The earliest known medical illustration of people with<unk> , Vienna, 1498 The first recorded outbreak of<unk>  in Europe occurred in 1494/1495 in Naples, Italy, during a French invasion. Because it was spread by returning French troops, the disease was known as "French disease", and it was not until 1530 that the term<unk> " was first applied by the Italian physician and poet Girolamo Fracastoro. The causative organism, Treponema pallidum pallidum, was first identified by Fritz Schaudinn and Erich Hoffmann in 1905. The first effective treatment, Salvarsan, was developed in 1910 by Sahachirō Hata in the laboratory of Paul Ehrlich. It was followed by the introduction of penicillin in 1943. Many well-known figures, including Scott Joplin, Franz Schubert, Friedrich Nietzsche, Al Capone, Lenin, and Édouard Manet are believed to have contracted the disease. Origin The<unk>  has been well studied, but the exact origin of the disease remains unknown. There are two primary hypotheses: one proposes that<unk>  was carried to Europe from the Americas by the crew(s) of Christopher Columbus as a byproduct of the Columbian exchange, while the other proposes that<unk>  previously existed in Europe but went unrecognized. These are referred to as the "Columbian" and "pre-Columbian" hypotheses.<unk>  is the first "new" disease to be discovered after the invention of printing. News of it spread quickly and widely, and documentation is abundant. For the time, it was "front page news" that was widely known among the literate. It is also the first disease to be widely recognized as a sexually transmitted disease, and it was taken as indicative of the moral state (sexual behavior) of the peoples in which it was found. Its geographic origin and moral significance were debated as had never been the case with any other illness. European countries blamed it on each other. Somewhat later, when the significance of the Western Hemisphere was perceived, it has been used in both pro- and anti-colonial discourse. Columbian theory This common theory holds that<unk>  was a New World disease brought back by Columbus, Martín Alonso Pinzón, and/or other members of their crews as an unintentional part of the Columbian Exchange. Columbus's first voyages to the Americas occurred three years before the Naples<unk>  outbreak of 1495. As Naples fell before the invading army of Charles the VIII in 1495, a plague broke out among the French leader's troops. When the army disbanded shortly after the campaign, the troops, composed largely of mercenaries, returned to their homes and disseminated the disease across Europe. 536 skeletal remains in the Dominican Republic have shown evidence characteristic of treponemal disease in 6–14% of the afflicted population, which Rothschild and colleagues have postulated was<unk> . The Aztec god Nanahuatzin is often interpreted as suffering from<unk> . The 2011 Yearbook of Physical Anthropology published an appraisal by Harper and colleagues, of previous studies and stated that the "skeletal data bolsters the case that<unk>  did not exist in Europe before Columbus set sail." The scientific evidence as determined by a systematic review of 54 previously published, peer-reviewed instances lends support to the theory that<unk>  was unknown in Europe until Columbus returned from the Americas. According to this appraisal, "Skeletal evidence that reputedly showed signs of<unk>  in Europe and other parts of the Old World before Christopher Columbus made his voyage in 1492 does not hold up when subjected to standardized analyses for diagnosis and dating, according to an appraisal in the current Yearbook of Physical Anthropology. This is the first time that all 54 previously published cases have been evaluated systematically, and bolsters the case that<unk>  came from the New World." In an article criticizing the presentation of new research findings in PBS and BBC documentaries about<unk> , researchers said they showed "a blatant disregard for the peer review process in making the case for pre-Columbian<unk>  in the Old World. ... As in all scientific fields, in order to resolve the controversy over the origin and antiquity of<unk>  in the Old World, there is a strong need for adherence to standard practice in scientific publication and the increased publication of relevant evidence in peer-reviewed journals." Pre-Columbian theory The theory holds that<unk>  was present in Europe before the arrival of Europeans in the Americas. Some scholars during the 18th and 19th centuries believed that the symptoms of<unk>  in its tertiary form were described by Hippocrates in Classical Greece. Skeletons in pre-Columbus Pompeii and Metaponto in Italy with damage similar to that caused by congenital<unk>  have also been found. Douglas W. Owsley, a physical anthropologist at the Smithsonian Institution, and other supporters of this idea, say that many medieval European cases of leprosy, colloquially called lepra, were actually cases of<unk> . However, these claims have not been submitted for peer review, and the evidence that has been made available to other scientists is weak. Although folklore claimed that<unk>  was unknown in Europe until the return of the diseased sailors of the Columbian voyages, Owsley says that<unk>  probably cannot be 'blamed'—as it often is—on any geographical area or specific race. The evidence suggests that the disease existed in both hemispheres from prehistoric times. It is only coincidental with the Columbus expeditions that the<unk>  previously thought of as 'lepra' flared into virulence at the end of the 15th century." Lobdell and Owsley wrote that a European writer who recorded an outbreak of "lepra" in 1303 was "clearly describing<unk> ." In 2015, researchers discovered 14th-century skeletons in Austria that they say show signs of congenital<unk> , which is transmitted from mother to child rather than sexually. In 2020 DNA analysis of nine infected skeletons was advanced to defend the "pre-Columbian" hypotheses, but is short of conclusive. Combination theory Historian Alfred Crosby suggested in 2003 that both theories are partly correct in a "combination theory". Crosby says that the bacterium that causes<unk>  belongs to the same phylogenetic family as the bacteria that cause yaws and several other diseases. Despite the tradition of assigning the homeland of yaws to sub-Saharan Africa, Crosby notes that there is no unequivocal evidence of any related disease having been present in pre-Columbian Europe, Africa, or Asia. Crosby writes, "It is not impossible that the organisms causing treponematosis arrived from America in the 1490s ... and evolved into both venereal and non-venereal<unk>  and yaws." However, Crosby considers it more likely that a highly contagious ancestral species of the bacteria moved with early human ancestors across the land bridge of the Bering Straits many thousands of years ago without dying out in the original source population. He hypothesizes that "the differing ecological conditions produced different types of treponematosis and, in time, closely related but different diseases." A more recent, modified version of the Columbian theory that better fits skeletal evidence from the New World, and also "absolved the New World of being the birthplace of<unk> ", proposes that a nonvenereal form of treponemal disease, without the lesions common to congenital<unk> , was brought back to Europe by Columbus and his crew. Upon arrival in the Old World, the bacterium, which was similar to modern day yaws, responded to new selective pressures with the eventual birth of the subspecies of sexually transmitted<unk> . This theory is supported by genetic studies of venereal<unk>  and related bacteria, which found a disease intermediate between yaws and<unk>  in Guyana, South America. However, the study has been criticized in part because some of its conclusions were based on a tiny number of sequence differences between the Guyana strains and other treponemes whose sequences were examined.
History of syphilis
History of smallpox
History of leprosy
History of HIV/AIDS
History of chemical warfare
History of plague
History of malaria
History of penicillin