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 French disease.
The route of transmission is almost invariably by sexual contact; however, there are examples of direct contact infections 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.
If not treated, syphilis can cause serious effects such as damage to the nervous system, heart, or brain. Untreated syphilis can be fatal. If you think you might have syphilis, or if you find out that a sex partner had or might have had syphilis, see a doctor as soon as possible.
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 effective, method is to inject procaine penicillin into each buttock (the procaine is added to make the pain bearable, and 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 resistent 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.
Health care professionals suggest that safer sex practices such as the use of condoms should be used in sexual activities, but they should by no means be considered an absolute safeguard. The best suggestion is to avoid sexual activities with anyone known to have a sexually transmissible disease, and indeed anyone whose disease-negative status you aren't certain of.
__History__
The origins of syphilis are not known, though it does appear to have been documented by Hippocrates in Classical Greece in its venereal/tertiary form. This form was known in a Greek city of Metaponto in Italy about 600 BC, and at Pompeii where additional archaeological evidence of uniquely grooved teeth of the children of mothers with syphilis has been found.
Evidence of syphilis in medieval Europe has been found at the site of a 13-14th century Augustinian friary in the northeastern English port of Kingston upon Hull.
This friary provided medical care including palliative care and burial rites for "wretched souls". Skeletons discovered at the friary bear bone lesions typical of tertiary venereal syphilis. Carbon dating affirms these skeletons were buried during the existence of the friary, which was destroyed in 1539.
Examination of the friary site revealed bone lesions on two-thirds of the skeletons, including those closest to the altar, a position reserved for the richer and more generous patrons of the order.
This suggests the privileged of Hull had had syphilis for a long time. At that time, Hull was the second largest port of England after London and was a sophisticated metropolitan international port.
Another school of thought has it that syphilis was brought back to Europe from the New World by the crew of Christopher Columbus's first voyage. The evidence is weak and circumstantial, and based on the fact that the first recognized outbreak was at Naples in 1494 where a number of Spaniards from the Columbus crew participated in the army of Charles VIII of France. This theory is challenged by the evidence of syphilis in Hull.
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 "Italian" or "Neapolitan disease", the Russians called it the "Polish 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, beginning with Charles VIII himself, 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.
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.
__Primary syphilis__
Chancres on penis due to primary syphilitic infectionPrimary 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__
Secondary syphilis manifested on labiaSecondary 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.
Neurological 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 complications include aortic aortitis, 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 CDC, 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: 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.
As the disease became better understood, effective treatments began to be found, beginning with the use of the arsenic-containing drug Salvarsan from 1910. 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, 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 (ie: anaphylaxis) can be effectively treated with oral tetracyclines.
__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 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 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. A character in Ibsen's play "Nora" 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 anarchist 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.nike air max 1 yeezy