Short answers, pulled from the story.
Syphilis is caused by the bacterium Treponema pallidum subspecies pallidum, a spiral-shaped organism that passes through intact mucous membranes or broken skin. It is transmitted primarily through sexual contact, including oral, vaginal, and anal sex, and can also pass from mother to baby during pregnancy or birth. Approximately 30-60% of people exposed to an active infection will acquire the disease.
Syphilis progresses through four stages: primary, secondary, latent, and tertiary. Primary syphilis produces a firm, painless skin ulcer called a chancre, typically 0.3-3.0 centimetres in size, appearing 2-6 weeks after exposure. Secondary syphilis, arising 4-10 weeks later, causes a rash covering the trunk and extremities including the palms and soles. Latent syphilis has no symptoms but can last many years, and tertiary syphilis can involve gummas, cardiovascular damage, or severe neurological disease.
A single dose of intramuscular benzathine benzylpenicillin is the first-line treatment for uncomplicated primary or secondary syphilis, and a treated person is typically rendered non-infective within about 24 hours. Neurosyphilis requires large doses of intravenous penicillin G for a minimum of 10 days. For those with a severe penicillin allergy, doxycycline or tetracycline are alternatives, though not for pregnant women.
The Tuskegee Study of Untreated Syphilis in the Negro Male was conducted by the U.S. Public Health Service between 1932 and 1972 in Macon County, Alabama, enrolling 600 poor African American men. Of those, 399 had contracted syphilis before the study began; none were ever told their diagnosis, and none were given penicillin even after it became the proven treatment. Whistleblower Peter Buxtun exposed the study in 1972, prompting major reforms to U.S. regulations on informed consent in clinical research.
The origin of syphilis is debated between a Columbian theory and a pre-Columbian theory. The Columbian theory holds that it was brought to Europe by men who sailed with Christopher Columbus in 1492, with a serious epidemic recorded in Naples by 1495. A 2024 study published in Nature supported syphilis having first emerged in the Americas in the mid-Holocene. A 2020 analysis of skeletal evidence, however, concluded that treponemal disease almost certainly existed in Europe before Columbus.
The name syphilis was coined in 1530 by the Italian physician and poet Girolamo Fracastoro in his Latin poem Syphilis sive morbus gallicus, meaning Syphilis or The French Disease. The poem featured a shepherd named Syphilis as its central character. Before this, the disease was called the great pox or the French disease in England, Germany, and Italy, while the French called it the Neapolitan disease.