The Rise and Fall of Syphilis in Renaissance Europe

Abstract

The rapid changes that syphilis underwent after the first major outbreak that occurred in Naples in the mid-1490s are believed to constitute the first well-documented example of a human disease. The new plague was of exceptional virulence, highly contagious and causing severe ulceration at the site of infection. According to medical and other historical sources, the 'genius epidemics' changed some years after this onset, and a slower-progressing form of syphilis seems to have replaced the initial severe form, as do many virulent epidemic infectious diseases that appear in devastating forms in a previously uninfected population. But what exactly were the features of the disease at the moment of its appearance in Europe at the end of the fifteenth century? How many years did it take for the early, virulent form to be replaced and become endemic? What was the pace of these changes through the decades following the onset of the epidemic? In this essay, I review these issues through an analysis of a large number of chronologically-ordered primary historical sources.

Prevention Strategies and Changes in Sexual Mores in Response to the Outbreak of Syphilis in Europe in the Early Modern Age

“…His contemporary Giovanni da Vigo, surgeon to Pope Julius II, describes the primary chancre on the genitalia followed by a latent period and the secondary stage of the disease with skin manifestations. He also mentions the severe pains that occurred, especially at night [8]. All contemporary sources, from physicians to chroniclers, to the sick who left personal stories, are unanimous in emphasising the violent and malignant character of syphilis at the beginning of the epidemic in the early 16th century [9].…”

Plague, pox and the physician in Aberdeen, 1495–1516

“…Secondary manifestations included painless regional lymphadenopathy, fever, mouth ulcers and a maculopapular rash, which could give way to the erosion of tissue in the extremities, painful tumours and eventual death. 1,2,4 The appearance of genital ulcers in the primary phase distinguished the Great Pox from the more familiar symptoms of plague and were most likely identifiable to the Aberdeen authorities despite the absence of a resident physician. Sexual promiscuity was therefore held particularly culpable for its spread, resulting in the city's prostitutes being targeted.…”

“…Many participants would have returned home to Scotland, probably bringing with them the disease and reports of its existence. 1,8 Not only did Scottish mercenaries participate in continental campaigns such as Charles VIII's attempted conquest of the kingdom of Naples, but foreign soldiers also joined forces that were involved in the ongoing Anglo-Scottish hostilities and their participation could plausibly have been a factor in spreading the Great Pox to Scotland. Perkin Warbeck, a pretender to the English throne under the guise of the duke of York, was first received at the court of Charles VIII of France and, having arrived at the Scottish King James IV's court in November 1495, subsequently launched a joint invasion of England from Scotland with the king's forces in September 1496.…”

Treponemal disease in the Old World? Integrated palaeopathological assessment of a 9th–11th century skeleton from north-central Spain

“…In the late 15th century, the first outbreak of this epidemic was reported in the Old World, carried and disseminated by mercenaries accompanying King Charles VIII of France in the invasion of Italy. In the 16th century syphilis became more widespread but reportedly became less virulent (Quétel, 1990;Sefton, 2001;Tognotti, 2009), and a controversy started about whether this disease could be a result of the mutual European-American discovery (Berlinguer, 1992). The exchange of infectious diseases in this context, at least from Europe to America was not rare, and some examples are very well known, such as influenza, poliomyelitis, rabies, smallpox, measles, and mumps.…”

“…Considering this fact and the existence of one account, albeit of dubious accuracy, of a syphilis outbreak in Barcelona in 1493 (Meyer et al, 2002), there exists the possibility that many early episodes of the epidemic could have actually taken place in Spain. This might have been historically unnoticed, given the presumably high mobility of sailors in the past and the documented speed with which the epidemic moved (Tognotti, 2009), which would have made any area of the European continent equally affected in a few years. While this is a hypothesis to consider, it is not currently supported by available data, as, to our knowledge, there have been relatively few published cases of palaeopathological putative acquired syphilis (Reverte, 1979;Lopes and Cardoso, 2000;Codinha, 2002;De Souza et al, 2006;Rissech et al, 2013;Schwarz et al, 2013) coming from the Iberian Peninsula before the Modern Age.…”