"Secret disease": Tracking syphilis through America
Main Article Content
Keywords
Syphilis, Stigma, Endemic, Abraham Lincoln, Bioarchaeology
Abstract
This review essay tracks syphilis, and the medical community’s responses to the disease, from the Colonial Period through the availability of penicillin in the 20th century (1585 to 1945). The essay demonstrates physicians actively aided their patients to hide their syphilis diagnosis due to the severe stigma associated with the disease. References from prominent figures from the 18th to the 20th centuries reveal an apparent debate within the medical community that lamented prioritizing patient privacy over public health, especially for a virulent, disfiguring disease. By mining data sources representing specific locations and broad regions it is suggested that syphilis likely became endemic in the USA sometime between 1810 and 1830. At that point, based on historical references, it appears that syphilis was widespread enough to persist endemically in most communities. A systematic analysis of bioarchaeological sites (28 sites; N=6,611; interments 1600-1944) is conducted to examine the rates and distribution of tertiary syphilis across time and by type of site. Reports demonstrate that no case of the disease has been found from a family, community, or military skeletal collection whereas all institutional skeletal collections report cases of tertiary syphilis with rates ranging from 1 to 19%. This pattern suggests an unrecorded cultural system was in place that culled individuals with tertiary syphilis from mainstream society and placed them in institutions where they were cared for by strangers, perished, and buried in anonymity. This study shows how bioarchaeology can provide significant information on disease and cultural practices not available from other sources.
References
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3. Parascandola J. Sex, sin, and science: a history of syphilis in America. New York: Greenwood Publishing Group; 2008.
4. Stokes JH. The third great plague: A discussion of syphilis for everyday people. New York: Saunders Press; 1917.
5. Francis AM. The wages of sin: how the discovery of penicillin reshaped modern sexuality. Arch Sex Behav 2013; 42:5–13.
6. Parascandola J. From mercury to miracle drugs: syphilis therapy over the centuries. Pharm Hist 2009; 51(1):14–23.
7. Tampa M, Sarbu I, Matei C, Benea V, Georgescu SR. Brief history of syphilis. J Med Life 2014; 7(1):4–10.
8. Manning C, Moore M. Sassafras and syphilis. N Engl Q, 1936; 9(3):473–5.
9. Willard FL, Aeby VG, Carpenter-Aeby T. Sassafras in the New World and the syphilis exchange. J Instr Psy 2009; 41:1–4.
10. Magner L. A history of medicine. New York: Marcel Dekker Press; 1992.
11. Winthrop J. The Journal of John Winthrop, 1630-1649. Boston: Harvard University Press; 2009.
12. Grob GN. The deadly truth: a history of disease in America. Boston: Harvard University Press; 2009.
13. Lowry TP. Venereal disease and the Lewis and Clark Expedition. Lincoln: U of Nebraska Press; 2004.
14. Baxter JH. “Illustrating by gradation of color the prevalence of syphilis,” in Statistics, medical and anthropological, of the Provost-Marshal-General’s Bureau, derived from records of the examination for military service in the armies of the United States during the late war of the rebellion. Washington, DC: US Gov’t Printing Office; 1875.
15. Hayden D. Pox: genius, madness, and the mysteries of syphilis. New York: Basic Books; 2003.
16. Herndon WH., Hertz E. The hidden Lincoln: From the letters and papers of William H. Herndon. New York: Viking Press; 1938.
17. Hirschhorn N, Feldman RG. Mary Lincoln's final illness: A medical and historical reappraisal. J Hist Med Allied Sci 1999; 54(4):511–42.
18. Dubos RJ, Dubos J. The white plague: tuberculosis, man, and society. New Brunswisk: Rutgers University Press; 1987.
19. Feldberg G. Disease and class: Tuberculosis and the shaping of modern North American society. New Brunswick: Rutgers University Press; 1995.
20. Leavitt JW. Public resistance or cooperation? A tale of smallpox in two cities. Biosecurity Bioterrorism Biodefense Strat Prac Sci 2003; 1(3):185–92.
21. Zipf KL. Bad girls at Samarcand: sexuality and sterilization in a southern juvenile reformatory. Baton Rouge: Louisiana State University Press; 2016.
22. Baker BJ, Armelagos GJ. The origin and antiquity of syphilis: paleopathological diagnosis and interpretation. Curr Anthropol 1988; 29(5):703–37.
23. Crosby Jr AW. The early history of syphilis: a reappraisal. Am Anthropol 1969; 71(2):218–27.
24. Harper KN, Zuckerman MK, Harper ML, Kingston JD, Armelagos GJ. The origin and antiquity of syphilis revisited: An Appraisal of Old World pre‐Columbian evidence for treponemal infection. Am J Phys Anthropol 2011; 146(53):99–133.
25. Meyer C, Jung C, Kohl T, Poenicke A, Poppe A, Alt KW. Syphilis 2001: a palaeopathological reappraisal. Homo 2002; 53(1):39–58.
26. Powell ML, Cook DC. The myth of syphilis: the natural history of treponematosis in North America. Gainesville: University Press of Florida; 2005.
27. Frith J. Syphilis: its early history and treatment until penicillin and the debate on its origins. J Mil Vet Health 2012; 20(4):49–58.
28. Karamanou M, Kyriakis K, Tsoucalas G, Androutsos G. Hallmarks in history of syphilis therapeutics. Infez Med 2013; 21(4):317–9.
29. Kępa M, Kozlowski T, Szostek K, Drozd A, Walas S, Mrowiec H, Grupa H. Analysis of mercury levels in historical bone material from syphilitic subjects—pilot studies. Anthropol Anz 2012; 69:367–77.
30. Zuckerman MK. More harm than healing? Investigating the iatrogenic effects of mercury treatment on acquired syphilis in post-medieval London. Open Arch 2016; 2(1):42–55.
31. Shogren MG, Turner KR, Perroni JC. Elko Switch Cemetery: An archaeological perspective. Birmingham: University of Alabama Press; 1989.
32. Maish A, Rose JC, Marks MK. Cedar Grove: African-American history in rural Arkansas. In remembrance: Archaeology and death. Westport: Bergin & Garvey; 1997. p. 105–18.
33. Novak SA. House of mourning: A biocultural history of the Mountain Meadows massacre. Salt Lake City: Utah University Press; 2008.
34. Buzon MR, Walker PL, Verhagen FD, Kerr SL. Health and disease in nineteenth-century San Francisco: skeletal evidence from a forgotten cemetery. Hist Arch 2005; 39:1–15.
35. McGloin CA. Crazy bones: evidence of insanity in the skeletal collection of the Colorado State Insane Asylum [master’s thesis]. Denver (CO): Colorado State University; 2007.
36. Larsen CS, Craig J, Sering LE, Schoeninger MJ, Russell KF, Hutchinson DL, Williamson MA. Cross Homestead: Life and death on the midwestern frontier. Bodies of evidence: Reconstructing history through skeletal analysis. New York: Wiley-Liss; 1995. p. 139–59.
37. Phillips SM, Dearth E. The Indiana frontier during the War of 1812: A bioarchaeological study of the siege of Fort Harrison. Ohio Valley Hist Arch 2007; 22:82–7.
38. Phillips SM. “Indian Orchard Cemetery, Terre Haute’s pioneer burial ground: Vigo County.” In, Highlighting hoosier archaeological sites – Examples from 92 counties. Amy Johnson, ed. © Copyright Indiana Department of Natural Resources, 2023.
39. Phillips SM. Treponematosis in 19th century USA: Evidence of dependency and stigma in an American institution. J Paleopath 2016; 26(1):9–13.
40. Phillips SM, Ellis E, Maynard M, Newton L, Moroz M, Rio SD. Bioarchaeology of the Vigo County Home cemetery: Recovering social systems of care for the impoverished, infirm, and disabled. Indiana Arch 2014; 9(1):229–52.
41. Killoran P, Pollack D, Nealis S, Rinker E. Cemetery preservation and beautification of death: investigations of unmarked early to mid-nineteenth-century burial grounds in Central Kentucky. In: Osterholtz AJ editor. Theoretical approaches to analysis and interpretation of commingled human remains. New York: Springer Press; 2016. p. 219–41.
42. Phillips SM. Bioarchaeology of a Kentucky pioneer family: The Vardeman-Holmes-Stephenson cemetery project, Lincoln County, Kentucky. Ohio Valley Hist Arch 2016 26:132–41.
43. Zuckerman MK, Kamnikar KR, Mathena SA. Recovering the ‘body politic’: A relational ethics of meaning for bioarchaeology. Camb Arch J 2014; 24(3):513–22.
44. Willey PA, Douglas D Scott. ‘The bullets buzzed like bees’: Gunshot wounds in skeletons from the Battle of the Little Bighorn. Int J Osteoarchaeology 1996; 6(1):15–27.
45. Buikstra JE, O’Gorman AO. Never anything so solemn: An archeological, biological, and historical investigation of the nineteenth-century Grafton Cemetery. Kampsville: Center for American Archeology; 1999.
46. Barrett AR, Blakey ML. Life histories of enslaved Africans in colonial New York: a bioarchaeological study of the New York African Burial Ground. Soc Bioarch 2011; 212–51.
47. Lanphear KM. Health and mortality in a nineteenth-century poorhouse skeletal sample [dissertation]. Albany (NY): State University of New York at Albany; 1988.
48. Pfeiffer S, Williamson RE. Snake Hill: an investigation of a military cemetery from the War of 1812. Toronto: Dundurn Press; 1991.
49. Phillips SM. Skeletal analysis of the Queesnbury Quaker Cemetery, Queensbury, NY. Unpublished CRM report; 1998.
50. Ficsher C. Archaeological investigations of the Albany County Almshouse, NY. Unpublished CRM report; 2004.
51. Phillips SM. Inmate life in the Oneida County Asylum, 1860–1895: A biocultural study of the skeletal and documentary records [dissertation]. Albany (NY): State University of New York at Albany; 2001.
52. Muller JL, Byrnes JF, Ingleman DA. The Erie County Poorhouse (1828–1926) as a heterotopia: a bioarchaeological perspective. In, The bioarchaeology of structural violence: A theoretical framework for industrial era inequality. New York: Springer Press; 2020. p. 111–37.
53. Sledzik, PS, Sandberg LG. The effects of nineteenth-century military service on health. In, The backbone of history: Health and nutrition in the Western Hemisphere, Cambridge: Cambridge University Press; 2002. p 185–97.
54. Ubelaker D, Jones E. Human remains from the Voegtly Cemetery, Pittsburgh, Pennsylvania. Smithsonian Contributions to Anthropology, Number 46. Washington, D.C.: Smithsonian Institution Press; 2003.
55. Davidson J. M. Freedman’s cemetery (1869-1907): A chronological reconstruction of an excavated African-American burial ground, Dallas, Texas [dissertation]. Fayetteville (AR): University of Arkansas; 1999.
56. Richards PB. Unknown man no. 198. The archaeology of the Milwaukee County Poor Farm Cemetery [dissertation]. Milwaukee (WI): University of Wisconsin-Milwaukee; 1997.
57. Atwell MM. The madness they endured: A biocultural examination of women's experiences of structural violence within 20th-century Missouri state mental hospitals. Int J Paleopath 2022; 39:75–84.
58. Zuckerman MK, Crandall J. Reconsidering sex and gender in relation to health and disease in bioarchaeology. J Anthropol Arch 2019; 54:161–71.
2. Brandt AM. No magic bullet: A social history of venereal disease in the United States since 1880. Oxford: Oxford University Press; 2020.
3. Parascandola J. Sex, sin, and science: a history of syphilis in America. New York: Greenwood Publishing Group; 2008.
4. Stokes JH. The third great plague: A discussion of syphilis for everyday people. New York: Saunders Press; 1917.
5. Francis AM. The wages of sin: how the discovery of penicillin reshaped modern sexuality. Arch Sex Behav 2013; 42:5–13.
6. Parascandola J. From mercury to miracle drugs: syphilis therapy over the centuries. Pharm Hist 2009; 51(1):14–23.
7. Tampa M, Sarbu I, Matei C, Benea V, Georgescu SR. Brief history of syphilis. J Med Life 2014; 7(1):4–10.
8. Manning C, Moore M. Sassafras and syphilis. N Engl Q, 1936; 9(3):473–5.
9. Willard FL, Aeby VG, Carpenter-Aeby T. Sassafras in the New World and the syphilis exchange. J Instr Psy 2009; 41:1–4.
10. Magner L. A history of medicine. New York: Marcel Dekker Press; 1992.
11. Winthrop J. The Journal of John Winthrop, 1630-1649. Boston: Harvard University Press; 2009.
12. Grob GN. The deadly truth: a history of disease in America. Boston: Harvard University Press; 2009.
13. Lowry TP. Venereal disease and the Lewis and Clark Expedition. Lincoln: U of Nebraska Press; 2004.
14. Baxter JH. “Illustrating by gradation of color the prevalence of syphilis,” in Statistics, medical and anthropological, of the Provost-Marshal-General’s Bureau, derived from records of the examination for military service in the armies of the United States during the late war of the rebellion. Washington, DC: US Gov’t Printing Office; 1875.
15. Hayden D. Pox: genius, madness, and the mysteries of syphilis. New York: Basic Books; 2003.
16. Herndon WH., Hertz E. The hidden Lincoln: From the letters and papers of William H. Herndon. New York: Viking Press; 1938.
17. Hirschhorn N, Feldman RG. Mary Lincoln's final illness: A medical and historical reappraisal. J Hist Med Allied Sci 1999; 54(4):511–42.
18. Dubos RJ, Dubos J. The white plague: tuberculosis, man, and society. New Brunswisk: Rutgers University Press; 1987.
19. Feldberg G. Disease and class: Tuberculosis and the shaping of modern North American society. New Brunswick: Rutgers University Press; 1995.
20. Leavitt JW. Public resistance or cooperation? A tale of smallpox in two cities. Biosecurity Bioterrorism Biodefense Strat Prac Sci 2003; 1(3):185–92.
21. Zipf KL. Bad girls at Samarcand: sexuality and sterilization in a southern juvenile reformatory. Baton Rouge: Louisiana State University Press; 2016.
22. Baker BJ, Armelagos GJ. The origin and antiquity of syphilis: paleopathological diagnosis and interpretation. Curr Anthropol 1988; 29(5):703–37.
23. Crosby Jr AW. The early history of syphilis: a reappraisal. Am Anthropol 1969; 71(2):218–27.
24. Harper KN, Zuckerman MK, Harper ML, Kingston JD, Armelagos GJ. The origin and antiquity of syphilis revisited: An Appraisal of Old World pre‐Columbian evidence for treponemal infection. Am J Phys Anthropol 2011; 146(53):99–133.
25. Meyer C, Jung C, Kohl T, Poenicke A, Poppe A, Alt KW. Syphilis 2001: a palaeopathological reappraisal. Homo 2002; 53(1):39–58.
26. Powell ML, Cook DC. The myth of syphilis: the natural history of treponematosis in North America. Gainesville: University Press of Florida; 2005.
27. Frith J. Syphilis: its early history and treatment until penicillin and the debate on its origins. J Mil Vet Health 2012; 20(4):49–58.
28. Karamanou M, Kyriakis K, Tsoucalas G, Androutsos G. Hallmarks in history of syphilis therapeutics. Infez Med 2013; 21(4):317–9.
29. Kępa M, Kozlowski T, Szostek K, Drozd A, Walas S, Mrowiec H, Grupa H. Analysis of mercury levels in historical bone material from syphilitic subjects—pilot studies. Anthropol Anz 2012; 69:367–77.
30. Zuckerman MK. More harm than healing? Investigating the iatrogenic effects of mercury treatment on acquired syphilis in post-medieval London. Open Arch 2016; 2(1):42–55.
31. Shogren MG, Turner KR, Perroni JC. Elko Switch Cemetery: An archaeological perspective. Birmingham: University of Alabama Press; 1989.
32. Maish A, Rose JC, Marks MK. Cedar Grove: African-American history in rural Arkansas. In remembrance: Archaeology and death. Westport: Bergin & Garvey; 1997. p. 105–18.
33. Novak SA. House of mourning: A biocultural history of the Mountain Meadows massacre. Salt Lake City: Utah University Press; 2008.
34. Buzon MR, Walker PL, Verhagen FD, Kerr SL. Health and disease in nineteenth-century San Francisco: skeletal evidence from a forgotten cemetery. Hist Arch 2005; 39:1–15.
35. McGloin CA. Crazy bones: evidence of insanity in the skeletal collection of the Colorado State Insane Asylum [master’s thesis]. Denver (CO): Colorado State University; 2007.
36. Larsen CS, Craig J, Sering LE, Schoeninger MJ, Russell KF, Hutchinson DL, Williamson MA. Cross Homestead: Life and death on the midwestern frontier. Bodies of evidence: Reconstructing history through skeletal analysis. New York: Wiley-Liss; 1995. p. 139–59.
37. Phillips SM, Dearth E. The Indiana frontier during the War of 1812: A bioarchaeological study of the siege of Fort Harrison. Ohio Valley Hist Arch 2007; 22:82–7.
38. Phillips SM. “Indian Orchard Cemetery, Terre Haute’s pioneer burial ground: Vigo County.” In, Highlighting hoosier archaeological sites – Examples from 92 counties. Amy Johnson, ed. © Copyright Indiana Department of Natural Resources, 2023.
39. Phillips SM. Treponematosis in 19th century USA: Evidence of dependency and stigma in an American institution. J Paleopath 2016; 26(1):9–13.
40. Phillips SM, Ellis E, Maynard M, Newton L, Moroz M, Rio SD. Bioarchaeology of the Vigo County Home cemetery: Recovering social systems of care for the impoverished, infirm, and disabled. Indiana Arch 2014; 9(1):229–52.
41. Killoran P, Pollack D, Nealis S, Rinker E. Cemetery preservation and beautification of death: investigations of unmarked early to mid-nineteenth-century burial grounds in Central Kentucky. In: Osterholtz AJ editor. Theoretical approaches to analysis and interpretation of commingled human remains. New York: Springer Press; 2016. p. 219–41.
42. Phillips SM. Bioarchaeology of a Kentucky pioneer family: The Vardeman-Holmes-Stephenson cemetery project, Lincoln County, Kentucky. Ohio Valley Hist Arch 2016 26:132–41.
43. Zuckerman MK, Kamnikar KR, Mathena SA. Recovering the ‘body politic’: A relational ethics of meaning for bioarchaeology. Camb Arch J 2014; 24(3):513–22.
44. Willey PA, Douglas D Scott. ‘The bullets buzzed like bees’: Gunshot wounds in skeletons from the Battle of the Little Bighorn. Int J Osteoarchaeology 1996; 6(1):15–27.
45. Buikstra JE, O’Gorman AO. Never anything so solemn: An archeological, biological, and historical investigation of the nineteenth-century Grafton Cemetery. Kampsville: Center for American Archeology; 1999.
46. Barrett AR, Blakey ML. Life histories of enslaved Africans in colonial New York: a bioarchaeological study of the New York African Burial Ground. Soc Bioarch 2011; 212–51.
47. Lanphear KM. Health and mortality in a nineteenth-century poorhouse skeletal sample [dissertation]. Albany (NY): State University of New York at Albany; 1988.
48. Pfeiffer S, Williamson RE. Snake Hill: an investigation of a military cemetery from the War of 1812. Toronto: Dundurn Press; 1991.
49. Phillips SM. Skeletal analysis of the Queesnbury Quaker Cemetery, Queensbury, NY. Unpublished CRM report; 1998.
50. Ficsher C. Archaeological investigations of the Albany County Almshouse, NY. Unpublished CRM report; 2004.
51. Phillips SM. Inmate life in the Oneida County Asylum, 1860–1895: A biocultural study of the skeletal and documentary records [dissertation]. Albany (NY): State University of New York at Albany; 2001.
52. Muller JL, Byrnes JF, Ingleman DA. The Erie County Poorhouse (1828–1926) as a heterotopia: a bioarchaeological perspective. In, The bioarchaeology of structural violence: A theoretical framework for industrial era inequality. New York: Springer Press; 2020. p. 111–37.
53. Sledzik, PS, Sandberg LG. The effects of nineteenth-century military service on health. In, The backbone of history: Health and nutrition in the Western Hemisphere, Cambridge: Cambridge University Press; 2002. p 185–97.
54. Ubelaker D, Jones E. Human remains from the Voegtly Cemetery, Pittsburgh, Pennsylvania. Smithsonian Contributions to Anthropology, Number 46. Washington, D.C.: Smithsonian Institution Press; 2003.
55. Davidson J. M. Freedman’s cemetery (1869-1907): A chronological reconstruction of an excavated African-American burial ground, Dallas, Texas [dissertation]. Fayetteville (AR): University of Arkansas; 1999.
56. Richards PB. Unknown man no. 198. The archaeology of the Milwaukee County Poor Farm Cemetery [dissertation]. Milwaukee (WI): University of Wisconsin-Milwaukee; 1997.
57. Atwell MM. The madness they endured: A biocultural examination of women's experiences of structural violence within 20th-century Missouri state mental hospitals. Int J Paleopath 2022; 39:75–84.
58. Zuckerman MK, Crandall J. Reconsidering sex and gender in relation to health and disease in bioarchaeology. J Anthropol Arch 2019; 54:161–71.
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May 23, 2024
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"Secret disease": Tracking syphilis through America. Med Histor [Internet]. 2024 May 23 [cited 2024 Jun. 30];8(1):e2024007. Available from: https://mattioli1885journals.com/index.php/MedHistor/article/view/15736
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Review articles: History of Medicine
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
"Secret disease": Tracking syphilis through America. Med Histor [Internet]. 2024 May 23 [cited 2024 Jun. 30];8(1):e2024007. Available from: https://mattioli1885journals.com/index.php/MedHistor/article/view/15736