Syphilis is a sexually transmitted infection caused by the Treponema pallidum bacterium. The infection can be transmitted by direct contact with skin lesions or mucosa, generally found around the genitals or anus. It is also possible for mothers to transmit the infection to their children during pregnancy or childbirth (congenital syphilis). 

Many people with syphilis do not notice any symptoms. If untreated, syphilis lasts many years and presents with several stages, the symptoms of which mirror many other infections. 

In the primary stage, a round, painless, usually hard sore can appear on the genitals, anus or elsewhere. If this is left untreated then the disease can progress to the secondary phase, which includes a non-itchy rash, usually on the palms and soles of the feet, and white or grey lesions that appear in warm and moist areas. The symptoms can go away on their own and if left untreated, the disease progresses to the third and final stage of syphilis after years. Tertiary syphilis can lead to permanent damage to the heart, brain, bones, skin and other organs.

The "French Disease": A Scourge of Renaissance Europe

Syphilis first made its infamous entrance into historical records during the late 1400s.  At the time, Renaissance art flourished, and explorers set sail across uncharted waters. There was also, unsurprisingly, a major war on the European continent, the Italian War between France and the Holy Roman empire.

^{Triumphal entry of Charles VIII in Florence, November 17, 1494, by Francesco Granacci.}

By 1495, soldiers began to exhibit symptoms of a new disease. Many soldiers returned from the war with severe skin lesions and excruciating pain. At the time, French troops were blamed for spreading the mysterious disease, leading to its one of its earliest names - the "French Disease". Ever quick to deflect, the French called it the "Italian Disease," and so the blame game continued across borders, facilitated by the relatively new invention - the printing press.

During the Renaissance time period, this epidemic wasn’t just a health crisis—it was a moral panic. Since the disease was linked to sexual behavior, syphilis forced early public health officials to confront taboos around sexuality. It also sparked some of the first efforts in sexual health education.

A Mysterious Origin: Syphilis and the Columbian Exchange

The origins of syphilis have long been debated, with one of the theories linking it to the voyages of Christopher Columbus. According to the Columbian Exchange hypothesis, syphilis may have been brought back to Europe by Columbus’s crew after their first contact with the Americas in 1493. Skeletal evidence from pre-Columbian Native American remains suggests the presence of treponemal diseases related to syphilis, lending credence to the idea that the pathogen was present in the New World long before European contact. However, skeptics of this hypothesis argue that syphilis, or a related treponemal disease, may have quietly lingered in Europe before Columbus’s fateful voyage, only becoming virulent under new conditions.

Regardless of its precise origin, syphilis exploded across Europe soon after Columbus’s return, making the 1490s a pivotal decade in its history.

Medical Breakthrough: Penicillin and the End of an Era

For centuries, syphilis was treated with ineffective and often dangerous methods, including mercury ointments and arsenic compounds. The saying "a night with Venus, a lifetime with Mercury" became a grim reference to the dangerous treatments of the time. 

A controversial "malaria therapy" was introduced during World War I for patients suffering from later stages of the disease, when it reached paralytic dementia. In 1917, Austrian physician Julius Wagner-Jauregg (1857–1940) pioneered this method, deliberately inducing a fever by infecting patients with malaria parasites. His groundbreaking approach earned him the Nobel Prize in 1927 for demonstrating the curative potential of fever induced by malaria. 

^{Julius Wagner-Jauregg - University of Graz}

It wasn’t until the discovery of penicillin by Alexander Fleming in 1928, and its subsequent application in syphilis treatment during the 1940s, that the tide finally turned. Penicillin proved to be a miracle cure, transforming syphilis from a life-threatening affliction into a treatable infection.

^{Alexander Fleming, gemeinfrei, https://commons.wikimedia.org/w/index.php?curid=4870767}

Dr. William A. Hinton: Pioneer in Syphilis Diagnosis

Testing can be as important as treatment and one of the most significant advancements in diagnosing syphilis came from Dr. William A. Hinton, a pioneering bacteriologist. In 1934, he developed the Hinton Test, the first reliable diagnostic test for syphilis. His work greatly improved the accuracy of syphilis detection, helping to reduce the spread of the disease and its complications.

Dr. Hinton’s contributions extended beyond science. He was the first Black professor at Harvard Medical School, breaking barriers in academia and public health. His commitment to medical excellence and equality left an indelible mark on history.

Why Testing Matters

Early detection of syphilis is crucial to prevent serious health complications and the spread of the disease to others. Regular testing for sexually transmitted infections (STIs) is a cornerstone of responsible sexual health. Modern tests are quick, accurate, and widely available, ensuring effective diagnosis and treatment.