Syphilis is a disease frequently shrouded in many levels of mystery. It appeared suddenly in Europe in the late 1400s as a highly virulent and often fatal disease, a disease that could give Ebola a run for its money when it comes to sheer grotesque-ness. Victims may be covered with pustules from head to toe, diseased flesh peeled from their bodies, and patients may be in agonizing pain for weeks or months prior to death. However, after this inauspicious beginning, syphilis seems to have become less virulent, and instead shifted in presentation to more of the chronic disease that we know it as today.
Syphilis is caused by a bacterium called a spirochete: a twisted corkscrew-like organism named Treponema pallidum. The disease itself has been known by many names over the centuries, including "Morbus Gallicus" ("The French Disease") and the Great Pox, to distinguish it from other diseases such as smallpox. It's also known as "The great imitator," due to the non-specific symptoms it frequently causes.
Illness caused by T. pallidum is typically divided into three stages: primary, secondary, and tertiary. Shortly after initial infection, a lesion may appear on the genitalia; typically, these will resolve on their own in another few weeks' time. During the secondary phase, which can occur weeks or months later, a rash may appear on the body, typically over the extremities and frequently including the palms of the hands and soles of the feet. Myriad other manifestations may also present at this point, making the diagnosis of syphilis (especially without the characteristic rash) difficult in the centuries prior to identification of the causative spirochete. Tertiary syphilis, then, would frequently manifest a year to ten years (but sometimes as long as 50) after the initial infection. This also was difficult to definitively diagnose, as symptoms could include effects in a number of bodily systems, including the cardiovascular, digestive, and nervous system. The best-known tertiary effect include late stages of neurosyphilis, which can result in blindness, dementia, and paralysis.
In times gone by, just like today, acquisition of sexually transmitted diseases carried a stigma. This stigma, combined with the difficulty of making an accurate syphilis diagnosis (especially prior to the 1900s, but even after identification of the causative organism, diagnostic tests could still show false negatives), has resulted in quite a bit of rumors swirling around famous historical figures: had they been infected with syphilis? Hitler is but one of the historical figures investigated in Deborah Hayden's Pox: Genius, Madness, and the Mysteries of Syphilis. More below...
Hayden pulls together an impressive list of historical figures that, for one reason or another, have been suspected having been infected with T. pallidum. This includes Christopher Columbus, who (along with his sailors) is suspected of bringing syphilis to the Old World from the New during his voyages; Beethoven; Abraham and Mary Todd Lincoln; van Gogh; Nietzsche; James Joyce; and Hitler, among others (though one missed was Shakespeare, the subject of speculation in a 2005 Clinical Infectious Diseases article). Speculation about many of them is based on a few things they frequently had in common. One, rumors at the time of syphilis specifically, or mention of some "dread disease" that was kept secret from the general public. Two, evidence of treatment with drugs used at the time for the disease, including mercury, arsenic, and other toxic chemicals--or evidence of symptoms characteristic of initial infection with the bacterium. (Luckily today, syphilis is highly treatable with simple penicillin injections). Three, history of chronic illnesses: pain, lethargy, sometimes the more characteristic paralysis and insanity that could manifest in the tertiary stages. Four, evidence from the possible victim themselves--hints in their writings, their paintings, their compositions that may be clues to their own personal sufferings.
Hayden draws on a vast array of material to analyze the case for each figure. In each instance, she recognizes the difficulty of a retrospective diagnosis, especially of "the great imitator." It can be easy to read too much into rumor and innuendo, or to over-interpret the author's own works in the light of syphilis; the use of mercury and other "curative" chemicals can cause some of the same symptoms as syphilis itself; and syphilis itself can manifest in many different ways, so no universal trajectory of infection could be looked to for comparison. Additionally, the long latency period makes diagnosis difficult as well, as it can be from years to decades between initial infection and tertiary syphilis (or death from the infection). Therefore, each case is cautiously presented, and the evidence for and against a syphilis diagnosis is laid out without necessarily any conclusion as to the definitive diagnosis.
One drawback to the book is that Hayden does seem to assume the reader will already have quite a bit of familiarity with the historical figures she introduces. Therefore, in my opinion she's a bit scant on the background for some of them, and specifically, why we should care if they had syphilis or not. Now admittedly, I was a science major in college and didn't get nearly as much coursework in arts as I'd have liked, but I consider myself to have somewhat of a rounded education and know bits and pieces about classical music. However, reading about Guy de Maupassant, I didn't know before why I should care about him, and I still don't know. Similarly for Karen Blixen, for whom she gives one introductory paragraph on the significance of her life (and part of that is simply that she married her cousin and became a baroness). So she was the inspiration for wrote "Out of Africa"--...and? Hayden is long on the medical evidence, but short on the significance for many of the chapters.
Still, Pox is an interesting read. Like Diamond's Guns, Germs, and Steel, Hayden suggests ways that this infectious disease may have influenced the course of history. For example, several sources have suggested that Hitler (if indeed, he was infected with syphilis) traced his own infection to a Jewish prostitute he visited during his youth. If not for that chance encounter--if not for that infection--could the course of history have changed? Simplistic, to be sure, but an intriguing hypothesis nonetheless.
Image from http://www.cdc.gov/nchstp/od/tuskegee/images/sf1ep.jpg
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"For example, several sources have suggested that Hitler (if indeed, he was infected with syphilis) traced his own infection to a Jewish prostitute he visited during his youth. If not for that chance encounter--if not for that infection--could the course of history have changed?"
Hmm, that'd explain a lot - Hitler's obsession with hygiene, both in the literal and "racial" sense.
It'd also explain why Hitler forbade R&D on biological warfare. (At least, be a more complete explanation than his experience of gas attacks in WW1).
When i tell someone that i'm a bird watcher, they'll often try to get me to identify some bird they saw last month by scant description. Every now and then, i'll get it right with confidence.
And this must be similarly frustrating. But that's exactly how the current understanding of the Universe has evolved. Even type 1A supernovea can only be seen half way back to the big bang.
Not seeing what this has to do with Hitler and VD ...
Karen Blixen didn't "inspire" Out of Africa, she wrote it.
Apologies, I was going to elaborate a bit on the movie (indeed, based on Blixen's writings including her book of the same name) but didn't continue that train of thought. Still, while people might know of that movie, that's still from 20 years ago, and very little is given about just what made Blixen important, which was my point.
Can tertiary syphilis explain a span of more than twenty years between Mein Kampf and the beer-hall putsch in the '20's and the end of Hitler in the mid '40's?
De Maupassant rocks! Guy de Maupassant was a late-19th c. French author of short stories, strongly influenced by Edgar Allan Poe, among others. Many of his stories contain fantastic and supernatural elements. Others are quite erotic for their time. Arguably his most famous story is "The Horla," about a man attacked by an invisible Brazilian soul-vampire (no, really). Read it (it's short), and see why people might speculate as to his health and state of mind.
That's really hard to say. Syphilis can be so variable in its course, and a problem is that we really lack good observational studies of untreated syphilis let to run its course. (This is what Tuskegee was designed to investigate--something that was needed scientifically, but which became, and remains, completely unethical with the realization that syphilis could be easily treated with penicillin.) From historical data from people assumed to have syphilis, it isn't outside the realm of possibility that it could indeed lead to a gradually worsening dementia that led to Hitler's actions, but whether there's another good example that parallels that progression, I'm not sure.
and HP, um, interesting. I definitely prefer Poe, but yes, I see how it lends itself to speculation.
Lovecraft's parents had Syphilis and are reported as having died of it in an asylum. Howard himself lived in fear he had gotten "Hereditary Syphilis". The belief being that Syphilis could be inherited by the child from the mother. According to legend he is said to have rejoiced in developing pancreatic cancer because it meant he would not die of Syphilis.
Check out information on the spirochete involved with Syphilis. I believe you'll find that it's genetically identical with the spirochete responsible for Yaws.
Also note that the appearance of Syphilis also coincides with a change in sleeping arrangements throughout western Europe. Where once the spirochete could spread through ordinary physical contact it now required sexual contact. In addition, Syphilis can be spread through ordinary physical contact in the secondary stage.
While this is largely a misconception (it's not passed on via genetics, it's passed on due to the spirochete), there *is* the congenital form of syphilis, whereby the infected mother passes the organism onto her child during birth.
They're related, but not identical. Yaws is caused by Treponema pertenue, not pallidum. But it's confusion over whether Treponemal diseases were yaws or syphilis in the pre-Columbian era, and a reason why there remains some debate over the origin of syphilis--if it's truly a New World disease that was brought back with sailors, or if it originated in the Old World and was transported to the New, or some combination. That story alone is an interesting one on its own...maybe a topic for another post sometime...
Re Hitler
Although Hitler may have had syphilis, there is evidence that he also had Parkinsons' disease. Dr. Abraham Lieberman, an expert on Parkinsons' disease made an extensive study of all available newsreel footage of Hitler and discovered the following.
1. During the 1920s' Hitler, when making a speech, would gesticulate with both hands.
2. After he assumed power in Germany, Lieberman noticed that Hitler had stopped using his left hand, which was always hidden behind his back out of view of the camera.
3. Lieberman was able to find one newsreel where Hitlers' left hand is revealed and shows the typical Parkinsons' tremor.
4. Hitlers physician, the quack Morell, apparently administered a shot of a concoction which contained a dose of speed every morning. It is speculated that Hitler required a larger and larger dose of speed to keep going, as his Parkinsons' progressed.