Syphilis: The Columbian Exchange

(Updated 8 February 06)

Syphilis is caused by a bacterium (a "spirochete") called Treponema pallidum

Three lectures on Syphilis

  • The Columbian Exchange
  • Syphilis as a precursor for HIV/AIDS
  • The Tuskeegee Study

The Columbian Exchange

  • Diseases
    • Syphilis, (controversial)
    • Smallpox, measles, etc. (certain)
  • Ecological and Sociological
    • potatoes and Maize
    • horses

The New World in 1490

  • Was it "new?"
    • human settlement ca. 30,000 BC
    • Isolation from Old World since about 10,000 years ago
  • General lack of large animals (died out in ice ages)
    • dinosaurs dies out much earlier, ca. 60,000,000 yrs. ago
    • All useful domesticatable animals died out between 40,000 and 10,000 years ago
      • horses, camels, mammoths, mastodons, giant sloths, saber-toothed tigers, woolly rhino, etc.
      • result, no plow animals

"Conquistador y Pestilencia"

A plague of conquerors and a plague of their diseases.

Smallpox: a viral disease

  • Endemic smallpox has mortality of about 3-10%
  • Epidemic smallpox is about 30% fatal for naive populations
    • e.g. Iceland in 1707, 18,000 deaths out of a total population of 50,000

Transatlantic crossing of Smallpox

  • normal cycle time of about 1 month
  • crossings by sailing ship take longer
    • must require a reinfection on shipboard
    • but most Europeans were immune.
    • still curious how it made it
  • reached Santo Domingo by 1519

Santo Domingo 1519

  • about 1/3 to 1/2 of the native population died
  • no Spaniard died
    • a few got sick
    • probably a mixed epidemic of smallpox and measles (another viral disease)
  • then on to Puerto Rico, Antilles, and Mexico

Cortez and Montezuma

  • Cortez invades Mexico
    • small force
  • Marches on Aztec capital
  • Trounced by Aztec army
  • Aztecs fail to follow up
  • Cortez gets allies from Aztec enemies
  • Defeats a greatly weakened Aztec army

What happened?

  • Some religious iconography suggests that Cortez is "of the gods"
  • Smallpox breaks out in the Aztec camp (not the Spanish) and decimates the army and kills the chief (Montezuma)
  • Power struggle and culture shock ensues
  • No organized resistance to Cortez

Effects of Introduction into Mexico

  • estimates say that population of central Mexico fell from 25 million to 17 million in a decade
  • had reached the Incan empire in Peru by the mid to late 1520's
    • Note: the epidemic PRE-dated the conquest of the Incans by Pizzaro -- cause and effect?

The Crisis of Incan Succession

  • Huayna Capac (great Incan emperor) dies of smallpox
    • so do many others in royal family
    • also many in bureaucracy
  • He had named his son Ninan Cuyoche as heir
  • Priests said Ninan's omens were "unfavorable"

The crisis worsens

  • Nobles risk everything and find another candidate
    • alas he died of smallpox before he could be crowned
  • Nobles returned to Ninan Cuyoche after all
    • alas he too died of smallpox before coronation
  • Two other sons began a great civil war of succession that divided the empire

Conquest of the Incas by Pizzaro

  • Pedro Pizzaro arrived after the civil war weakened the empire
  • First came the death followed by horrid disfigurement unknown in the Americas
  • Then came the Spaniards
    • horses, steel swords, guns, and immunity to Smallpox
  • No choice but to surrender
  • But more complicated than that!

Aztec and Incan Plagues

  • Effect of plague on Aztecs was decisive because it arrived WITH the Spaniards
  • Less of an effect on the Incans because it arrived BEFORE the Spaniards
  • In both (and all other) cases, cultural dislocation led to surrender of power and culture (religion) to the Spaniard influence

Effects on North America

  • Central and South America well documented
    • priests
    • tax collectors
    • military outposts
    • slavery
    • Effects on North America only now becoming known

What about New England?

  • Verrazzano (1532) Sailed North from NC to RI
    • Dense population, smoke from cooking fires even 100 miles away!
    • Remarkably healthy race!
  • By 1600, a lively British trade (200 English ships alone!) with densely populated coast.

Plagues and Peoples

  • By 1616, both sides has taken hostages
  • One group of French sailors threatened “God’s wrath”
  • A plague broke out (hepatitis A?) that raged for 3 years and probably killed 90% of the population of Northern New England!
  • A smallpox epidemic in 1637 decimated Southern New England

 

Estimates

  • Range from 1/3 of the population to 90% or more of the population destroyed.
  • Clear change in culture
  • May be less because few large cities
    • is that true?
  • DeSoto (tour of FL, AL, and GA) described large city
    • not there 70 years later

DeSoto’s March

  • Landed near modern Tampa
  • Marched through Fl, GA, NC, SC, TN, AL, MS, AK, TX, and LA. 
  • He was a slaver
  • Died along the way, but left a trail of disease and death behind.

Along the Mississippi

  • DeSoto (1540s)saw many great cities, with moats and walls.  The region was thick with population
  • LaSalle (1680s) found it almost deserted
  • Probable cause, disease carried by spanish pigs!
  • Caddoan populaton (Texas) fell from ca. 200,000 to about 8,500 in that time.  100 years later, it was ca. 1,400

The Columbian Exchange

  • Diseases
    • Syphilis (controversial)
    • Smallpox, measles, etc. (certain)
  • Ecological and Sociological
    • potatoes and Maize
    • horses

Syphilis: Was it part of the exchange? I will take the position "yes"

"The Bones"

  • First appear in Europe ca. 1493
    • no prior record of such symptoms
      • not even in Greece, China, India, Japan
  • No evidence of bone lesions (characteristic of one form of syphilis) before 1493
    • But there is evidence in the Americas from much earlier

"Eyewitness"evidence

  • Columbus' son's book
  • report of Fra Ramon (supposedly from ca. 1495)
    • Great Arawak Indian hero "had pleasure" with many women, but then needed many bathhouses to scrub himself clean of "French Disease"
      • Myths change slowly
      • Unlikely something newly invented

A Historians' evidence: LasCasas

  • Talked to sailors whose relatives were on the ships
  • Asked the Natives in the New World
    • they said it was as old as beyond memory
  • it was milder in the natives than in the Spaniards
    • suggests it was established already

A second historian: Oveido

  • in Spanish court in 1490's and knew Columbus before the voyages
  • went to New World in 1513
  • Called it "the Disease of the Indies"

a third "historian -- Diaz de Isla

  • (writing in 1539)
  • Claims he treated Columbus' crew for syphilis
  • He was the greatest syphilographer of his time
    • was he telling the truth or blowing his own horn?

Evidence against Columbian Origin of Syphilis

  • Similarity of syphilis and yaws
    • both from spirochetes (Treponema pallidum)
    • could just be a venereal form
    • central heating and insulation were making Yaws hard to spread and it may have needed a new way
  • Poor discrimination of diseases
    • was it formerly part of leprosy?
  • Syphilis then differs from syphilis now

Summary

  • New World origin of syphilis
    • the bones
    • the contemporary witnesses
    • the lack of descriptions in the orient
  • Old World origin
    • too much difference between then and now
    • absence of evidence not evidence of absence

Epidemiology of syphilis

  • Slow spread from 1493
  • In 1494-5 Charles VIII of France invaded Italy and France
  • Both Italy and France had epidemics by 1495-6
  • Reached Germany by 1495 (also Switzerland)
  • Greece, Holland, and England by 1496
  • N. Africa and Middle East by 1498
  • Russia and Hungary 1499
  • India by 1498
  • Canton (china) by 1505 (probably via Portuguese Sailors)
  • In early times, no shame associated, so many blunt, detailed records

The changing Face of Syphilis

  • 1494-1516
    • first small genital ulcers
    • then bad rash
    • then spread through body (esp. mouth)
    • large gummy tumors, agonizing muscle pain
    • then deterioration and death (common)
  • 1516-1526
    • bone inflammation and degeneration
    • sometimes hard genital warts or corns
  • 1526-1540
    • general decrease in symptoms and sequellae
  • 1540-1560
    • decrease in the more spectacular symptoms
    • Gonorrhea symptoms become dominant
  • 1560-1610
    • continued decline in symptoms
    • add "noise in the ears"
    • this is the modern form we know today

Old Treatment for syphilis

  • Mercury ("Unguentum Saracenum")
    • effective against "scabies" -- which also makes sores, so why not try here
    • the slobbering resulting from mercury poisoning also fit "humoral theory" -- purge the phlegm
    • it actually worked!
  • Gaiacum wood (probably did nothing)

Modern Syphilis

  • Three stages
    • Primary: usually a simple genital ulcer
    • Secondary: rash, fever, swollen glands, general malaise. Sometimes so mild it is unnoticed.
    • Latent period -- can last for many years. Bacteria are growing within body tissues
    • Tertiary: bacteria multiply in various tissues
      • effects depend on where they grow best
      • took a long time before it was clear that all the diseases were actually syphilis (cf. TB)
      • originally thought to have different spectrum of symptoms based on race

Modern Treatments

  • Mercury rubs (with bismuth to counteract Mercury poisoning)
  • Dr. Erlich's Magic Bullet Salvorsan
    • and Arsenic derivative
    • not a cure, but could arrest the disease
    • made a person non-infectious
  • Penicillin