The Myth of Syphilis: The Natural History of Treponematosis in North America

The Myth of Syphilis: The Natural History of Treponematosis in North America. MARY LUCAS POWELL and DELLA COLLINS COOK (eds.). Florida Museum of Natural History, Ripley P. Bullen series; Jerald T. Milanich, series editor. University Press of Florida, Gainesville, 2005. xx + 528 pp., series editor's foreword, foreword, 49 tables, 125 figs., 15 maps, index. $85.00 (cloth), ISBN 0-8130-2794-2. Reviewed by Shannon Chappell Hodge Powell and Cook's Myth of Syphilis is a welcome addition to a recent and notable trend in the bioarchaeological literature of intensive and extensive exploration of a single disease, including studies such as Susan Kent and Patricia Stuart-Macadam's 1992 volume on anemia (Diet, Demography, and Disease: Changing Perspectives on Anemia [Hawthorne, N.Y.: Aldine de Gruyter]) and Charlotte A. Roberts and Jane E. Buikstra's 2003 volume on tuberculosis (The Bioarchaeology of Tuberculosis: A Global View on a Reemerging Disease [Gainesville: University Press of Florida]). This trend represents a maturation of the field of paleopathology beyond regional and topical overviews, to the creation of authoritative syntheses of the state of knowledge of a single and sometimes controversial topic. Few have been more controversial in the medical, anthropological, and bioarchaeological literature than the origins and spread of syphilis, particularly the debate over the New World or Old World origin of this dread disease. Powell and Cook have gathered sixteen New World case studies authored by the leading voices of regional expertise in paleopathology, who deliver overwhelming evidence as to the presence and prevalence of treponemal disease (the medical classification to which syphilis belongs) across the New World for at least two millennia. These regional chapters are preceded by an introductory chapter and a chapter summarizing the present understanding of treponematosis, and followed by two chapters of geographic and temporal synthesis, and a final chapter which reconsiders North American treponematosis in worldwide context. According to Powell and Cook, there are two key unanswered questions about treponemal disease. First, what is the geographic origin of treponematosis, particularly venereal syphilis, the sexually transmitted variant of the disease? Did it originate in the New World, only to be transmitted to European populations following the return of Columbus' ships to their home ports? Furthermore, was it a purely nonvenereal syndrome at its origin, which mutated into a venereal form when confronted with the transmission barriers of a buttoned-up and straitlaced European society (a loaded question at best)? Or did the venereal form exist in the disease's homeland as well? second, what is the biological relationship among the four basic variants of treponematosis-venereal syphilis and nonvenereal endemic syphilis, yaws, and pinta? Pinta is now recognized as a distinct species of the genus Treponema, but what about the remaining three? Do these represent three varying disease expressions of a single microorganism, or like pinta, do they represent separate (though closely related) diseases caused by distinct pathogens? This second question remains unresolved and can best be answered by microbiologists prying into the DNA of these microbes. However, paleopathologists can provide valuable supporting evidence by identifying environmental and transmission factors that might assist in teasing apart the varying treponemal syndromes. The first question forms a consistent and explicit thread throughout the articles in this volume: when and where is there evidence for New World treponematosis, and does the evidence represent the venereal or nonvenereal forms of the disease? The second question is approached tangentially from a bioarchaeological approach: what are the cultural factors surrounding the expression of treponemal disease in the prehistoric New World? The great value of this volume is in the approach taken by Powell and Cook in designing explicit reporting guidelines for their authors to follow to ensure that results from each geographic region will be comparable. …