August 26, 2014 • 26 mins
Doctors have called it the great imitator because this destructive venereal disease can manifest almost any symptom. Initially spreading through sexual contact, Syphilis can remain dormant in the body for decades before flaring up again in brutally disfiguring, debilitating and deadly ways. In this episode of Stuff to Blow Your Mind, Robert and Julie explore the science of syphilis.
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Speaker 1 (00:03):
Welcome to Stuff to Blow your Mind from how Stuff
Works dot com. Hey, you welcome to Stuff to Blow
your mind. My name is Robert lamp and Julie Douglas,
and I'd like you to take a moment to just
try and create. Try and imagine the most destructive disease possible.
Imagine a disease that ravages the body. That ravage is
(00:27):
just about every tissue, every every part of the human
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
(00:48):
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
(01:08):
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,
(01:33):
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
(01:57):
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
(02:18):
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
(02:41):
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
(03:02):
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,
(03:24):
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,
(03:48):
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
(04:09):
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
(04:31):
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
(04:53):
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.
(05:15):
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
(05:38):
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
(06:02):
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
(06:25):
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,
(06:45):
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
(07:06):
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
(07:26):
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
(07:47):
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,
(08:09):
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
(08:32):
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
(08:55):
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
(09:19):
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
(09:40):
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
(10:01):
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
(10:24):
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
(10:44):
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
(11:06):
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
(11:28):
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
(11:51):
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.
(12:13):
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
(12:35):
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
(12:58):
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
(13:21):
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
(13:43):
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
(14:03):
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
(14:24):
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
(14:47):
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
(15:07):
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.
(15:31):
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
(15:53):
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
(16:16):
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
(16:38):
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
(17:01):
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
(17:22):
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
(17:43):
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
(18:06):
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
(18:28):
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
(18:50):
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
(19:14):
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,
(19:40):
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
(20:04):
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
(20:27):
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
(20:47):
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
(21:10):
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,
(21:31):
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
(21:54):
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
(22:15):
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,
(22:37):
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
(22:59):
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
(23:23):
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
(23:46):
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,
(24:08):
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,
(24:29):
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
(24:52):
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
(25:16):
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
(25:38):
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
Welcome to Stuff to Blow your Mind from how Stuff
Works dot com. Hey, you welcome to Stuff to Blow
your mind. My name is Robert lamp and Julie Douglas,
and I'd like you to take a moment to just
try and create. Try and imagine the most destructive disease possible.
Imagine a disease that ravages the body. That ravage is
(00:27):
just about every tissue, every every part of the human
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
(00:48):
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
(01:08):
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,
(01:33):
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
(01:57):
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
(02:18):
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
(02:41):
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
(03:02):
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,
(03:24):
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,
(03:48):
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
(04:09):
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
(04:31):
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
(04:53):
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.
(05:15):
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
(05:38):
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
(06:02):
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
(06:25):
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,
(06:45):
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
(07:06):
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
(07:26):
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
(07:47):
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,
(08:09):
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
(08:32):
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
(08:55):
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
(09:19):
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
(09:40):
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
(10:01):
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
(10:24):
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
(10:44):
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
(11:06):
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
(11:28):
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
(11:51):
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.
(12:13):
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
(12:35):
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
(12:58):
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
(13:21):
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
(13:43):
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
(14:03):
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
(14:24):
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
(14:47):
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
(15:07):
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.
(15:31):
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
(15:53):
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
(16:16):
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
(16:38):
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
(17:01):
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
(17:22):
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
(17:43):
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
(18:06):
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
(18:28):
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
(18:50):
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
(19:14):
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,
(19:40):
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
(20:04):
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
(20:27):
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
(20:47):
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
(21:10):
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,
(21:31):
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
(21:54):
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
(22:15):
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,
(22:37):
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
(22:59):
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
(23:23):
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
(23:46):
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,
(24:08):
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,
(24:29):
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
(24:52):
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
(25:16):
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
(25:38):
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