We read with pleasure and admiration the 1999 Wakley prize essay by Christopher Whitty1
in which he argues persuasively for an end to the stigma associated with HIV infection. While the patients we see in our community who are living with HIV infection may not always be “the most attractive, socially successful, [and] sexy”, we applaud Whitty for recognising that their risk behaviours are no different from people not infected with HIV.
We were, however, curious about the accompanying woodcut by Albrecht Durer of a syphilitic man. The woodcut carries the date of 1484, which struck us as strange. Many medical historians believe that syphilis was unknown in western Europe before 1493, when Columbus and his sailors first returned from The New World bearing a variety of gifts (including venereal treponemal infections).2
If this Columbian hypothesis of the history of syphilis is true, Durer could not have seen or known anyone who was infected with Treponema pallidum
The Durer woodcut was actually printed as part of a larger sheet4
that was not published until 1496 in Nuremberg. Accompanied by verse in Latin, the illustrated man purports to be someone who is suffering with the “epidemica scabiem” (ie, a scab-bearing dermatological disease), and seems to be an advertisement for the services of one Dr Theodoricus Ulsenius; the sheet carries the title Der Syphilitische oder Die Franzosenkrankheit
(the syphilitic or the French disease). Did the printer in 1496 use Durer's image (done 12 years earlier) as convenient clip-art to illustrate the new epidemic disease that would soon sweep the continent of Europe? Was T pallidum
infection actually endemic in Europe before Columbus' return in 1493? Was the “epidemica scabiem” some non-treponemal malady?
Whatever illness Durer portrayed, be it in 1484 or 1496, it certainly was not called syphilis. The disease acquired its present name from the poem Syphilis sive morbus gallicus
written by the Italian physician Girolamo Frascatoro. The poem describes the shepherd Syphilis, who is afflicted with a pustular and ulcerative disease as a punishment for blasphemy.5
Art historians may note that Frascatoro's eponymous poem was not published until 1530, 2 years after Durer's death.