1.4 Sexually Transmitted Infections in Ancient Times
There are records of STIs most notably urethral discharge that was probably gonorrhoea from the earliest times [].
During the Middle Ages in Europe, advances in the knowledge of gonorrhoea were made. Roger of Salerno (1180) and William of Salicet (121077) wrote on the causality and natural history of gonorrhoea; John of Gaddesden (12801361) recognised urethritis, epididymitis and vaginitis [].
Other STIs, including scabies and pediculosis pubis, have also been recognised since ancient times [].
1.5 The Development of the Concept of Venereal Diseases Prior to the Nineteenth Century
The Renaissance showed that any change in medical knowledge is as much influenced by outside social, geopolitical and economic forces as it is from within medicine [].
The Columbian (Americanist) view is that syphilis was acquired by the sailors of Christopher Columbus and spread after 1493 through Europe [], who emphasized the evolutionary relationships of yaws, pinta, endemic syphilis, and sporadic syphilis. He regarded them as variants of the same disease that originated in sub-Saharan Africa.
There is a great amount of literature not only on syphiliss effect in Italy [], had been described.
However, some controversies surrounded syphilis for many years. The Diet of Worms (7th August 1495) was the first printed document to mention this new severe disease: There have been severe diseases and plagues of the people, to wit bsen Blattern which have never occurred before nor been heard of within the memory of man [].
However, the venereal origins of syphilis were quickly realised and bluntly stated by Andrew Boord in 1547: It may come when one pocky person doth synne in lechery the one with another. All the kyndes of the pockes be infectiouse [].
Cautery of the primary sore was also utilised as treatment, as shown on contemporary watercolours [].
Jean Fernel (15061588) rejected the Galenic concept that genital lesions were secondary to humoral disorders arising in the liver. He taught that morbus Gallicus was caused by a virus usually acquired through intercourse. He stated that midwives may contract it through the hand and the wet nurse through her nipple. He also noted that oral and anal moist lesions were contagious and that the virus could not pass through intact skin. He taught about a long incubation period, prolonged latency, and exacerbations. He also referred to lues venerea- venereal plague (De lues venereae curatione perfectissimo, 1556) [] thought they were separate.
Lancisi (16541720) posthumously correlated dilatation of the heart with syphilis aneurysma gallicum in 1728 []. He provided clinical descriptions of several conditions, including genital herpes, condylomata acuminata, phimosis, and balanoposthitis.
Van Swieten (17001772), a pupil of Boerhaave called to Vienna after 1749, popularised more liberal treatment of syphilitics, as well as the introduction of graduated dosage with mercury to prevent side effects such as oversalivation (ptyalism), the shakes (tremors), and renal disease [].
John Hunter (17281793) wrote A Treatise on the Venereal Disease in 1786, but it was not one of his best works. His error was to adhere to the monist doctrine. In an experiment in 1767, he tried to prove that gonorrhoea and syphilis had a single cause. Gonococcal pus was inoculated onto the prepuce and glans penis. Unfortunately, the inoculum was chosen from a patient suffering from syphilis as well as gonorrhoea. As the inoculum was not put in the urethra, no gonorrhoea, only syphilis, resulted. This caused the faulty deduction that the result depended on the nature of the surface of the inoculumgonorrhoea for moist surfaces and ulceration for a cutaneous surface [] used 2,500 inoculation experiments performed between 18311837 to show conclusively that gonorrhoea and syphilis were different diseases (Trait Pratique des Maladies Vnriennes). Although ethical standards in those days were different, when others in France tried similar experimentation on patients, cases were taken before the courts.
After the French Revolution, postreform medical teaching had an immense impact globally []or that secondary syphilis was contagious. His pupils, such as Paul Diday and Alfred Fournier (18321914), were worthy successors to his school and its teaching traditions.
There were some other smaller advances in knowledge in those times. In 1814, Thomas Batemans fourth edition of A Practical Synopsis of Cutaneous Disease described Herpes praeputalis [].
1.6 The Development of a Scientific Basis for Sexually Transmitted Disease from the Nineteenth Century