It’s On The Syphilis

0:00From my understanding, Jurassic Park was a really big deal upon its initial release. I read that it won three Academy Awards. Yes, it was a huge cultural phenomenon. You couldn't go anywhere without there being Jurassic Park on something, because of the logo. And so you would go out to eat at McDonald's, there'd be the logo.

0:18You would go to Walmart, there would just be an aisle full of toys with the logo on it. And what's really amazing is that you would turn on the news and they were talking about Jurassic Park. But they were also talking about science.

0:32And this movie really captured the imagination of a lot of people, including myself. And so there was kind of a phenomenon where you had people interested in DNA. Whether they were going to pursue science or not. So you go get your hair cut and the person would be talking about DNA and talking about genetic engineering.

0:50And it was incredible. Do you have a favorite Jeff Goldblum quote? From Jurassic Park? Yeah, from Jurassic Park. Life finds a way. I forgot what he said. I really like the one where after he's been wounded and he says, yeah, but John, if the Pirates of the Caribbean breaks down, the pirates don't eat the tourists.

1:16I can't imagine being in searing pain from my leg and then still sassing someone. My other favorite was, your scientists were so preoccupied with whether they could. They didn't stop to think whether they should. Yeah, yeah, that's a really good one. That's a really important quote, I think.

1:33When Jurassic Park was first advertised, it was touted as a movie 65 million years in the making. I saw this old article from the early, no, I guess it was mid 80s, that called finding a case of either syphilis or yaws in an ancient Pleistocene bear from over 11,500 years ago.

1:55And the researcher Bruce Rothschild said that the only way to distinguish between the diseases would be to do a medical history. And he's quoted as saying, the bear ain't talking.

2:13The researcher also said that it's probably yaws disease, because that can be transmitted by flies. Otherwise, the researcher said, and I quote, you have to explain how a bear got syphilis.

2:28I'm Dr. Dustin Dolophosaurus Edwards. And I'm Faith Cox. Welcome to Germomics, where we go to, be, from, a, in the most roundabout way, a mixture of microbiology and history. In this series, we connect different aspects of modern life and society to microbes through seemingly unconnected natural events, discoveries, and inventions.

2:47How else can we connect blockbuster movies to syphilis? Let's find out. I read a tweet about Jurassic Park being a scientifically accurate movie. Now, it's not like the most scientifically accurate. And there are some problems like the DNA replication and the way the dinosaurs are represented.

3:03But it was a lot for its time. There are more scientifically accurate movies now, though, such as like Interstellar, which did a really good job representing the black holes. Yes, Chris Nolan worked with actual scientists and to create that black hole. And he actually changed it a little bit.

3:18It was too realistic initially. And then he had a little bit of artistic creativity with it. Yeah, and it looked pretty similar to what we were able to visualize now. Thanks to the work of Dr. Katie Baumann and her team. There's also Contagion, where the director worked with epidemiologists to see what it would look like if there were to be like a global pandemic that occurred, how it would look from an epidemiological standpoint.

3:44That movie had Kate Winslet in it. She played one of the doctors that helps track the virus and does some of the boots on the ground epidemiology. I hear that Kate Winslet keeps her Oscar in the bathroom so guests can do pretend like acceptance speeches in the bathroom mirror without being embarrassed.

4:00Do you think people wash their hands like afterwards? Afterwards? I hope they're washing their hands before they're handling someone else's award. They should do it like before and after. I hope so. I can't imagine. It's probably like a disgusting Oscar otherwise. There's this man, Ignaz Semmelweis, that could be attributed as like the inventor of handwashing.

4:22He was called the savior of mothers. In the 1840s, Dr. Semmelweis discovered that the incidence of childbed fever, which was just any bacterial infection as a result, or after like giving birth or having a miscarriage, that those infections could be dramatically cut by having physicians wash their hands with an antiseptic.

4:43Semmelweis was a Hungarian physician and scientist who worked in Wiener, Austria at a maternity institution. The maternity institution that he worked at was set up as a gratis institution and offered to take care of any infants that were not wanted, such as like illegitimate children.

4:58How would you define a gratis institution? A gratis institution is one that's like free. However, in return for these free services, the women would be subject to the training of physicians and midwives. It wasn't like entirely free, but... Yeah, it sounded like maybe a bad deal.

5:16Maybe. It was a bad deal, but because it was the best that some of them had for like illegitimate children, they went through with it. What some of them would do is that they would give birth in the streets en route to the clinics because it still qualified them for like leaving their illegitimate infant to be cared for by the clinic rather than taking it home with them.

5:35He noticed that the women who gave birth in the streets were having significantly lower rates of childbed fever, which didn't make sense to him because he thought the incidence of childbed fever in birth and street births and clinic births should be at least equal.

5:50But then he also noticed that the women who were patients at the other clinic in Vienna, which only employed midwives and not physicians, also had a lower rate of childbed fever. He began eliminating all differences between the two clinics to see what could possibly be causing the fever.

6:04He even removed like religious practices to see if those were playing like a role in it. But he eventually realized that the difference was that the medical students and physicians would perform autopsies on patients who had died, people who had often died of childbed fever, before going to examine patients.

6:19The midwives didn't do this because they weren't medical students, so they had no reason to like perform autopsies. As he thought about it more, Semmelweis determined that the physicians and students were carrying over particles from the cadavers and then inoculating the patients. So Semmelweis proposed that the physicians and medical students should wash their hands with a chlorinated lime solution until the smell of putrid cadaver flesh was no longer present.

6:43So this was before germ theory of disease was like established and well accepted. So he didn't have evidence of contaminants being removed, and he actually only relied on the scent. So he would just have like the students and the physicians wash their hands until they didn't smell anymore.

6:58So you'd have to do like a sniff test? Yeah, yeah. I can't imagine like how bad that must have smelled if you were like not there yet. But after implementing this at the clinic in mid-May, the mortality rate dropped from 18 .3% in April to 2.2% in June, 1.2% in July, and 1.9% in August.

7:22It sounds like he was doing really good work, but in 1849, for political reasons combined with his term at the time, which is kind of like just the length of time that they could have their job, that they were appointed to that position, his term expired.

7:36He was not rehired at the clinic. Semmelweis went to work at another hospital in Budapest, where there he was also able to virtually eliminate deaths from childbed fever during his time there. Like I said, germ theory of disease wasn't yet established, so his findings didn't explain the cause of childbed fever, only that washing with a solution in between autopsies and patients decreased the incidence.

7:59After the establishment and acceptance of germ theory of disease, we understand now that it was caused by not washing your hands and that you have to wash your hands to remove microbes. But at the time, people still believed in miasma. So as a result, washing your hands didn't make sense to them because microbes weren't known to be causes of infectious diseases yet.

8:17So how can we define miasma? Oh, miasma was the belief that like bad air was what was getting you sick. And so like people would like close the windows of the sick because they thought the air would circulate like the neighborhood. Actually made things worse, huh?

8:33Yeah, it made things worse. You just were like trapping your housemates. So without more scientific backing, Semmelweis's findings were largely rejected at the time. Some physicians even felt like Semmelweis was implying that they were like filthy and unhygienic for not washing hands, which is impossible because they were supposed to be like high class gentlemen.

8:50Semmelweis also had a tendency to be quite confrontational and even published a book called Open Letter to All Physicians of Obstetrics in 1862, where he lashed out against the critics of his first book, Autology, Concept, and Prophylaxis of Childhood Fever, which was the main literature regarding his like hand washing concept.

9:17In the end, Semmelweis's findings weren't very well disseminated by him. And as he like lashed out against critics, it made a lot of the medical community turn against him and start rejecting his idea. Like I said, it did gain a lot of popularity after germ theory of disease was established, but not during his lifetime, unfortunately.

9:36In the 1860s, Semmelweis became increasingly hysterical about physicians not washing their hands between cadavers and patients. He's like flipping tables. Oh, yeah, he was pissed. He was like very, very mad. And his wife thought he was like going insane. In his book that he wrote, the Open Letter one, he even went as far as to call all of the obstetricians that weren't like listening to him, like blatant murderers.

10:02So he was not taken kindly, people weren't listening to him. And they weren't taking kindly to the words he was saying because like no one wants to be called a murderer when like you just don't understand the science. But all of that combined with him being eventually checked into an insane asylum against his will.

10:16He was actually tricked there by a colleague to go and examine a patient. And then as soon as he realized what was going on, he tried to escape where he was beaten by the guards. After that, he got an infected wound. They don't really know if it's specifically by that beating or from something else.

10:33And his wound got infected. And he later died of blood poisoning just 14 days after entering the asylum. That's very ironic. Yeah, something that like hand washing could have prevented. It's a horrible irony for him. Why he became increasingly hysterical isn't known. It could have been like a type of dementia.

10:55It could have been emotional exhaustion. It could have been like the sheer emotional aspect of knowing that you had this knowledge and this understanding of how to like prevent people from dying and no one taking you seriously. But it also could have been syphilis, which is a really common disease of obstetricians who worked at gradus institutions like Similwise.

11:14So you'd have a lot of like prostitutes that were coming using these services. So there's a really high incidence of the obstetricians later contracting syphilis because of their work at the gradus institutions. There are about 45 million people worldwide infected with syphilis with about 6 million new cases each year.

11:33In the U.S. in 2017, there were about 100,000 new cases. It's been reported that in the 19th century, so the 1800s, about 15% of the world's population, everybody, had syphilis at some time. So as you can imagine, there's a huge list of famous people who either were known to have syphilis or were suspected of having syphilis.

11:59Some of these were like Scott Joplin, the famous jazz pianist. He did the ragtime music like The Entertainer

12:13or the Maple Leaf Rag.

12:40If you ever had to read War and Peace in School, that was written by Leo Tolstoy, also suspected to have been affected by syphilis. There's also important world leaders such as Vladimir Lenin of the USSR or Adolf Hitler of Nazi Germany. Again, they were suspected but not quite proven.

13:02The gangster Al Capone, famous for being in Chicago and going to Alcatraz. Even Vincent Van Gogh, famous for his painting of The Starry Night. The poet and playwright Oscar Wilde. He wrote The Picture of Dorian Gray, where the painting was getting older but the person didn't age.

13:24He also wrote The Importance of Being Earnest. There is also the composer Franz Schubert, who is known for his haunting Unfinished Symphony. That was one of the songs that my grandpa and I used to listen to. Another famous composer that was suspected of having syphilis was Ludwig van Beethoven, famous for the Fifth Symphony, Moonlight Sonata, the Ninth Symphony, the Ode to Joy.

14:11Another world leader that's often included on this list is Napoleon Bonaparte, and that's because he died of arsenic poisoning, which was a popular therapy at the time. And so some people consider that maybe he did have syphilis. However, more current research shows that he probably had gastric cancer.

14:30Another world leader would be Henry VIII, the person who had six different wives. And perhaps shocking for most people are Abraham Lincoln and his wife Mary Todd. There's evidence of his wife having syphilis, as well as three of their children. Syphilis is caused by Trypanema pallidum.

14:50It is a spirochete, and it looks just like a corkscrew. So if you ever drink wine and you put in the corkscrew and you twist it, that's very similar to how they're shaped. Their flagella is also positioned in such a way that it kind of moves in a spiral-like motion, which allows it to work its way through the smallest of micro tears in skin.

15:10Syphilis is most often transmitted as a sexually transmitted disease, but it can be transmitted from mother to child during pregnancy or at birth, and they call this congenital syphilis. There's no approved vaccine yet, but it can be treated with the antibiotic benzathine penicillin G, or if the person has an extreme penicillin allergy, you can treat it with doxycycline or tetracycline.

15:33Syphilis has four disease stages, and it's often called the great pretender or the great imitator because there are symptoms of syphilis that are similar to other diseases. The first stage in primary syphilis, which occurs after about three weeks after infection, a skin lesion or an ulcer appears that's called a chancre.

15:53And this is the symptom most people picture or imagine when they think about syphilis. It is circular, about one to three centimeters in diameter, so about the size of a fingernail. And even though they look like they might hurt, they're actually painless and not itchy, and they're firm.

16:14So they're these firm, round lesions. And they're going to occur at the place where the infection occurred at. So it's going to appear on the penis, the vagina, anus, or on the rectum, on lips, or in the mouth. Secondary syphilis happens after about one to three months.

16:33It is a non-itchy rash that's going to appear, and it will appear also on the palms of hands or the soles of feet. And on the body, it's going to look like raised discs. And I've viewed several photos of this. And if you look at somebody from the back, so on the back torso, it looks like it covers about 80 to 90 percent of the surface.

16:55So many of these raised, like, nodules. During this stage, there's also lots of other symptoms that can be associated with just feeling bad, such as having a fever, a sore throat, weight loss, and headaches. A third stage of the disease is latent syphilis.

17:13So this is when you are infected, but you don't show any symptoms after having secondary syphilis. In the fourth stage, without treatment, a third of infected people will develop the tertiary disease or tertiary syphilis. This occurs about 10 to 30 years after the initial infection occurred.

17:33And during this stage, syphilis is no longer infectious. However, you're going to start to see multiple organ systems affected, including the brain, nerves, eyes, the heart, blood vessels, liver, bones, and even joints. Symptoms of tertiary syphilis are going to vary depending on which of the organ systems were affected.

17:55So, for example, if it impacted the brain and the nervous system, it's going to be called neurosyphilis, while if it was affecting the eyes, it would be called ocular syphilis. I follow this medical historian on Twitter, and she tweeted about how there was this gentleman in London that had these no-nose clubs where he was, she just, like, went out on the street and he saw everyone who, like, also didn't have a nose and he didn't have a nose for reasons most likely syphilis.

18:22And he invited all the, like, noseless people to his house for dinner. They just had these, like, clubs of everyone without noses where they just, like, were able to live life and have, like, companions where no one was, like, judging them for not having noses because not having a nose was frowned upon at the time.

18:36And so they just had these, like, parties of people who had, like, the same struggle and they were, like, judging each other for their struggle. The chef of the gentleman even, like, he would roast, like, whole pigs for them and then cut the snouts off the pigs when serving it to them.

18:51For our science and society message, let's talk about public trust in science. So last month, the Pew Research Center conducted a study that showed public confidence in scientists to act in public interest has increased in recent years, where half or more Americans have positive views about science.

19:08However, most still turn a skeptical eye to issues of scientific integrity. There are lots of reasons why there is a negative view towards science. There was the Tuskegee experiment where poor black sharecroppers who had syphilis were told that they were going to receive free health care, but they didn't.

19:25Instead, they were part of a 40-year study to observe the natural progression of syphilis Yes, and this was occurring in the 1940s onward, so right around World War II. Yeah, it ended in the 1970s, actually, so it was rather recent. Of the original 399 men with latent syphilis, 28 had died of syphilis, 100 were dead of related complications, 40 of their wives had been infected, and 19 of their children were born with congenital syphilis.

19:53There was also the Guatemala experiment, which was led by a physician that had a role in the Tuskegee experiment. In this experiment, they infected healthy people with syphilis, either through a direct injection or using known infected prostitutes. They would send the prostitutes to have sex with prisoners.

20:11Yes. Only half of the infected received treatment, and those experiments occurred around World War II in the 1940s, and the effects on our society have lasted more than half a century. In a study from 2013, it appeared that HIV rates had doubled in Washington, D.C.

20:26in the five years previous among people who identified as Black, and there was a big question as to whether the rates had actually doubled, or was it just that public trust was finally improving enough that people were no longer fearing and hiding from authorities in white coats but were getting tested and responding to surveys?

20:41To address this, scientists and non-scientists need to continue to work together on this march of progress, and these unethical experiments also highlight the disparity of healthcare between different populations. It's just a fact of life that different groups of people are getting different treatment and it shouldn't be that way.

20:58No, it shouldn't. And we need to address that by knowing that it's a factor that's going on and then trying to compensate for it. Well, I'd like to end on a happier note about disparity within healthcare. That's just not the reality. I'd still like to thank you for listening to Episode 5.

21:13It's on the syphilis. Show notes, transcripts, citations, and social media links are available on our website at germamix.com. I was thinking back on what we were talking about at the beginning with Jurassic Park and I am just glad that the non -scientist was driving the Jeep.

21:31Why? Because there was this guy I know, we were headed towards a conference and he, no matter what, would stop at three hours. Yeah, yeah, yeah. So he'll drive just three hours and then stop, take a nap. Yeah, he would stop and take a nap.

21:48So if you had the Tyrannosaurus Rex chasing after you in that Jeep scene, had the chase gone on for two hours and 59 minutes, he would have pulled over. I know, maybe that's a bit dramatic, but I don't think it is because there's one day we went to a conference and it was three hours and 15 minutes away.

22:08So like three hours and 15 minutes away and he makes it to the three-hour mark. And I had everyone text me when they left because I wanted to make sure they got there and text me when they get there. So I know everyone should be taking about three hours and 30 minutes for shopping for gas or something.

22:23And after five hours, he's not there. And I'm like, where are you? Why are you not here? Are you alive? I don't have your wife's contact information. And he arrives at the conference and is like, what took you five hours to get here on a three-hour trip?

22:38And he's like, oh, I always stop and nap after three hours. What do you mean? This was a three-hour and 15-minute trip. And he's like, I know. I always stop at three hours. So rather than pushing through the last 15 minutes of your drive to sleep in a bed, you decided to pull over on the road to nap in your car on the side of a highway for the last 15 minutes.

23:01Because that's safer. Because it's safer, right? He was concerned about being drowsy. So he thought that was safer. And I don't understand it. And I've asked him about it and it never has a satisfactory answer. And it just keeps me up at night.