Medicine and Disease in History: Syphilis


1996 series 200 Deutsche Mark banknote featuring Dr. Paul Ehrlich

By Ashlee Mosley

Note: Essay 2 in a series, all from Dr. Amanda McVety’s Spring 2019 class on Medicine and Disease in Modern Society

In the 1930’s syphilis was known as a sexually transmitted disease.  Even then syphilis was a preventable disease, but it still caused a worldwide panic.  Syphilis has been referred to as the “third great plague”, due to its significance in affecting the population all around the world.  The symptoms have stayed the same within 90 years.  Sores or lesions all over the body which vary in size and placement, they are usually painless.  Treatment and the social stigma has changed within this time frame.  In the past 90 years, the social perception of syphilis changed due to a shift in social acceptance and scientific understanding of the disease which resulted in more effective treatment.

            In the 1930s syphilis was STD that was caused by an organism called spirochete or treponeme.  It was long debated to decide which one caused syphilis.  Schaudinn was unable to determine the membrane which characterized spirochete, then suggested the name Terponema pallidum.   Though, it was also called Spirochaeta pallida during this time.  This organism is delicate and can be killed by the mildest of antiseptics and drying.[1]  During this time people did know that syphilis was preventable and curable if handled and caught in time.[2] 

Syphilis today is a systemic disease caused by spirichaete, Treponema pallidum. This can be transmitted the same way in 1930s, sexual acts, blood transfusion, or from mother to fetus in utero.  Syphilis has four different stages that it is broken up into.  There is primary, secondary, and early latent which are the early stages of syphilis and then there is late latent syphilis.  To put people into groups, anyone less than two years is early latent and more than two years without clinical evidence is referred to as late syphilis.[3]

It was known to be contracted not just from sexual acts but in other innocent ways.  People thought that by using contaminated and dirty dishes and utensils they would contract syphilis.  Infected money and simple kissing was thought to spread syphilis.[4]  In other works, it was said that prostitution was a main reason for the spread of syphilis.  Since prostitution was such a big thing, people believed that everyone who was a prostitute or was with a prostitute had syphilis. Everyone was at risk for syphilis, men, women, children, and even a fetus still in utero.  Children that are born with syphilis are more likely to be handicapped for the rest of their lives, physically and mentally.[5] 

To determine if one was to have syphilis they would administer blood test.  Treatment for syphilis was only handled at home until Dr. Ehrlich came up with “bullets”.  Patients can be discharged after a week in the hospital.  The new treatment does require treatment from a trained professional at the hospital.  The treatment was to take Dr. Ehrlich’s “bullets” and use an IV to get the medicine.  For poorer, malnutrition patients they would gain up to ten pounds during the week of care.  They would be on a continuous drip for five days and it was about ten quarts of the solution.[6]  Another type of treatment was the use of arsenic, bismuth and mercury which are nephrotoxic drugs but they can cause irritation to the kidneys.  Also the use of arsphenamines which causes severe damage to the liver.[7] 

            Today, to determine if someone has syphilis they would administer a blood test or test the cerebral spinal fluid.  The treatment for syphilis today is a single dose of penicillin if caught early.  In all cases, syphilis is curable if caught in time.  The penicillin will stop the sextually transmitted disease from progressing.  This works for people that have been infected for less than a year.  If pregnant, the doctor will only recommend penicillin.  The newborn child must receive antibiotic treatment as well.  Follow up treatment is to have periodic blood test to make sure the patient is responding well to the dosage of penicillin the doctor prescribed.  People should avoid sex until their sores have healed.  Still with this, they should always use condoms when engaging in sexual activity.  Even though cured, they can still get syphilis again.  [8]  Though syphilis can be cured, it cannot reverse any damage that has been done. 

            The public health officials proposed some action to help with the spread of syphilis.  They wanted to more control prostitution.  Control the marriage of someone who has syphilis and is not receiving treatment.  The officials also said they will punish people who do not receive treatment.  Start giving good treatment at the expensive of the state.  They want to work on earlier detection of syphilis and reporting all causes of sexual disease.2

            The social stigma around syphilis has changed in the way that is more accepted.  In the 1930s, Kaempffert wrote, “Nice people don’t have syphilis, nice people don’t have syphilis and nice people shouldn’t do anything about having syphilis.”4  Works about this disease are only for professionals.  They were published and put into libraries until many people were reading and talking about it.  During this time, if someone was to get syphilis it was as if they “deserved it.”  In the Third Great Plague, Stokes raised the question of why other sexually transmitted diseases were not seen as a sign of shame. Other STDs were not seen as bad or for bad people. Today, people today see syphilis as a risk.  Syphilis is not something that happens due to bad behavior or a bad person.  STDs in general is something that everyone has a risk of if they engage in sexual activity.  People are now trying not to brand people and make them feel bad for having a sexually transmitted disease.  This will cause people not to get tested and for them to spread this others without knowing. If people are not being safe or not getting tested then many more people are at risk for syphilis. 

            The social stigma of syphilis has changed for the better.  There are still going to be people that see it as the person is bad.  From the new understanding, this is just not the case.  The new treatment that has been developed has also helped with the social stigma.  Since it is easier to cure, it is not such a scary topic to talk about.  People are not ashamed to have syphilis anymore because it is not a bad thing.  Anyone is at risk for this anytime they engage in sexual activity. Within the past 90 years, the stigma has changed because of the new treatments and the moral understanding of what the disease is.

References

Kaempffert, Waldemar. “The Battle Against Syphilis: Dr. Parran’s “Shadow on the Land” Is A…” New York Times, August 1, 1937.

Kazanjian, Kaiden. “5 Day Treatment for Syphilis.” New York Times, April 13, 1940.

Lehman. “Lehman Urges War against Syphilis.” New York Times, February 5, 1937.

Moulton, Forest Ray. Syphilis: Presented by the Section on the Medical Sciences. American Association for the Advancement of Science by THE SCIENCE PRESS, 1938.

Nelson, Nels A., and Gladys L. Crain. Syphilis, Gonorrhea and the Public Health. New York: Macmillan Company, 1938.

Stokes, John H. The Third Great Plague: A Discussion of Syphilis for Everyday People. W.B. Saunders Company, 1917.

“Syphilis.” Mayo Clinic. January 16, 2019. Accessed March 05, 2019. https://www.mayoclinic.org/diseases-conditions/syphilis/symptoms-causes/syc-20351756

The WHO. “GUIDELINES FOR THE MANAGEMENT OF SEXUALLY TRANSMITTED INFECTIONS.” The WHO.

https://www.who.int/reproductivehealth/topics/rtis/treatment_syphilis.pdf.

[1] Nelson, Nels A., and Gladys L. Crain. Syphilis, Gonorrhea and the Public Health. New York: Macmillan Company, 1938.

[2] Stokes, John H. The Third Great Plague: A Discussion of Syphilis for Everyday People. W.B. Saunders Company, 1917.

[3] The WHO. “GUIDELINES FOR THE MANAGEMENT OF SEXUALLY TRANSMITTED INFECTIONS.” The WHO.

https://www.who.int/reproductivehealth/topics/rtis/treatment_syphilis.pdf.

[4] Kaempffert, Waldemar. “The Battle Against Syphilis: Dr. Parran’s “Shadow on the Land” Is A…” New York Times, August 1, 1937.

[5]  Lehman. “Lehman Urges War against Syphilis.” New York Times, February 5, 1937.

[6] Kazanjian, Kaiden. “5 Day Treatment for Syphilis.” New York Times, April 13, 1940.

[7] Moulton, Forest Ray. Syphilis: Presented by the Section on the Medical Sciences. American Association for the Advancement of Science by THE SCIENCE PRESS, 1938.

[8] “Syphilis.” Mayo Clinic. January 16, 2019. Accessed March 05, 2019. https://www.mayoclinic.org/diseases-conditions/syphilis/symptoms-causes/syc-20351756.

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