illustrative.--User:Dittaeva 12:32, 17 Aug 2004 (UTC) I vote for a link. This looses nothing and gives people choice. Interestingly, I still have concerns about the photo of my newborn son I posted on caesarian section comments welcome on its talk page! best wishes User:Erich gasboy 21:16, 19 Aug 2004 (UTC) :actually change my mind, those tiny thumbs are fine, although the penis file size is ridiculously big - it should be JPEG not a PNG! but the limerick should go. completely innapropriate User:Erich gasboy 21:21, 19 Aug 2004 (UTC) ::The picture is PNG and big because I wanted to provide the loss-less original for anyone to use as they see fit, in one place. I agree that it is not very practical, but since its PD one might as well provide the best original available. I have also tried to solve the problem by including a fast-loading thumbnail, but since its on the bottom along with the description one has to kind of discover it. I don't think its necessary to do anything about it now, but I will request that the software display pictures underneath their description and not over. I think the limerick should stay. And BTW: PNG is more in line with the GNU FDL and the FOSS nature of Wikipedia.--User:Dittaeva 21:45, 19 Aug 2004 (UTC) :::I've just re-read JPEG and the licencing concerns don't outway that the disadvantage of that huge file! surely? (btw thanks for the comments on the other photo) User:Erich gasboy 01:13, 20 Aug 2004 (UTC) ::::No I don't think JPEG is a problem, but PNG is still better, but the reason I did what I did was that I wanted everyone to have access to the best version available without uploading several different versions. I have put up [http://bugzilla.wikipedia.org/show_bug.cgi?id=182 an enhancement "bug" at MediaZilla] to address the issue in the software, if you'd like you can sign up and vote for it. --User:Dittaeva 16:58, 20 Aug 2004 (UTC) :::::Would it be possible to have a PNG original and JPG thumbnail? or is the size of the thumbnail a non-issue? --User:Ssd 06:43, 21 Aug 2004 (UTC) ::::::If the thumb could display in JPG I don't find that a problem, but is it doable without uploading a new JPEG version? (Another feature request?). If you are talking about uploading a new JPEG version I don't think its worth it.--User:Dittaeva 09:21, 21 Aug 2004 (UTC) :I agree with User:Erich gasboy; I think the thumbnail works well... draws attention to it without being exposed in its full glory -- so to speak -- to people who'd be repulsed (and yes, I find that picture nauseating, but useful). User:Mindspillage 01:42, 23 Aug 2004 (UTC) Dittaeva, let's hear why you think the limerick should stay. –User:Floorsheim 23:14, 19 Aug 2004 (UTC) :I agree with User:Ksheka, and I think removing it would reduce the quality of the article and reduce the information given. The Limerick gives a very good picture of how it could be have have syphilis at the time. But: I kind of agree with User:Andries too. :Conclusion if you: # Copy the limerick to [http://sources.wikipedia.org WikiSource]."dry" summary of short and long term symptoms for men and women. # Write "a "dry" summary of short and long term symptoms for men and women". :then I think you can replace the limerick with a link to it, but please, the above mentioned points should be carried out before replacing the limerick. --User:Dittaeva 16:58, 20 Aug 2004 (UTC) I would be alright with something to that effect. Why don't you work on putting that together? For now, I'm going to go ahead and snip the limerick. I think the information currently in the main body of the article is extensive enough that we can afford to go without the limerick for now. –User:Floorsheim 11:29, 21 Aug 2004 (UTC) == A limerick on syphilis == Quite a good description of how one might have suffered from syphilis back in the days before modern antibiotics. It starts out with him having a chancre; he goes on to develop secondary syphilis, losing his hair to secondary syphilis; following which he has all the common complications of tertiary syphilis before he ends up mad from neurosyphilis. The limerick (poetry) also mentions his wife catching it from him and then passing it on to his children. There was a young man of Back Bay, Who thought syphilis just went away, And felt that a chancre, Was merely a canker, Acquired in lascivious play. Now first he got acne vulgaris, The kind that is rampant in Paris, It covered his skin, From forehead to shin, And now people ask where his hair is. With symptoms increasing in number, His aorta's in need of a plumber, His heart is cavorting, His wife is aborting, And now he's acquired a gumma. Consider his terrible plight, His eyes won't react to the light, His hands are apraxia, His gait is ataxia, He's developing peripheral vision loss. His passions are strong, as before, But his penis is flaccid, and sore, His wife now has tabes dorsalis And congenital syphilis, She's really worse off than a whore. There are pains in his belly and knees, His sphincters have gone by degrees, Paroxysmal incontinence, With all its concomitants, Brings on quite unpredictable pees. Though treated in every known way, His spirochetes grow day by day, He's developed paresis, Converses with Jesus, And thinks he's the Queen of the May. == Inconsistant information == The article on Friedrich Nietzsche referred to in this article points out that the insanity that Nietzsche suffered is not consistant with syphilis infection, and that the accusation that he was a syphilis sufferer is probably a canard perpetrated by his detractors. From that article... "While the story of syphilis indeed became generally accepted in the twentieth century, recent research in the Journal of Medical Biography shows that syphilis is not consistent with Nietzsche's symptoms, and that the contention that he had the disease originated in anti-Nietzschean tracts." Perhaps the cross reference should be removed, or at least amended to indicate the questionable nature of the inference of syphilis? Shokaman :I'd go ahead and do what you suggested (remove nietzsche reference), but you should probably check the validity of what you just quoted first. --User:Dittaeva 14:59, 8 Nov 2004 (UTC) :You must consider that Nietzche's own sister did a major coverup of whatever was wrong with him after his death so that she could use his writings for her own pollitical agenda. I think it would be wrong to remove any reference for or against syphilis in his case until you had gotten multiple MODERN confirmations. And no, a single author on either side is not good enough. References to collected evidence should go on Talk:List of notable people identified as probably syphilitic. --User:Ssd 05:52, 9 Nov 2004 (UTC) == Removal of images == I have reverted User:GenerlaPattons last edits because they were in complete disregard of the discussion that has been held here. The edits also crippled the article as links with image captions in the beginning of paragraphs is just unusable. Please add your conserns/objections/replies to the discussion first if you'd want to revert. --User:Dittaeva 21:38, 3 Dec 2004 (UTC) :Well, i've got no reason to revert as i've started this policy discussion Wikipedia:Graphic and potentially disturbing images that i hope will give us guidelines on how to deal with such issues in the future. I hope you, and others, join in the discussion. User:GeneralPatton 23:01, 4 Dec 2004 (UTC) :Would anyone be opposed to a header announcing that it contains these pictures? I think it's really not obvious that the article would contain such images—especially for those who, like myself, were previously unaware of ''how'' syphilis affects in the body. :If there is support for such a header, how about the type of solution I crafted for Abu Ghraib prisoner abuse? Basically, we can make a version of the article with images suppressed by using the main article as a template. This does not duplicate the article, but creates a version without potentially offensive pictures. User:Cool Hand Luke Luke">User talk:Cool Hand Luke 19:27, 7 Dec 2004 (UTC) ==Syphilis in bones== I saw this picture [http://news.bbc.co.uk/1/shared/spl/hi/pop_ups/05/health_surgical_history/html/1.stm/1.stm] and i tried to think of how this disease affected the bones. I am somehow at a loss. Did it cut calcium intake? Would someone medically knowledgable include a more explicit sentence or two one how the bactaria affected bones please? That would make the article far more rich that most of the other writings out there :One of syphilis's major mechanisms of damage is through the formation of squishy painful lumps. (I seem to recall these are labeled ''tabes'' but I can't find a refernece for that.) These nodules can form anywhere -- on the surface of the skin, in nerve tissue (esp. the spine -- tabes dorsalis), in the heart muscle, and even in bones. The result of them in bones and joints is a painful arthritis. --User:Ssd 04:34, 12 Feb 2005 (UTC) ::There's more than one way for syphilis to produce bony manifestations, but the predominant one is the "gumma" or "gummatous lesion", which is a tumor-like inflammatory reaction provoked in direct response to the causative organism, the spirochete. If you look at a gumma under the microscope, you'll see dead cells (necrosis), epithelioid cells, and multinucleated giant cells, but you generally won't find the spirochete. Gummas in the knee were fairly common signs of advanced untreated syphilis. ("Tabes dorsalis" is a neurological manifestation of tertiary syphilis, but isn't itself related to any bony changes). - User:Nunh-huh 04:41, 12 Feb 2005 (UTC) == Bacteria ID == A recent anonymous changed the bacterium name for yaws in this article. I have no criteria to judge which is accurate and have no sources to hand. Any microbiologists out there?? ''Yaws (also Frambesia tropica, thymosis, polypapilloma tropicum or pian) is a tropical infection of the skin, bones and joints caused by the spirochete bacterium Treponema pertenue. Other treponematosis diseases are pinta (Treponema carateum) and syphilis (Treponema pallidum).'' - from the Yaws article. User:WBardwin 03:13, 8 Mar 2005 (UTC) :I thought I'd fixed that one, but it didn't seem to "take": I've done it again now - taking the chance to remove tangential, though related, diseases out of the first paragraph. ''Treponema pertenue'' and ''Treponema pallidum pertenue'' indicate the same organism. - User:Nunh-huh 03:20, 8 Mar 2005 (UTC) == History Section == I changed the history of Syphilis. Whoever posted the old history wrote that the columbian theory is weak and unsupported, wheras in reality is is probably more prevalent in scholarship today. I tried to be balanced in presenting both theories. User:Notenderwiggin :I moved this sentence from the head of the discussion page, placing it in date order and with a discussion topic. Please note significant history sections changes by the author above. Appears to me that too much was taken out of Pre-Columbian side of the controversy, which is hardly as weak today as the author seems to think. Will put some of the information back in. User:WBardwin 20:17, 20 Mar 2005 (UTC) I think the changes made by Notenderwiggin are very well balanced (and NPOV) and cover current evidence well. Perhaps too much was removed, but I don't think adding it back will make the article more well balanced. My personal feeling on this is that there was a more virulent strain in the new world, and although Christopher Columbus brought it back with him, it had been brought over first by others, but somehow did not reached epidemic levels and stayed local to where it landed previously. Perhaps the others were merely fishermen, where Columbus brought soldiers who traveled further when they came back. Similarly, there may have been cultural barriers to the disease's travel in ancient Greece. --User:Ssd 21:08, 20 Mar 2005 (UTC) :I left a note with the original author -- a brand new contributer!! -- and asked him to make changes before the rest of us chime in. I personally am on the Pre-Columbian side of the argument as there are too many human remains from historic and prehistoric Old World sites with evidence of congenital syphilis to call the disease new. However, from a biological point of view, some believe that a mutation from yaws produced the syphilis bug and that it has rapidly evolved in various niches worldwide ever since. See the Crosby reference. Having a New World strain collide with the Old World strain does seem a reasonable sequence, which perhaps led to the sudden explosion in Post-Columbian Europe. Consideration has to be made for the historic reporting problems with disease as well, as disease names were used very flexibly in the past. In particular, an accusation of syphilis infection was sometimes used as propoganda or a way of making a political enemy appear degenerate. Let's make these changes at a reasoned pace and try to present both sides of the issue. Comments welcome. User:WBardwin 23:45, 20 Mar 2005 (UTC) ::I'm in favor of the third idea now presented in history -- neither side has the whole picture. I think it is very clear that Columbus brought it back with him and started an epidemic in Europe. It is less clear (though I have been convinced with recent evidence) that it was already in Europe, although perhaps not wide spread or in a virulent form. I have also seen evidence that it was in the new world pre-Columbus, in both a skin and STD form, both of which were virulent. Also, the natives seem to have had ways of keeping it under control (like, with hot baths). As I said, I feel the article is now balanced. It gives about equal space to all three views. I think giving more than that is excessive unless we're going to divote a whole article on the history of syphilis, and talking about any one view more is POV until the experts come to agreement on one of them, which I suspect is not possible without a time machine. --User:Ssd 05:00, 21 Mar 2005 (UTC) Oh, for that time machine!. History is full of mysteries like this one -- little dibs and dabs of information but never a real answer. Let's see if our new contributor makes some changes and I'll look for a few more current references on all points. A quote from Crosby article might go well -- as would some archaeological confirmation from earlier European periods. Thanks for the interest. User:WBardwin 05:37, 21 Mar 2005 (UTC) Thanks for the help everybody, as noted I am a new Wiki contributer and am not sure of all the conventions yet. I tried to make the contribution balanced, I personally support the Crosby theory that Syphilis is a particular strain of Yaws that was brought back from the New World. If you think more evidence from the pre-columbian side should be put in then feel free to add it, but I think I left enough it there. I don't think we can go into to much more detail without creating a seperate page. If we want to create a new page for the History of Syphilis I could write some of the text, as it is an interest of mine, but I would need help creating a page and linking it properly. I think the really interesting thing is the spread of the epidemic from Naples and how the pathogen mutated so as be less virulent to spread itself better. I don't think we have room for this unless we start a new page though. User:Notenderwiggin 23:04, 28 Mar 2005 (UTC) :Hi! Welcome back. When I get around to tracking down your Crosby reference, I might tack a little more information to this article. I like the idea of a entire category on the History and Impact of Disease. The social impact of plagues and outbreaks was a subspecialty of mine as an undergrad. I've been playing with this in the plague area - with special pages on the three major outbreaks. History of syphilis would also be good, and I would be glad to help too. We might want to look over the Columbian Exchange article. User:WBardwin 00:29, 29 Mar 2005 (UTC) == Friedrich Nietzsche == An anon removed Nietzsche from the syphilus sufferers section. I think it probably should go back in/and so I'm reverting. I've read a couple of books that assert he had the disease. Does anyone have any idea why it was removed or disagree with putting it back? (I admit to questioning whether the article needs the section at all - but that is for another day.) Comments welcome. User:WBardwin 04:39, 20 Apr 2005 (UTC) :The question is where did these books get that information from. You should see if you can check the original sources. [http://www.opinion.telegraph.co.uk/news/main.jhtml?xml=/news/2003/05/04/wniet04.xml&sSheet=/news/2003/05/04/ixworld.html This article] claims that Nietzsche probably died of a brain tumor and that the syphilis story was created after the war by Wilhelm Lange-Eichbaum. The article summarizes Dr. Sax's claims regarding why he believes Nietzsche's symptoms were inconsistent with syphilis. Also, according to the Nietzsche article: "One of the best arguments against the syphilis theory is summarized by Claudia Crawford in the book ''To Nietzsche: Dionysus, I Love You! Ariadne''." User:Zensufi 02:22, 22 Apr 2005 (UTC) == Statistics/Sources == ''"United States has reported over 32,000 cases of Syphilis in 2002 and the cases were reported from 16 countries and 1 city. The number of cases of syphilis happened 20 to 39 years of age. Female’s highest cases were 20 to 24 years of age. Male’s highest cases were 35 to 39 years of age. The cases of congenital syphilis decreased from 2001 to 2002 in 2001, there were 492 cases of congenital syphilis in the 2002 it became 412 new cases syphilis and for the adolescence including mid adults between the ages of 15 and 34 who are sexually active have the highest rates of syphilis."'' :Anon. contribution to article moved here. Sources not cited and information needs improvement/clarity. User:WBardwin 07:46, 16 May 2005 (UTC) ''"Natchitoches, LA is the syphilis capitol of the world."'' :Anon. contribution to article moved here. Probable vandalism as no source or context cited. User:WBardwin 14:55, 16 May 2005 (UTC) ==Syphilis and malaria== Reportedly a dose of malaria was used to cure syphilis at one time. Is this true, and would it have worked? :Rather implausible. User:Jfdwolff | User_talk:Jfdwolff 21:33, 19 May 2005 (UTC) ::Yes, it doesn't seem like a good idea now, but it certainly occurred. See ''From mercury to malaria to penicillin: The history of the treatment of syphilis at the Mayo Clinic, 1916–1955'', which is cited in the article. It probably worked better than the equally improbable, yet true, concept of "bleeding". - User:Nunh-huh 00:14, 20 May 2005 (UTC)
:And now bleeding is being explored in some controlled experiments, as a treatment for types of hypertension (these days, "blood donation" is the method). And leaches -- are starting to be used to improve blood circulation in reattached limbs, such as fingers. So things come around again!! User:WBardwin 18:29, 2 Jun 2005 (UTC)
At least the malaria "cure" has some obvious logic to its working - bleeding does not.
Are there any other examples of one disease being used to cure another?
:See 'TB may have killed off leprosy' at Talk:Tuberculosis and also see the malaria article section 'Sickle cell anemia and other genetic effects' having protection against malaria User:Petersam 06:59, 2 Jun 2005 (UTC)
See other meanings of words starting from letter:
Words begining with Syphilis:
Syphilis
Syphilis
Syphilis,_congenital
Syphilis_disease
Syphilis_test
Syphilis_testing
Syphilis
Syphilis (historically called lues) is a sexually transmitted disease (STD) that is caused by a spirochaete bacterium, ''Treponema pallidum''. Syphilis has many alternate names, such as: Miss Siff, the Pox, and has been given many national attributions, ''e.g.'' the France disease or the English disease. The route of transmission for syphilis is almost invariably by sexual contact; however, there are examples of direct contact infections (see yaws) and of congenital syphilis (transmission from mother to child in utero). The signs and symptoms of syphilis are myriad; before the advent of serological testing, diagnosis was more difficult and the disease was dubbed the "Great-Imitator" because it was so often confused with other diseases. In the United States, about 36,000 cases of syphilis are reported each year, and the actual number is presumed to be higher. About three-fifths of the reported cases occur in men. Syphilis can be treated with penicillin or other antibiotics. Statistically, treatment with a course of pills is dramatically less effective than other treatments, because patients tend not to complete the course. The oldest, and still most effective, method is to inject procaine and penicillin into each buttock (the procaine is added to make the pain bearable); the dose must be given half in each buttock because the amount given would be painful if given in a single injection. An alternative treatment is to administer several capsules of azithromycin orally (which has a long duration of action) under observation. This latter course, however, may be falling on hard times, as strains of syphilis resistant to azithromycin have developed and may account for 10% of cases in some areas in 2004. Other treatments are less effective as the patient is required to take pills several times a day. If not treated, syphilis can cause serious effects such as damage to the nervous system, heart, or brain. Untreated syphilis can be ultimately fatal. == History == There are two schools of thought on the origin of Syphilis- the Colombian and pre-Colombian thesis. There is ongoing debate in anthropological and historical fields about the validity of either theory. The pre-Colombian theory holds that syphilis symptoms are described by Hippocrates in Classical Greece in its venereal/tertiary form. Some passages in the Bible could refer to syphilis, especially Exodus 20:5 where the sins of the father are visited unto the third and fourth generation. There are other suspected syphilis findings for pre-contact Europe, including at a 13th century-14th century century Augustinian friary in the northeastern England port of Kingston upon Hull. The anthropological evidence is contested by those who follow the Colombian theory. The Colombian theory holds that syphilis was a new world disease brought back by Columbus. Although this evidence has been derided as "weak and circumstantial" the first well recorded outbreak of what we know as syphilis occurred in Naples in 1494. There is some documentary evidence to link Columbus' crew to the outbreak. Supporters of the Colombian theory find syphilis lesions on pre-contact Native americans. Again, all the anthropological evidence is heatedly discussed on both sides of the Colombian/pre-Columbian debate. (Baker, et al.) Alfred Crosby has argued that neither side has the full story. Syphilis is a form of Yaws, which has existed in the Old World since time immemorial. Crosby argues that syphilis is a specific form of Yaws that had evolved in the New World and was brought back to the old, "the differing ecological conditions produced different types of treponematosis and, in time, closely related but different diseases". (ref:225 Crosby) The epidemiology of the first syphilis epidemic indicates that the disease was either new or a mutated form of an earlier disease. The disease swept across Europe from the early epicenter at Naples. The early form was much more virulent than the disease of today, the incubation period was shorter, only a few months, and the symptoms were more severe. In addition, the disease was more frequently fatal than it is today. By 1546, the disease had evolved into the form we know now. Syphilis had many different names. ''Great pox'' was used during the 16th century to distinguish it from smallpox. Great pox produced a similar rash in its early stages to small pox, but other than that it has no relation to the ''Variola'' virus. However the name is misleading, as small pox was a far more deadly disease. Because of the outbreak in the French army, it was first called ''morbus gallicus'', or the French disease. In that time it is noteworthy that the Italians also called it the "Spanish disease", the French called it the ''la maladie anglaise'' - the English disease and "Italy" or "Neapolitan disease", the Russians called it the "Poland disease", and the Arabs called it the "Disease of the Christians". The name "syphilis" was first applied by Girolamo Fracastoro in 1530 from the name of a shepherd in a poem by Leonardo da Vinci. A number of famous historical personages, including Charles VIII of France, have been alleged to have had syphilis. Guy de Maupassant and Friedrich Nietzsche are both thought to have been driven insane and ultimately killed by the disease. Al Capone contracted syphilis as a young man. By the time he was incarcerated at Alcatraz, it reached its third stage, ''neurosyphilis'', making him confused and disoriented. The painter Paul Gauguin is also said to have suffered from syphilis. Syphilis has been cited as the cause for various medical symptoms afflicting Adolf Hitler in his later years. The insanity caused by late-stage syphilis was once one of the more common forms of dementia; this was known as the general paresis of the insane. See also: List of notable people identified as probably syphilitic ==Stages of syphilis== Different manifestations occur at each stage of the disease. ===Primary syphilis=== [[Image:Penis syphilis.png|thumb|70px|Chancres on penis due to primary syphilitic infection]] ''Primary syphilis'' is manifested after an incubation period of 10-90 days (the average is 21 days) with a primary sore. During the initial incubation period, individuals are asymptomatic. The sore, called a ''chancre'', is a firm, painless skin ulceration localized at the point of initial exposure to the bacterium, often on the penis, vagina or rectum. Local lymph node swelling can occur. The primary lesion may persist for 4 to 6 weeks and then heal spontaneously. ===Secondary syphilis=== [[Image:Vaginal syphilis (disturbing image).jpg|thumb|50px|left|Secondary syphilis manifested on labia]] ''Secondary syphilis'' is characterized by a skin rash that appears 1-6 months (commonly 6 to 8 weeks) after the primary infection. This is a symmetrical reddish-pink non-itchy rash on the trunk and extremities, which unlike most other kinds of rash involves the palms of the hands and the soles of the feet; in moist areas of the body the rash becomes flat broad whitish lesions called ''condylomata lata''. ''Mucous patches'' may also appear on the genitals or in the mouth. ''A patient with syphilis is most contagious when he or she has secondary syphilis''. Other symptoms common at this stage include fever, sore throat, malaise, weight loss, anorexia, headache, meningismus, and enlarged lymph nodes. Rare manifestations include an acute meningitis that occurs in about 2% of patients, hepatitis, renal disease, hypertrophic gastritis, patchy proctitis, ulcerative colitis, rectosigmoid mass, arthritis, periostitis, optic neuritis, iritis, and uveitis. ===Tertiary syphilis=== ''Tertiary syphilis'' occurs from as early as one year after the initial infection but can take up to ten years to manifest - though cases have been reported where this stage has occurred fifty years after initial infection. This stage is characterised by gummas, soft, tumor-like growths, readily seen in the skin and mucous membranes, but which can occur almost anywhere in the body, often in the skeleton. Other characteristics of untreated syphilis include Charcot's joints (joint deformity), and Clutton's joints (bilateral knee effusions). The more severe manifestations include neurosyphilis and cardiovascular syphilis. Nervous system complications at this stage include ''generalized paresis of the insane'' which results in personality changes, changes in emotional affect, hyperactive reflexes, and Argyll-Robertson pupils, a diagnostic sign in which the small and irregular pupils constrict in response to focusing the eyes, but not to light; Tabes dorsalis, a disorder of the spinal cord, often results in a characteristic shuffling gait. Cardiovascular system complications include aortic aortitis, aortic aneurysm, aneurysm of sinus of Valsalva, and aortic regurgitation, and are a frequent cause of death. Syphilitic aortitis can cause ''de Musset's sign'' (a bobbing of the head that de Musset first noted in Parisian prostitutes). ===Congenital syphilis=== Congenital syphilis is syphilis present in utero and at birth, and occurs when a child is born to a mother with secondary or tertiary syphilis. According to the Centers for Disease Control and Prevention, 40% of births to syphilitic mothers are stillborn, 40-70% of the survivors will be infected, and 12% of these will subsequently die. Manifestations of congenital syphilis include abnormal x-rays; Hutchinson's teeth (centrally notched, widely-spaced peg-shaped upper central incisors); ''mulberry'' molars (sixth year molars with multiple poorly developed cusps); frontal bossing; saddle nose; poorly developed maxillae; enlarged liver; enlarged spleen; petechiae; other skin rash; anemia; lymph node enlargement; jaundice; pseudoparalysis; and ''snuffles'', the name given to rhinitis in this situation. ''Rhagades'', linear scars at the angles of the mouth and nose result from bacterial infection of skin lesions. Death from congenital syphilis is usually through pulmonary hemorrhage. ==Testing and treatment== Originally, there were no effective treatments for syphilis. The commonest in use were guaiacum and mercury (element): the use of mercury gave rise to the saying "A night in the arms of Venus leads to a lifetime on Mercury". It was only in the 20th century that effective tests and treatments for syphilis were developed. In 1906, the first effective test for syphilis, the Wassermann test, was developed. Although it had some false positive results, it was a major advance in the prevention of syphilis. By allowing testing before the acute symptoms of the disease had developed, this test allowed the prevention of the transmission of syphilis to others, even though it did not provide a cure for those infected. In the 1930s the Hinton test, developed by William Hinton, and based on flocculation, was shown to have fewer false positive reactions than the Wasserman. Subsequent syphilis tests, such as the Rapid Plasma Reagin (''RPR'') and Venereal Disease Research Laboratory (''VDRL'') test, and others based on monoclonal antibodies and immunofluorescence, are used in place of the Wassermann and Hinton tests today. As the disease became better understood, effective treatments began to be found, beginning with the use of the arsenic-containing drug Arsphenamine from 1910, and later, Neosalvarsan. One treatment that was tried was the use of malaria; the intense fever produced by a malarial attack raising the body temperature sufficiently to kill off the spirochaetes. Though this did leave the patient with a malaria infection, it was considered to be preferable to the long term effects of syphilis. These treatments were finally rendered obsolete by the discovery of penicillin, and its widespread manufacture after World War II allowed syphilis to be effectively cured for the first time. In one of the more shameful episodes of the twentieth century, the Tuskegee syphilis study continued to study the lifetime course of syphilis in a group of black Americans, long after effective treatments for syphilis were available. In the July 17, 1998 issue of the journal ''Science (journal)'', a group of biologists reported the sequencing of the genome of ''T. pallidum''. To this day, the primary treatment for syphilis remains penicillin. Treatment typically consists of benzathine penicillin G or aqueous procaine penicillin G for several days to weeks. Individuals who have allergic reactions to penicillin (i.e., anaphylaxis) can be effectively treated with oral tetracyclines. == Suffering from syphilis == A detailed although somewhat crude description of how one might have suffered from syphilis before modern antibiotics is provided in a limerick (poetry) of unknown origin [http://www.ucolick.org/~randi/aecom/syphilis.txt
Syphilis
==Limerick== The limerick is amusing, but what's its copyright status? I found it on [http://pagebuild.com/limerick/97declim.htm this web page] dated 1997, but there's no indication of permission to re-use it. -- User:Ortonmc 03:43, 13 Nov 2003 (UTC) :I agree that the limerick is amusing (and horrible) but it doesn't belong here in the encyclopdia. Instead there should be a "dry" summary of short and long term symptoms for men and women. User:Andries 11:52, 4 Apr 2004 (UTC) ::I don't mind the limerick. It shows how much this disease has to do with the culture of the time. User:Ksheka 11:42, May 20, 2004 (UTC) It is claimed to be Victorian in origin (see http://www.simegen.com/pipermail/simegen-l/Week-of-Mon-20010409/002145.html ), which, if true, puts it in the public domain. -- User:The Anome 13:11, 16 Nov 2003 (UTC) ==:Image:Vaginal syphilis.jpg== Can we link to this photo instead of displaying it? User:RickKUser talk:RickK 22:51, Aug 10, 2004 (UTC) :I feel this photo would be better off with a link. Ditto with any other non-work-safe photos. User:Samboy 08:38, 13 Aug 2004 (UTC) :: If you are so concerned about what people at work think about you, then why are you viewing an article about syphilis at work? - User:Ta bu shi da yu 15:11, 13 Aug 2004 (UTC) ::: I, for one, view it in biology classes. It is then not very appropriate for close-ups of human genitalia to be displayed on my monitor, when one is discussing the biological properties of a disease. Ergo, put it in a link.--User:TVPR 08:01, 10 Feb 2005 (UTC) :Why? If you don't like vaginas there are plenty of other syphilis photos where it came from, but since syphilis is a STD I found a vagina more appropriate. Also this is an illness and showing the effects of such things are bound to show things that are not very nice looking. --User:Dittaeva 22:58, 10 Aug 2004 (UTC) ::How, exactly, is a vagina more appropriate than a penis to show the effects of an STD? Are you, perhaps, assuming that women are unclean? You sure as bloody hell sound like it, if I may say so. Respectfully, --User:TVPR 08:01, 10 Feb 2005 (UTC) ::The point is that we want to offer the reader the opportunity to look at "not very nice looking" things without depriving the reader of the opportunity not to look at "not very nice looking things". The best way to do this is to show a link rather than the "not very nice looking" thing itself on the initial page. - User_talk:Nunh-huh''">User:Nunh-huh|''User talk:Nunh-huh'' 23:37, 10 Aug 2004 (UTC) :::That is a point that applies to all articles with images that might be deemed "not very nice looking". I do not think the image looks so awful that it needs to be merely linked. Syphilis is a medical subject and an STD, and this is how many medical pictures look like. The reader does also have a choice not to read articles concerning STDs. Removing the picture will reduce its visibility and likely audience, and in my opinion will reduce the value and quality of the article. --User:Dittaeva 08:29, 11 Aug 2004 (UTC) ::Anyway, I'd still like to know what kind of problems you have with the image, because, as I have already stated there are alternatives out there. Do you not want any "not very nice looking" images inline in articles on medical subjects? --User:Dittaeva 08:42, 11 Aug 2004 (UTC) :::That's the point. We can use the photo by linking to it, instead of putting it directly onto the page where people who don't want to be grossed out don't have to look at it. User:RickKUser talk:RickK 19:26, Aug 11, 2004 (UTC) ::::And you think this should be done for all medical articles concerning subjects (and images) that people might be "grossed out" by? I understand verz well what you want to do, but let me ask you some direct and clear questions since you haven't answered my more general ones until now: 1. What exactly is it about the current picture that makes you want it linked and not inline? 2. Would you be willing to accept a non-genital syphilis picture inline? 3. Do you think it should be policy to link (instead of including inline) pictures that you think will "gross out" people in all articles? I am trying to work with you here, but until now you have just been repeating yourselves. I still do not think it is necessary to merely link this picture that might "gross out" people in an article that should have the potential to "gross out" people without the picture. --User:Dittaeva 22:56, 11 Aug 2004 (UTC) :::::Yes, I think we should be sensitive to our readers. [1] as you were the first to point out, it's ''not very nice looking'' (hereinafter referred to as ''repulsive''). [2] not if it's not "gross". And I would oppose you removing a ''link'' to the current one. [3] It already is more or less the policy. The problem is defining the level of 'grossness' at which it takes effect. Beheading" videotapes seems to be agreed to be over that level, as are "beheading" photographs. A woman spreading her labia to reveal her clitoris with nail polish on is also over that level, while the same woman spreading her labia to reveal her clitoris with the nail polish Photoshopped out is below that level. I think the present photograph of ''condylomata lata'' falls above that level, and that inline inclusion makes people more likely to click away rather than continue to read it. Gross pictures are appropriate for medical texts, and less appropriate for encyclopedias. I'm also uncomfortable with the moralistic overtones of "wanting" to put repulsive photos into STD articles: we're trying to make an encyclopedia, not an army training film: we're here to disseminate knowledge about STDs, not scare people away from sex. - User:Nunh-huh 23:27, 11 Aug 2004 (UTC) ::::::So I suppose it boils down to whether one find it above or under "the level", I find it is under, you and RickK think it is above. The moralistic overtones that you find in me "wanting" what you call repulsive photos probably comes from the excitement of opposing you guys, it is certainly not part of my POV. Anyhow, as I have said before, the archive where I found this picture have many other syphilis pictures, why don't you head over and try to find some that fits under "the level". BTW: I am aware that we are writing an encyclopedia. It would be nice if you linked the above mentioned examples.--User:Dittaeva 22:36, 12 Aug 2004 (UTC) :::::::It's spread about in talk pages and their associated histories: Talk:Nick Berg for the beheading discussion, Talk:Clitoris (and the Village Pump and the English Wikipedia Mailing List) for the clitoris. - User:Nunh-huh 23:02, 12 Aug 2004 (UTC) ::I don't really understand why do people oppose to linking the image : a link allows people who want to look at it to look at it, and people who don't want to see it just won't follow the link, whereas putting the image directly in the article forces them to see it. For me, giving the choice is obviously better, since it doesn't prevent people from seeing the image. Linking would give the choice instead of imposing the picture. User:SeeSchloss 00:26, 14 Aug 2004 (UTC) I've listed it at Wikipedia:Requests for comment. User:RickKUser talk:RickK 23:39, Aug 11, 2004 (UTC) The article is categorized on "Infectious diseases", and this warns enough for the unadvised readers. Nobody is forced to read about syphilis. The article is clearly about biology (science), describing the symptoms of a very ugly disease. "The sore, called a chancre, is a firm, painless skin ulceration localized at the point of initial exposure to the bacterium, often on the penis, vagina or rectum." The readers interested in knowing more about this disease will appreciate the complementary images. A good encyclopedic article should be comprehesive and an image is worth 1000 words. I agree that removing the picture will reduce the quality of this article. --User:Vasile 01:42, 14 Aug 2004 (UTC) :[1] Not all Infectious diseases articles will have repulsive pictures: one does not follow from the other [2] one learns what classification a pages is by viewing it...too late if you're basing your opinion to visit or not on its classification. [3] ''No one'' is talking about removing any images. They will all be there for those who wish to see them to view. They'll have to click their mouse button. - User:Nunh-huh :: The content of the article is mainly medical. I suppose the esthetic principles aplies in science apart of the art. Those images are not art. --User:Vasile 12:34, 14 Aug 2004 (UTC) :Do you think that someone looking for info on "Syphilis in art and literature" should expect to see such pictures ? And should be ''forced'' to see them ? I don't agree. User:SeeSchloss 21:52, 14 Aug 2004 (UTC) :: We discuss about the article "Syphilis". Those pictures are related with chapter 2-"Stages of syphilis". Those pictures are very good in describing different stages of syphilis -the subject of this medical article. In a medical article about syphilis such pictures should be expected. Nobody could be forced to read this or any other article. --User:Vasile 02:37, 15 Aug 2004 (UTC) :::This is not a "medical" text, and this is not simply a "medical" article. Among those pages from which syphilis is one click away are: Al Capone, Bacterium, Edgar Allen Poe, Edward VI of England, Howard Hughes, July 17, Jane Eyre, Honeysuckle, Pastoral, Recluse spider, and Magic bullet. - User:Nunh-huh 04:45, 15 Aug 2004 (UTC) ::::Hopefully, this article may be extended becoming a simple medical article. --User:Vasile 02:42, 16 Aug 2004 (UTC) :::::Hopefully not. In fact, not even a "medical" article would be complete without a historical overview, and not even in medical textbooks would such a section be omitted when discussing syphilis. Of course, a medical textbook wouldn't make mistakes like claiming a penis has primary syphilis or a vagina has secondary syphilis (a ''person'' may have primary or secondary syphilis, a penis can have a chancre, a ''lesion'' of primary syphilis, and a vagina (actually in this photograph I believe it's labia) can demonstrate condylomata lata, a ''lesion'' of secondary syphilis, but genitalia do not "have" either primary or secondary syphilis. Nor would your typical medical text illustrate the ''usual'' (one chancre per customer) with a photograph of the ''unusual'' (three chancres on one penis). - User:Nunh-huh 03:41, 16 Aug 2004 (UTC) ===Alternative resolution=== I am a bit disappointed at you guys, since it seems to me you do not want to resolve this, you'd rather have it your way. So since you are not trying to resolve this any other way than "the link way" I have come up with two other options: 1. Replace image with other image less repulsive: I have found :Image:Penis_syphilis.png at PHIL which you might find less repulsive. I'd rather use that image anyhow because it depicts a penis which is more approriate since more men than women have syphilis. 2. Use very small thumbnail: This should grab more attention than a link, and look less repulsive. I have just as well implemented the changes. I do not object to replacing the vaginal image with a link or removing it completely. --User:Dittaeva 21:13, 13 Aug 2004 (UTC) Out of curiosity, have you seen any non-genital pictures of syphilis sores? --User:Ssd 06:39, 21 Aug 2004 (UTC) :Yeah, there are many extragenital images where the two others came from, maybe we should find one more to include? --User:Dittaeva 13:58, 2 Dec 2004 (UTC) ===From RfC=== I agree with ''Rick'', ''Andries'' and company. The more grotesque elements of this article, including the pictures and the limerick, should be linked to with warning. No thumbnails. I agree with the general policy that non-work-safe images should ''not'' be placed on Wikipedia regardless of the article they belong to. –User:Floorsheim 05:25, 16 Aug 2004 (UTC) :It would be helpful if you and User:Samboy wrote an article on work-safe internet. Okay. Looks like as per Vulva, Clitoris, and Penis, there's general agreement among the community in support of the inclusion of clinical photos. Is it possible to get one that's not quite so hideous as the vagina one, though? My opinion on the limerick remains unchanged. It's crude and has no place in an encyclopedia. User:Floorsheim 12:27, 17 Aug 2004 (UTC) :You can search for syphilis at the source of the vagina image, but I have tried and did not find any "less hideous" and equally illustrative.--User:Dittaeva 12:32, 17 Aug 2004 (UTC) I vote for a link. This looses nothing and gives people choice. Interestingly, I still have concerns about the photo of my newborn son I posted on caesarian section comments welcome on its talk page! best wishes User:Erich gasboy 21:16, 19 Aug 2004 (UTC) :actually change my mind, those tiny thumbs are fine, although the penis file size is ridiculously big - it should be JPEG not a PNG! but the limerick should go. completely innapropriate User:Erich gasboy 21:21, 19 Aug 2004 (UTC) ::The picture is PNG and big because I wanted to provide the loss-less original for anyone to use as they see fit, in one place. I agree that it is not very practical, but since its PD one might as well provide the best original available. I have also tried to solve the problem by including a fast-loading thumbnail, but since its on the bottom along with the description one has to kind of discover it. I don't think its necessary to do anything about it now, but I will request that the software display pictures underneath their description and not over. I think the limerick should stay. And BTW: PNG is more in line with the GNU FDL and the FOSS nature of Wikipedia.--User:Dittaeva 21:45, 19 Aug 2004 (UTC) :::I've just re-read JPEG and the licencing concerns don't outway that the disadvantage of that huge file! surely? (btw thanks for the comments on the other photo) User:Erich gasboy 01:13, 20 Aug 2004 (UTC) ::::No I don't think JPEG is a problem, but PNG is still better, but the reason I did what I did was that I wanted everyone to have access to the best version available without uploading several different versions. I have put up [http://bugzilla.wikipedia.org/show_bug.cgi?id=182 an enhancement "bug" at MediaZilla] to address the issue in the software, if you'd like you can sign up and vote for it. --User:Dittaeva 16:58, 20 Aug 2004 (UTC) :::::Would it be possible to have a PNG original and JPG thumbnail? or is the size of the thumbnail a non-issue? --User:Ssd 06:43, 21 Aug 2004 (UTC) ::::::If the thumb could display in JPG I don't find that a problem, but is it doable without uploading a new JPEG version? (Another feature request?). If you are talking about uploading a new JPEG version I don't think its worth it.--User:Dittaeva 09:21, 21 Aug 2004 (UTC) :I agree with User:Erich gasboy; I think the thumbnail works well... draws attention to it without being exposed in its full glory -- so to speak -- to people who'd be repulsed (and yes, I find that picture nauseating, but useful). User:Mindspillage 01:42, 23 Aug 2004 (UTC) Dittaeva, let's hear why you think the limerick should stay. –User:Floorsheim 23:14, 19 Aug 2004 (UTC) :I agree with User:Ksheka, and I think removing it would reduce the quality of the article and reduce the information given. The Limerick gives a very good picture of how it could be have have syphilis at the time. But: I kind of agree with User:Andries too. :Conclusion if you: # Copy the limerick to [http://sources.wikipedia.org WikiSource]."dry" summary of short and long term symptoms for men and women. # Write "a "dry" summary of short and long term symptoms for men and women". :then I think you can replace the limerick with a link to it, but please, the above mentioned points should be carried out before replacing the limerick. --User:Dittaeva 16:58, 20 Aug 2004 (UTC) I would be alright with something to that effect. Why don't you work on putting that together? For now, I'm going to go ahead and snip the limerick. I think the information currently in the main body of the article is extensive enough that we can afford to go without the limerick for now. –User:Floorsheim 11:29, 21 Aug 2004 (UTC) == A limerick on syphilis == Quite a good description of how one might have suffered from syphilis back in the days before modern antibiotics. It starts out with him having a chancre; he goes on to develop secondary syphilis, losing his hair to secondary syphilis; following which he has all the common complications of tertiary syphilis before he ends up mad from neurosyphilis. The limerick (poetry) also mentions his wife catching it from him and then passing it on to his children. There was a young man of Back Bay, Who thought syphilis just went away, And felt that a chancre, Was merely a canker, Acquired in lascivious play. Now first he got acne vulgaris, The kind that is rampant in Paris, It covered his skin, From forehead to shin, And now people ask where his hair is. With symptoms increasing in number, His aorta's in need of a plumber, His heart is cavorting, His wife is aborting, And now he's acquired a gumma. Consider his terrible plight, His eyes won't react to the light, His hands are apraxia, His gait is ataxia, He's developing peripheral vision loss. His passions are strong, as before, But his penis is flaccid, and sore, His wife now has tabes dorsalis And congenital syphilis, She's really worse off than a whore. There are pains in his belly and knees, His sphincters have gone by degrees, Paroxysmal incontinence, With all its concomitants, Brings on quite unpredictable pees. Though treated in every known way, His spirochetes grow day by day, He's developed paresis, Converses with Jesus, And thinks he's the Queen of the May. == Inconsistant information == The article on Friedrich Nietzsche referred to in this article points out that the insanity that Nietzsche suffered is not consistant with syphilis infection, and that the accusation that he was a syphilis sufferer is probably a canard perpetrated by his detractors. From that article... "While the story of syphilis indeed became generally accepted in the twentieth century, recent research in the Journal of Medical Biography shows that syphilis is not consistent with Nietzsche's symptoms, and that the contention that he had the disease originated in anti-Nietzschean tracts." Perhaps the cross reference should be removed, or at least amended to indicate the questionable nature of the inference of syphilis? Shokaman :I'd go ahead and do what you suggested (remove nietzsche reference), but you should probably check the validity of what you just quoted first. --User:Dittaeva 14:59, 8 Nov 2004 (UTC) :You must consider that Nietzche's own sister did a major coverup of whatever was wrong with him after his death so that she could use his writings for her own pollitical agenda. I think it would be wrong to remove any reference for or against syphilis in his case until you had gotten multiple MODERN confirmations. And no, a single author on either side is not good enough. References to collected evidence should go on Talk:List of notable people identified as probably syphilitic. --User:Ssd 05:52, 9 Nov 2004 (UTC) == Removal of images == I have reverted User:GenerlaPattons last edits because they were in complete disregard of the discussion that has been held here. The edits also crippled the article as links with image captions in the beginning of paragraphs is just unusable. Please add your conserns/objections/replies to the discussion first if you'd want to revert. --User:Dittaeva 21:38, 3 Dec 2004 (UTC) :Well, i've got no reason to revert as i've started this policy discussion Wikipedia:Graphic and potentially disturbing images that i hope will give us guidelines on how to deal with such issues in the future. I hope you, and others, join in the discussion. User:GeneralPatton 23:01, 4 Dec 2004 (UTC) :Would anyone be opposed to a header announcing that it contains these pictures? I think it's really not obvious that the article would contain such images—especially for those who, like myself, were previously unaware of ''how'' syphilis affects in the body. :If there is support for such a header, how about the type of solution I crafted for Abu Ghraib prisoner abuse? Basically, we can make a version of the article with images suppressed by using the main article as a template. This does not duplicate the article, but creates a version without potentially offensive pictures. User:Cool Hand Luke Luke">User talk:Cool Hand Luke 19:27, 7 Dec 2004 (UTC) ==Syphilis in bones== I saw this picture [http://news.bbc.co.uk/1/shared/spl/hi/pop_ups/05/health_surgical_history/html/1.stm/1.stm] and i tried to think of how this disease affected the bones. I am somehow at a loss. Did it cut calcium intake? Would someone medically knowledgable include a more explicit sentence or two one how the bactaria affected bones please? That would make the article far more rich that most of the other writings out there :One of syphilis's major mechanisms of damage is through the formation of squishy painful lumps. (I seem to recall these are labeled ''tabes'' but I can't find a refernece for that.) These nodules can form anywhere -- on the surface of the skin, in nerve tissue (esp. the spine -- tabes dorsalis), in the heart muscle, and even in bones. The result of them in bones and joints is a painful arthritis. --User:Ssd 04:34, 12 Feb 2005 (UTC) ::There's more than one way for syphilis to produce bony manifestations, but the predominant one is the "gumma" or "gummatous lesion", which is a tumor-like inflammatory reaction provoked in direct response to the causative organism, the spirochete. If you look at a gumma under the microscope, you'll see dead cells (necrosis), epithelioid cells, and multinucleated giant cells, but you generally won't find the spirochete. Gummas in the knee were fairly common signs of advanced untreated syphilis. ("Tabes dorsalis" is a neurological manifestation of tertiary syphilis, but isn't itself related to any bony changes). - User:Nunh-huh 04:41, 12 Feb 2005 (UTC) == Bacteria ID == A recent anonymous changed the bacterium name for yaws in this article. I have no criteria to judge which is accurate and have no sources to hand. Any microbiologists out there?? ''Yaws (also Frambesia tropica, thymosis, polypapilloma tropicum or pian) is a tropical infection of the skin, bones and joints caused by the spirochete bacterium Treponema pertenue. Other treponematosis diseases are pinta (Treponema carateum) and syphilis (Treponema pallidum).'' - from the Yaws article. User:WBardwin 03:13, 8 Mar 2005 (UTC) :I thought I'd fixed that one, but it didn't seem to "take": I've done it again now - taking the chance to remove tangential, though related, diseases out of the first paragraph. ''Treponema pertenue'' and ''Treponema pallidum pertenue'' indicate the same organism. - User:Nunh-huh 03:20, 8 Mar 2005 (UTC) == History Section == I changed the history of Syphilis. Whoever posted the old history wrote that the columbian theory is weak and unsupported, wheras in reality is is probably more prevalent in scholarship today. I tried to be balanced in presenting both theories. User:Notenderwiggin :I moved this sentence from the head of the discussion page, placing it in date order and with a discussion topic. Please note significant history sections changes by the author above. Appears to me that too much was taken out of Pre-Columbian side of the controversy, which is hardly as weak today as the author seems to think. Will put some of the information back in. User:WBardwin 20:17, 20 Mar 2005 (UTC) I think the changes made by Notenderwiggin are very well balanced (and NPOV) and cover current evidence well. Perhaps too much was removed, but I don't think adding it back will make the article more well balanced. My personal feeling on this is that there was a more virulent strain in the new world, and although Christopher Columbus brought it back with him, it had been brought over first by others, but somehow did not reached epidemic levels and stayed local to where it landed previously. Perhaps the others were merely fishermen, where Columbus brought soldiers who traveled further when they came back. Similarly, there may have been cultural barriers to the disease's travel in ancient Greece. --User:Ssd 21:08, 20 Mar 2005 (UTC) :I left a note with the original author -- a brand new contributer!! -- and asked him to make changes before the rest of us chime in. I personally am on the Pre-Columbian side of the argument as there are too many human remains from historic and prehistoric Old World sites with evidence of congenital syphilis to call the disease new. However, from a biological point of view, some believe that a mutation from yaws produced the syphilis bug and that it has rapidly evolved in various niches worldwide ever since. See the Crosby reference. Having a New World strain collide with the Old World strain does seem a reasonable sequence, which perhaps led to the sudden explosion in Post-Columbian Europe. Consideration has to be made for the historic reporting problems with disease as well, as disease names were used very flexibly in the past. In particular, an accusation of syphilis infection was sometimes used as propoganda or a way of making a political enemy appear degenerate. Let's make these changes at a reasoned pace and try to present both sides of the issue. Comments welcome. User:WBardwin 23:45, 20 Mar 2005 (UTC) ::I'm in favor of the third idea now presented in history -- neither side has the whole picture. I think it is very clear that Columbus brought it back with him and started an epidemic in Europe. It is less clear (though I have been convinced with recent evidence) that it was already in Europe, although perhaps not wide spread or in a virulent form. I have also seen evidence that it was in the new world pre-Columbus, in both a skin and STD form, both of which were virulent. Also, the natives seem to have had ways of keeping it under control (like, with hot baths). As I said, I feel the article is now balanced. It gives about equal space to all three views. I think giving more than that is excessive unless we're going to divote a whole article on the history of syphilis, and talking about any one view more is POV until the experts come to agreement on one of them, which I suspect is not possible without a time machine. --User:Ssd 05:00, 21 Mar 2005 (UTC) Oh, for that time machine!. History is full of mysteries like this one -- little dibs and dabs of information but never a real answer. Let's see if our new contributor makes some changes and I'll look for a few more current references on all points. A quote from Crosby article might go well -- as would some archaeological confirmation from earlier European periods. Thanks for the interest. User:WBardwin 05:37, 21 Mar 2005 (UTC) Thanks for the help everybody, as noted I am a new Wiki contributer and am not sure of all the conventions yet. I tried to make the contribution balanced, I personally support the Crosby theory that Syphilis is a particular strain of Yaws that was brought back from the New World. If you think more evidence from the pre-columbian side should be put in then feel free to add it, but I think I left enough it there. I don't think we can go into to much more detail without creating a seperate page. If we want to create a new page for the History of Syphilis I could write some of the text, as it is an interest of mine, but I would need help creating a page and linking it properly. I think the really interesting thing is the spread of the epidemic from Naples and how the pathogen mutated so as be less virulent to spread itself better. I don't think we have room for this unless we start a new page though. User:Notenderwiggin 23:04, 28 Mar 2005 (UTC) :Hi! Welcome back. When I get around to tracking down your Crosby reference, I might tack a little more information to this article. I like the idea of a entire category on the History and Impact of Disease. The social impact of plagues and outbreaks was a subspecialty of mine as an undergrad. I've been playing with this in the plague area - with special pages on the three major outbreaks. History of syphilis would also be good, and I would be glad to help too. We might want to look over the Columbian Exchange article. User:WBardwin 00:29, 29 Mar 2005 (UTC) == Friedrich Nietzsche == An anon removed Nietzsche from the syphilus sufferers section. I think it probably should go back in/and so I'm reverting. I've read a couple of books that assert he had the disease. Does anyone have any idea why it was removed or disagree with putting it back? (I admit to questioning whether the article needs the section at all - but that is for another day.) Comments welcome. User:WBardwin 04:39, 20 Apr 2005 (UTC) :The question is where did these books get that information from. You should see if you can check the original sources. [http://www.opinion.telegraph.co.uk/news/main.jhtml?xml=/news/2003/05/04/wniet04.xml&sSheet=/news/2003/05/04/ixworld.html This article] claims that Nietzsche probably died of a brain tumor and that the syphilis story was created after the war by Wilhelm Lange-Eichbaum. The article summarizes Dr. Sax's claims regarding why he believes Nietzsche's symptoms were inconsistent with syphilis. Also, according to the Nietzsche article: "One of the best arguments against the syphilis theory is summarized by Claudia Crawford in the book ''To Nietzsche: Dionysus, I Love You! Ariadne''." User:Zensufi 02:22, 22 Apr 2005 (UTC) == Statistics/Sources == ''"United States has reported over 32,000 cases of Syphilis in 2002 and the cases were reported from 16 countries and 1 city. The number of cases of syphilis happened 20 to 39 years of age. Female’s highest cases were 20 to 24 years of age. Male’s highest cases were 35 to 39 years of age. The cases of congenital syphilis decreased from 2001 to 2002 in 2001, there were 492 cases of congenital syphilis in the 2002 it became 412 new cases syphilis and for the adolescence including mid adults between the ages of 15 and 34 who are sexually active have the highest rates of syphilis."'' :Anon. contribution to article moved here. Sources not cited and information needs improvement/clarity. User:WBardwin 07:46, 16 May 2005 (UTC) ''"Natchitoches, LA is the syphilis capitol of the world."'' :Anon. contribution to article moved here. Probable vandalism as no source or context cited. User:WBardwin 14:55, 16 May 2005 (UTC) ==Syphilis and malaria== Reportedly a dose of malaria was used to cure syphilis at one time. Is this true, and would it have worked? :Rather implausible. User:Jfdwolff | User_talk:Jfdwolff 21:33, 19 May 2005 (UTC) ::Yes, it doesn't seem like a good idea now, but it certainly occurred. See ''From mercury to malaria to penicillin: The history of the treatment of syphilis at the Mayo Clinic, 1916–1955'', which is cited in the article. It probably worked better than the equally improbable, yet true, concept of "bleeding"
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SB | SC | SD | SE | SF | SG | SH | SI | SJ | SK | SL | SM | SN | SO | SP | SR | SS | ST | SU | SW | SX | SY | SZ |Words begining with Syphilis:
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