Some of the earliest records of clinical manifestations of syphilis, such as skin, bone, cardiovascular, and neurological lesions, date back to the last years of the 15th century, already appearing as an epidemic in Europe. However, more recent studies have identified, in American and Asian human fossils predating the great European voyages of discovery, deformations characteristic of the disease, meaning that its origin remains uncertain. Moreover, until the 19th century, syphilis was easily confused with other diseases, such as leprosy, scabies, mycosis, and leishmaniasis, since its diagnosis remained unknown until the creation of syphilography, the medical specialty dedicated to it.
Finger bones of a syphilis-infected infant who died at 6 months of age. Santa Isabel Collection, Lab. of Osteology, ENAH, Mexico
Image description: This is a photograph of a set of human bones and bone fragments, arranged against a dark background. On the left side, we see long, fragmented bones, while in the center there is a broken spine. On the right, we find short, small bones, some with rounded shapes. All the bones display a yellowish color, typical of fossils or ancient bone remains.In 1798, the Senate of the Chamber of Rio de Janeiro organized an inquiry to find out which were the most common endemic and epidemic diseases in the then federal capital. At the time, two of the three specialists consulted identified the so-called "venereal diseases" as having the highest incidence and attributed this result to a prejudice that was very common at the time: the "immorality reigning in the city." One of them, in particular, even went so far as to consider the idleness and wealth acquired through slave labor as the main causes behind this depravation of morals.
Although employing a distinct approach, this same moralistic underlying reasoning would end up being enshrined years later in the classic The Masters and the Slaves, by Gilberto Freyre. According to the sociologist from Pernambuco, syphilis, one of the best-known sexually transmitted infections, caused by the bacterium Treponema pallidum, would have arrived in Brazil with colonizing "miscegenation." In this sense, Freyre would write that, in Brazil, "civilization and syphilization" would have gone hand in hand; or, more than that: we would have been "syphilized" before being "civilized."
In Brazil, syphilography - a branch of biomedicine - became institutionalized between 1880 and 1920, with Rio de Janeiro serving as the center of the main chairs, societies, and specialized journals. On the one hand, initiatives such as the holding of the 1st South American Congress of Dermatology and Syphilography, held in Rio de Janeiro in 1918, revealed the stage of development and encouragement of research in the field. On the other hand, they highlighted the latent concern about the number of infected people, not only in the federal capital, but also in several other urban centers across the country.
"Syphilis cases in Brazil grow more than 2,000% in six years." O Globo Newspaper, 10/31/2017. Pedro Kirilos and Tatyane Mendes. Agência O Globo
Image description: This is a photograph of a medical setting, likely a doctor's office or clinic. On the left, there is a white table with several people wearing white medical clothing. A woman is holding a white paper and appears to be handing something out to the others. In front, there is another table where two women are working with medical equipment. On the right, there is an open red door, revealing a line of people waiting to be seen. The people in line are wearing a variety of clothing, including colorful shirts and jeans. The lighting is bright, highlighting the details of the setting.Since the beginning of the 20th century, society has no longer depended on treatments for syphilis involving bloodletting, baths, mercury rubs, or even confessions, purges, and fasts. In 1928, Alexander Fleming discovered penicillin, making the fight against syphilis more effective. Furthermore, all the scientific investment meant that syphilis stopped being seen as a sinful disease, the predominant view up to the 19th century; or as a form of madness, a sexual perversion, and even a facilitator of crime and immorality, interpretations that persisted until the mid-20th century. Even so, the disease seems far from being under control. In 2019, the Fundação Oswaldo Cruz (Fiocruz) published an article revealing that, since 2016, the country's health authorities have recognized the existence of a syphilis epidemic.
Drawing of a child with Syphilis. Source: "A Sifilis e a prenhez," thesis by Arnaldo Cavalcanti de Albuquerque, 1913. Faculdade de Medicina do Rio de Janeiro. Published on SciElo
Image description: This is a black and white illustration of a seated child. The figure is centered in the frame, with arms folded over the abdomen. The child's face is turned upward, with closed eyes and a slightly open mouth. The legs are crossed, and the drawing is simple, with no additional details.
