The Story Of Syphilis Treatment

Table of Contents

Introduction

The sexually transmitted infection syphilis is caused by a spirochete called Treponema pallidum. This dry fact belies the fascinating history of the disease. Starting with the origin of syphilis, the story gets pretty twisted. Some believe Christopher Columbus brought T. pallidum back from the Americas; others believe it was always present in the Old World but was diagnosed as leprosy until the 1500s.

The confusion with leprosy stems from the fact that syphilis trots through the unlucky host in three stages.

First, the infected individual develops a chancre-an open ulcer usually on the genitals. These sores are teeming with spirochetes, but because they are not painful they can be overlooked or at least ignored. The next stage, secondary syphilis, is where the leprosy confusion arises. The most common sign of this syphilis stage is a rash that can be variable in nature, but can involve any part of the body including inside the mouth.

In fact, the medical specialty of dermatology has its origins in the diagnosis and treatment of syphilis. The last or tertiary stage of syphilis can be manifested as neurosyphilis, once called “general paresis of the insane” because the patient may become blind, lose mental agility, and develop motor paralysis. These ailments result from inflammation of the central nervous system triggered by persistent infection with T. pallidum.

Syphilis Treatment

Apart from the stigma that might be attached to contracting syphilis, there were compelling reasons to develop a cure. After the first major outbreak of syphilis in the 1500s, two treatments were advocated: a potion made from the guaiac tree and mercury ointments. Both were thought to cleanse the patient of syphilis “toxins,” the potion through severe sweating and diarrhea and the ointments through sweating and increased urination.

Apart from dehydration, guaiac treatment was relatively benign, but mercury treatment caused some to die. Nonetheless, various forms of mercury were used to treat syphilis through the beginning of the twentieth century, when it was replaced with arsenic-based compounds.

In fact, in 1908 the “father of antibiotics,” Paul Ehrlich, won a Nobel Prize for his arsenic-based medication, Salvarsan. Later Salvarsan was used to treat many soldiers in World War I, for their wounds of love rather than war. But Salvarsan was difficult to administer and, not surprisingly, had a number of toxic side effects. Antibiotic development was at the stage where arsenic was considered an improvement over mercury.

Salvarsan, as imperfect as it was, was only (sometimes) effective against primary and secondary syphilis. But in the early twentieth century, 5 to 10% of psychiatric inpatients had neurosyphilis. Serendipity led to the development of pyrotherapy; here the idea was that very high fevers could “cook to death” the syphilis spirochete. As WW I was raging in 1917, Austrian physician Julius Wagner-Jauregg encountered a wounded soldier who had malaria, which he could treat with quinine.

However, the soldier had also been diagnosed with the early stages of neurosyphilis. After allowing the soldier to endure rounds of high fever that characterize malaria, Wagner-Jauregg noted that the symptoms of neurosyphilis abated. In experiments that could never happen today for many reasons, Wagner-Jauregg took the soldier’s malaria-laden blood and infected nine other neurosyphilis patients; six were cured. Thousands of neurosyphilis patients would eventually be treated with malaria and Wagner-Jauregg won the Nobel Prize in 1927.

Conclusion

As this story illustrates, the search for cures to infectious disease is sometimes barely believable. Now very few people living in the industrialized West reach adulthood without having taken an antibiotic. But what does the term antibiotic really mean? Antibiotic (Greek anti, against; bios, life) refers to microbial products and their derivatives that kill susceptible microorganisms or inhibit their growth. The rise in antibiotic resistance among microbes has forced modern medicine to develop new drugs and rethink antimicrobial strategies. This chapter introduces the principles of antimicrobial chemotherapy and resistance.

Reference and Sources:

https://en.wikipedia.org/wiki/Syphilis
https://quizlet.com/ph/910236849/midterm-microbio-lab-antimicrobial-susceptibility-testflash-cards/
https://www.msdmanuals.com/professional/infectious-diseases/sexually-transmittedinfections-stis/syphilis

The Story of Syphilis Treatment