Syphilis has influenced human health and society, leaving a visible mark throughout history. This bacterial infection has impacted countless lives, shaping medical understanding and societal perceptions. Its presence has been documented in various forms, reflecting scientific and cultural responses.
Understanding Syphilis
Syphilis is an infection caused by the bacterium Treponema pallidum. This spirochete is primarily transmitted through sexual contact with infectious lesions or from a mother to her fetus during pregnancy. The disease progresses through distinct stages if left untreated. Penicillin, particularly benzathine penicillin G, is the preferred medication for all stages of syphilis. Alternative treatments like doxycycline or tetracycline can be used for patients with penicillin allergies.
The Visible Progression of Syphilis
The progression of syphilis unfolds in several stages, each presenting distinct physical manifestations.
Primary Syphilis
The first sign of primary syphilis is typically a chancre, a small, firm, and usually painless sore that appears at the site where the bacteria entered the body. These chancres often develop within 10 to 90 days after exposure. Common locations include the genitals, mouth, or anus, and due to their painless and sometimes hidden nature, they may go unnoticed. The chancre usually heals on its own within three to six weeks, even without treatment, but the infection persists in the body.
Secondary Syphilis
Secondary syphilis manifests as a widespread rash, appearing two to twelve weeks after the chancre develops. This rash is characterized by reddish-brown, small, solid, flat, or slightly raised lesions that are not itchy. It commonly affects the trunk, palms of the hands, and soles of the feet. Other mucocutaneous lesions, such as moist, wart-like sores called condyloma lata, can develop in warm, moist areas like the anogenital region. Systemic symptoms accompany the rash, including fever, fatigue, sore throat, muscle aches, headaches, weight loss, and patchy hair loss, sometimes described as “moth-eaten” alopecia.
Latent Syphilis
If left untreated, secondary syphilis transitions into the latent stage, where there are no visible signs or symptoms. This hidden stage can last for many years, even decades. During this time, the bacteria remain in the body, and while the individual is less contagious, the infection can still be transmitted from a pregnant person to their baby.
Tertiary Syphilis
Tertiary syphilis, the most severe stage, can develop years to decades after the initial infection in about 25-40% of untreated individuals. This stage can cause extensive damage to various organ systems. One manifestation is gummas, large, soft, rubbery growths that can appear on the skin, bones, or internal organs, potentially leading to significant tissue destruction. Cardiovascular syphilis, affecting the heart and blood vessels, can lead to conditions like aortitis or aortic aneurysms, often appearing 10 to 25 years after the initial infection. Neurosyphilis, impacting the brain and spinal cord, can cause neurological and psychological issues, including changes in behavior, memory loss, paralysis, seizures, and vision problems.
Depicting Syphilis Through History
Syphilis has been visually documented and portrayed across centuries, providing a unique historical record of the disease and its societal impact. Early medical illustrations and anatomical drawings played a significant role in depicting syphilitic lesions and their progression. These detailed drawings appeared in dermatological atlases and medical texts, serving as educational tools for physicians and aiding in diagnosis. These visual records allowed for the precise study of the disease’s physical manifestations.
Artists and satirists also used visual media to comment on syphilis, its social consequences, and perceived origins. Albrecht Dürer’s 1496 woodcut, “The Syphilitic Man,” is one of the earliest known pictorial representations of the disease, showing a figure with visible lesions and reflecting widespread concern during a major syphilis outbreak. This artwork, often accompanied by text explaining the disease, blended observable symptoms with astrological and moral interpretations of suffering. Such depictions illustrated the physical aspects of syphilis and reflected societal attitudes, sometimes linking the disease to moral failings or demonizing certain groups. These historical drawings offer insights into how past societies perceived, studied, and reacted to this illness.