Fatal attractions : AIDS and syphilis from medical, public and personal perspectives : an exhibition at the Wellcome Institute for the History of Medicine / Ken Arnold [and others].

  • Wellcome Institute for the History of Medicine
Date:
1995
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: Fatal attractions : AIDS and syphilis from medical, public and personal perspectives : an exhibition at the Wellcome Institute for the History of Medicine / Ken Arnold [and others]. Source: Wellcome Collection.

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    THE GREAT IMITATOR: SYPHILIS IN HISTORICAL PERSPECTIVE C A fter the first few weeks I claim [syphilis] as a medical affection. I often V.tell my students that [it] is the only disease which they require to study thoroughly. Know syphilis in all its manifestations and relations, and all things clinical will be added unto you'. So wrote Sir William Osier in 1897. In 1800, even the word syphilis was used sparingly in medical writings, although it had been coined in 1530 by Girolamo Fracastoro (1483-1553) in his medical poem about the affliction. Until the nineteenth century, however, doctors preferred to use more general phrases such as venereal disease, or the 'lues' (from the Greek for plague), or vernacular expressions such as 'the pox' or the 'great pox'. For one thing, medical opinion remained divided about whether gonorrhoea (the clap, the whites, spermatorrhoea, etc.) and syphilis were two separate diseases, or merely two stages within a single venereal disorder. For earlier generations, syphilis was principally an acute disease characterized by the primary sore (the chancre), and the rash. The latter meant that the affliction had to be differentiated from smallpox, hence the 'great pox'. Various chronic manifestations, mostly of a suppurative kind, were associated with syphilis, but only from the 1830s did doctors such as Philippe Ricord (1799-1889) in Paris begin systematically to study the long-term course of the disease. Ricord staged the disorder into its primary, secondary and tertiary phases, the first two corresponding to the chancre and the rash. Because the tertiary phases might not occur for ten, twenty or more years, or not at all in many patients, it is easy to see how the first two phases conformed to patients' and doctors' experiences. Ricord followed, over many years, patients who had contracted primary syphilis and was thus able to associate manifestations of the tertiary phase with an illness occurring much earlier. The tertiary phase might affect the heart and large blood vessels, it could lead to damage of the liver and kidneys, to the joints, to further skin disorders, or the brain and spinal cord. Other doctors such as Paul Diday He was speaking on behalf of the two generations of pathologists and clinicians which had demonstrated just how complex a disease syphilis is.