Syphilis: The Great Imitator

form that it takes down. The sex organs that that takes apart the face, takes apart your identity, and in some cases ultimately robbed you of your mind as well before killing you outright. Yeah, you mentioned sex organs. So also imagine that there's a moral to mention to this disease that would give you the sort of outward appearance that perhaps you had been engaging in conduct unbecoming to you. Yes, And of course, in all of this, we're talking about

a very real ill this and that is syphilis. We're actually going to devote two whole episodes to syphilis here. This first episode, Syphilis the Great Imitator, is mainly going to focus on the organism that causes syphilis and how

syphilis manifests itself in the human body. In the second episode, we are going to get into the cultural and historical impact of syphilis, because that that in its own right is an enormous topic of interest, because for four and a half centuries, syphilis ravages the Old World, ravages Western culture, and it's it's really kind of difficult to overstate the the role that syphilis played in coloring Western civilization during

that time. Yes, don't run away, because this is alf really interesting that the bacterium itself is fascinating, and then of course the cultural implications. Now we have our first recorded epidemic of venereal syphilis occurring in Europe, and by the close of the fifteenth century you have chaos just raining in Naples, Italy, where there's a huge outbreak. In fact, uh, Pope Innocent the eighth asked French King Charles the Eighth to invade the city with troops to try to keep

it under control. But what do you think happens? Well, as we would as we it would eventually learned, Sending troops then to deal with syphilis not the best strategy because because that they're going to end up catching the syphilis. And then when you draw the troops out, they're going to take the syphilis elsewhere exactly. And the problem here is that syphlis has being known as the great imitator because it has all these different symptoms that at the

outset might be mistaken for other illnesses. So imagine this time period in which this was happening and people not quite knowing what they were dealing with. Yeah, to quote Sir William Afler, he says, no syphilis in all its manifestations and relations and all other things clinical will be added to you. There is no organ in the body, nor any tissue in the organs, which syphilis does not invade.

And it is therefore manifestly difficult to speak, at least at all concisely of the pathology of the disease, just as as it is almost impossible to describe its clinical symptoms without mentioning almost every symptom of every known disease. And these symptoms are not going to be the same from one person to the next. So you have a disease that is that is seemingly very stealthy, very nefarious.

It's uh, it's it's changing its shape, it's changing its strategy, it's going dormant it's popping back up and uh and the whole time everyone's trying to understand what's going on, how to prevent it. Uh. Again, there there's there's this this whole seemingly moral side to it because it's spread through sexual contact, and it ends up spreading across every social level in society. Uh. It's it's a disease that

ravages the poor, it ravages the rich. It's hitting the royalty, it's hitting the clergy, it's hitting anyone who's engaging in sexual contact, which is everyone, right, And in fact, it is so prevalent that you get a couple of references to it in Shakespeare's works like pox of your houses and Romeo a nguliet, which is now a curse like a pox on you. It's but the problem with this is is that we tend to think of it as this

antiquated illness, right, it is not. In fact, The Centers for Disease Control estimate that annually more than fifty five people in the US get new syphilis infections, and during two thousand and twelve there were more than forty nine thousand reported new cases of syphilis, compared to forty thousand estimated new diagnosis of HIV. So it is still present and it is most common in people between the ages of twenty and twenty nine years of age, which has

led it to be called Cupid's disease by the way. Yeah, and of course, one other way we should mention that you can transfer syphilis is through an unborn child, and so congenital syphilis, which will we'll talk about a little bit more later. That's also a huge problem because when the syphilis manifests in a newborn child, uh, the the

the effects are kind it can be pretty disastrous. So once against syphilis, even though it is a tremendous interest from a historical standpoint, it is not a purely historical disease. Now we just don't put as much emphasis on it these days in terms of infectious diseases because it can be controlled by penicillin, and we'll talk about that later. Yes, yes, they can be wiped out by penicillin and uh uh.

And and that has been a huge advantage in the war against cephalis for sure, But still it is it is an adversary that that carries on even in the advent of what would seem a magic bullet. Yeah, and let's talk about this dastardly organism also known as Treponema palladum. Yes, such Treponema palladum, which is a treponemal disease. There are other treponemal diseases which will get into these and co

include a visual penta and yaws. None of these, of course are sexually transmitted, but they are essentially skin ailments that are that are transferred by skin to skin contact. Yes, so they are related to Treponema palladum, but they themselves, as you say, are not spread through sexual contact. And I should add to to be clear if you want to get really particular. Syphilis is caused by a subspecies

of Treponema palladum, essentially Treponema paladum palatum. But for all intents and references going forward, Treponema palladum ke palatum syphilis. You'll know what we're talking about. Yeah, Now, this is a spial shaped bacterium also known as a sparrow keet and that we're talking about slender, spirally undulating bacteria here and again. It is most often spread by sexual contact, and the disease occurs in three primary stages. We'll talk

more about that. And uh, now, these these later stages that will discuss are not so common in our modern era, right, yeah, because the later stages obviously deal with a case of syphilis that has not been treated, not been cured with the penicillin. All right, Well, let's let's start with transmission. And I'd like to sort of encourage you to think throughout this with an invasion. Sorry, all right, well, let's

let's talk about how syphilis is transmitted. And I'd like you to think about this, uh in terms of an invasion, because that's what it is. And we're dealing with an invasion of these spiral keets into the human body. And this invasion takes place in a few different phases. So syphilis can be spread again by through the through the birthless, sent by kissing, close contact, um, transfusion of fresh human blood. But the main ways that it's that it's spreading us

through sexual contact. We're talking vaginal sex, oral sex, anal sex um. All of these will serve as as a as an entry point. Now, the way that the spiro keets into the body they enter through the skin, and when intimate contact of this nature is made that is when when the spire key enters the body, enters through the skin and there it will hang out until it makes itself known in the form of a syphilitic sore, also known as a shanker. And shankers occur mainly on

external genitals that jina anus or in the rectum. They can also occur on the lips and in the mouth. So this is when you see most of the transmission occur among people when these sores are present. Right, this is primary syphilis. This is first stage syphilis. And think of this in terms of the enemy initially getting into the fortress. This is the shanker is literally the entry

point for the for the spiro keets. And it may be a small number of spire keets and maybe a larger number of spire keets, but this is where they're getting in. This is the whole in the fortress wall. Yeah. And these shankers can appear usually around twenty one days after infection, but sometimes as little as ten or even ninety days. Yeah, and it may hang around for three

to six weeks. And here's the thing. They can if you look up pictures online and sure, you should definitely go into a Google image search for for what these look like? Your loins, your your loins, but they may look pretty intense at times, but these are painless, uh, And they're easily confused with any number of small skin ailments that may pop up in even a healthy person's life, you know, the stuff like ingrown hairs or or you know, or various other bumps. So then would be caused by

by any number of other ailments. Again, it's a great imitator right now. If you do not get treated at this point, well then it gets into secondary syphilis. And during this stage that's when you see those skin rashes, swords in your mouth. And so that's the primary stage and the and it's key to note here that the shanker disappears advantishes. So if you were concerned about it, if you really, I wonder what this painless, you know, ugly spot on my genitals is, well, then it goes away.

And that's one of the day dangers that we see over and over again with syphilis is that the the infection seems to go away, the illness may seem to go away, but as we're about to learn, it does not. And again, imagine yourself in you know, the fifteenth century. If you have this and then that disappears and think, oh, everything is fine. I got upset over and over nothing, and maybe you didn't even notice. It's it's entirely likely

that one wouldn't even notice that the shanker had popped up. Now, most likely you wouldn't have been treated at that point in time because there wasn't anything necessarily to treat you with that was really effective. So it would then develop into a secondary stage called secondary syphilis, in which you would have skin rashes and or source in your mouth vagina and anus, often called mucus membrane lesions. Yeah, and you may also see other varying symptoms such as fever, lethargy, headaches,

general body aches, hair loss. And this is the point of the invasion in which the enemy, the me made it in in the primary stage and in secondary syphilis, the enemy has spread throughout the castle, all right, and and is making itself known throughout the invaded city, that is the human body, right, And you are highly contagious at this point. In fact, gentle, those sours caused by syphilis make it a lot easier to transmit and acquire things like HIV infection. Right, so you can get a

secondary infection at this point. In fact, there is an estimated two to fivefold increased risk of acquiring HIV if you're exposed to infection when syphilis is present in these

first and second stages. Now, at this point, after secondary syphilis, and here again we see that the secondary syphilis, this outbreak cut period, this goes away as well, which again could lead someone to say, well, that was horrible, and maybe they may not even realize that it was connected to the primaries outbreak, And they might, but they can easily imagine, well, I'm done with this now, it's it's

it's it's done. It's finished. Whatever illness was affecting me, the pox has left me, right, Yeah, But little do they know that this is just the latent stage of this and it's just waiting around. It might not even reveal itself for decades. Yeah. So imagine the enemy has invaded the castle, They've made a lot of mischief, and then suddenly they seem to be gone, But they're not gone. There in the basement. They're in the basement, they're in

there in every house in the city. There. They've literally become a part of the city. They're essentially a sleeper cell. Uh, and that is what latent syphilis is. Tertiary syphilis, the stage really is quite gruesome because it kind of takes everything in the body down to the studs are more so, I should say, it's like you say, the sleeper cells in the basements. They become stronger and they come roaring

back into the body and they cause a lot of havoc. Yeah, it's I mean, we see this over and over again with with syphilis, but it has such metaphorical power. Is one of the reasons that I think we're aside from its uh, its power to harm and his figuous uh, the reason we're drawn to it so is you do

see this idea of the the infection. It flared up, and it flared up again, and then it comes back in only fift The case is a much stronger form in the tertiary stage, far more debilitating, far more destructive and ultimately lethal stage of the illness. Yeah. In this late stage you could have sometimes that include difficulty coordinating your muscle movements, paralysis, not being able to move some

of your body, uh, numbness, blindness, and dementia. And then in the late late stages, the disease begins to ravage your internal organs, and that is what can result in death. And this is one of the remarkable things about this is that this stage can occur ten to twenty years after primary syphilis. So this is it's again the metaphoralthorical power of this. It's like the the sins of the young individual coming back to destroy the older individual. You know.

It's um, it's it's gruesome stuff, and and and and against that one may not even remember that first outbreak all that clearly, and suddenly all these changes are happening to their body and ultimately to their mind. Yeah, and we have largely up until this point treated this in a very clinical fashion and not really talked about the sights and the sounds and the spells of what this looks like, which you will do more in the next podcast.

But just know that at this point, um, this this this is really adding injury to insult because you might have lost your nose, you know, and recovered from that, and and all of a sudden you think you're out in the clear, and boom it comes back in in such a corrosive manner that you find out that this is really the death knell. Yeah, corrosive is an excellent term to use, because you see the you see a loss of teeth, you see the destruction of the palette

in the mouth. You see you see the the the collapse of the nose into what is known as saddle nose, where basically the nose collapses and around the bridge and becomes kind of upturned and smaller looking uh, and then may eventually um appear to rot entirely. Uh. Saddle nose is also caused can also be caused by just damage to the nose. You see boxers that suffer from saddle nose. Also extreme cocaine addiction can somehow sometimes have that effect

on individuals. But Yeah, you're seeing it attack your facial features. You're seeing it attack uh, your genitals in a very destructive manner, and then also getting into your organs. Again. To back to the quote that I read at the beginning of the podcast by uh Dr William Ostler, it it the spiral keets of syphilis attack every part of

the body like nothing is off limits. To go back to that castle analogy from from earlier, the invader has lived in the city for ten to twenty years and now in potentially every household in the city has decided to just burn everything to the ground. Right now. The other part of this is that simple is as we have mentioned before, can be transmitted through the placenta. So

what does this mean. It means that during that time period from the fifteenth century to the twentieth century, there are a lot of children born with syphilis also called congenital syphilis. And even to this day, corner of the World Health Organization, you have a million children born annually

with congenital syphilis. Yeah, and it's very serious stuff because nearly half of all children infected with syphilis, whether in the womb, guy shortly before or after birth, and sometimes this can also result in still borns um And despite the fact that syphilis can be cure with antbiotics if caught early, there are arising rates among pregnant women in the United States, and that of course has increased the

number of infants born with this. Now, some of the complications include blindness, deafness, deformity of the face, and nervous system problems. Now, why does syphilis hang out in the body so long, you might be wondering, Well, Uh, it's it maybe due in part to palladum having a slow dividing time of thirty to thirty three hours, and it's likely that P. Pallatum undergoes an even slower rate of

division during the latent stages of the disease. So it's a it's it's a long living creature from a bacterial standpoint, Yes, it's like a bacterial croc pot Yeah. Alright, um, let's talk about the current state of treatment and infections. Oh but I say current, I have to mention that there are a couple of old timey ways in which they were thought to be cures for it, one of which

is mercury. Yes, inhaling mercury vapor. In fact, there is This was so common for hundreds of years that a little phrase came out of that, A night with venus, a lifetime with mercury. Yeah. So you would find yourself going regularly for essentially skin treatments, taking these these mercury steam bats, and and enduring the harmful effects of that of that mercury relation on top of the ravages of syphilis. It did kill the sparrow key, but yes, it also

poisoned the patient. Yeah. Well, there are a few different factors involved. There because on one hand, uh, their you know, their arguments to what effect the mercury had in killing the sparrow keets, But then the sparrow keets are so entrenched in the body. What can you do. Also, again, think about that that primary and secondary stage, the flare

ups and the disappearance. You have individuals that could go into it to be treated for for their symptoms of syphilis, and lo and behold, the symptoms vanish with the treatment, not because of the treatment, just because of the timing of the treatment. And ultimately, again you're dealing with four and a half centuries in which there is no cure for this illness. So if someone's trying to sell you an illness, you're going to try and buy it. That's just how it goes. And you know, this disease is

ravaging my body. If you tell me that mercury might help, then I'm probably going to try mercury. Sure, You're gonna try anything at that point, including malaria, which is apparently something that was discovered in nineteen seventeen by Julius Wagner Jarig to help halt some of the symptoms of syphilis, particularly neurosyphilis that advanced stage in which you get psychosis and you get paralysis. And they found that if you induced a malarial fever in patients, well, that could help

with the actual infection. You also saw the use of so called ciphilization treatments. This was where you would essentially try to inoculate the patient in the same way that you would treat them for smallpox. Um, this didn't work, uh, But submitting yourself to the disease right right, Yeah, trying to to build up you know, bodily immunity doesn't work. Now, I've I've read some mixed reports of how experiments on rabbits uh in the modern age have potentially shown some

possibility there. But you get into a situation where it would take so many applications of syphilis and and we're talking about a rabbit and it hasn't been studied enough and you would certainly could not study it in humans. So so yeah, and then also want to study it when we have penicillin that can wipe it out. And sometimes it's diagnosed by testing fluid from a syphilis sore and looking for the sparrow keet via dark field microscopy.

The name of that blood test by the way, is the Wasserman blood test uh and it was developed in nineteen o six just to get everything in the timeline squared away there. So, as we had mentioned, symphilis can be treated with antibotics, So we're talking about penicillin. We're talking about G benzotine, doxycycline, or tetracycline, and that's for patients who are usually allergic to penicillin. In the length of treatment depends on the extent of the infection and

factors such as the person's overall health. So let's say you didn't get to it right away and you kind of get to the second or have a secondary phase of it, you would still have to deal with any sort of ill effects that you might have sustained at that point. All right, So at this point you might be wondering, what can I do two decrease my chances of catching syphilis. Well, according to the CDC, they're basically two things you can do because there's no there's no

vaccine for syphilis. We have a cure for syphilis. But then again you get into the problem of detecting it, knowing to report it, etcetera um. And then even once you've treated syphilis. There's no undoing any damage that it's done. Um, So number one, be a part of a long term, mutually monogamous relationship with a partner who has been tested and it has negative STD test results. And number two use latex condoms the right way every time you have sex.

Condoms prevent transmission of syphilis by preventing contact with a sore. Sometimes sores occurring areas not covered by a condom. However, in contact with these sores can still transmit syphilis because again it's about it. It's it come goes through the skin. It's not something that travels through the orifice. Now this might surprise you, but the people who really need to hear this most besides year olds, are senior citizens. Yes, and this surprised me. This was some some some interesting

material that you discovered. Yeah, we actually a while ago we had someone from the CDC come and talk to us about STDs. Not because our our group needed a talking to because the outbreak at work right now, but because every once in a while someone will come and and sort of give us information and and um, it's

always very interesting. And he had mentioned then that retirement communities, assisted living facilities these are all hotbeds for STDs, and this is in part because they are not practicing safe sex. And also you have to keep in mind that that for a long time, perhaps many of of the community members were in long term relationships, but now they probably have lost a partner. And it's a very social community.

There's a lot of sex going on within your citizens in these communities, and numbers from the Centers for Disease Control and Prevention show a rapid increase among older people. Were talking about between two thousand and seven and two thousand and eleven, clamydia infections among Americans sixty five and over increased by and syphilis by fifty two percent. See,

I just had I had no idea. I end up struggling to try and piece together, like a timeline for a hypothetical UH assisted living resident, how they acquire the syphilis and then how and then how they end up passing it on to multiple people in the facility. They just need to get the old posters, you know, in the nineteen forties and put them back up, and we'll talk more about that in the next episode. But there were definite campaigns, uh, you know, trying to get some

sort of awareness going with Americans about s TDS. Indeed, yes, we'll get into all of that in our next episode titled Syphilis through the Ages. Alright, so there you have it, UH, A little introduction there to syphilis, to treponema palatum, to the spiral keet, and with what it does to the body as it invades and then sets sets up a residence and ultimately in some cases tears the body down.

In our next episode we will get into all the cultural aspects of this, well maybe not all of them, but some of the high points for sure, the history of the disease in Western culture. UM, all of that. So do check that episode out. UM if you enjoyed this one. UH. In the meantime, be sure to head up stuff to Blow your Mind dot com. That is where you will find all of our podcast episodes are blog post our videos, links out to our various social media accounts and UH and when you do check out

the podcast page for this episode. In the next cephilis episode, I'll include some links to some cool resources about syphilis, about the history of the illness, as well as links to various blog posts that we put together that deal with the topics. So you can see some of these posters that we're talking about, you can see some images

of tertiary syphilis, etcetera. And after you've visit such to blow your Mind dot com and percolate on all of this, no doubt you'll have some thoughts that you want to

share with us, and you can do that. And also I wanted to mention if you have personal accounts of STDs that you want to share, be assured that we will not share your name, that we will keep this confidential, so you can send your missive to us about this stuff at blow the Mind at house touff works dot com for more on this and thousands of other topics. Does it How stuff works dot com