Sex, Society, and Syphilis: A Social, Ecological, and Evolutionary History of Syphilis in Late Medieval and Early Modern England (c. 1494-1865) Público
Zuckerman, Molly Kathleen (2010)
Abstract
This study presents a social, ecological, and evolutionary history
of acquired
syphilis in early modern England (c. 1495-1864). Specifically it
examines the influence
of different proximate ecological factors, such as biological sex
and overall health, on the
pathophysiology of syphilis, explores the influence of social
identity on access to
treatment, and assesses whether the disease evolved in response to
changes in human
behavior and ecology. I synthesized my own and previously published
data on sex, health
indicators, and evidence of syphilis in several 15th to 19th
century skeletal samples with
published and unpublished archaeological and historical data, my
own trace element data
on evidence of treatment with mercury, and re-analysis of 19th and
20th century studies of
untreated infection to address four research questions. First, did
syphilis evolve in
virulence (attenuate) soon after its emergence? Controversial
historical evidence suggests
that syphilis became milder soon after its 15th c. emergence,
making it the first credible
example of this valuable phenomenon. Instead, results show no
evidence of attenuation
and fail to support the most popular explanation: that syphilis
altered to become less
evident to potential mates (Knell 2004). Second and third, did
overall health and
biological sex (e.g., sex steroid hormones) affect the
pathophysiology of syphilis?
Analysis of 18th-19th c. skeletons and clinical and epidemiological
data suggest a strong
relationship between the former, particularly in regards to early
life stressors, which
potentially supports the Barker hypothesis. The same was not found
for the latter, which
contradicts a large body of 19th -20th c. medical knowledge and
invites further study.
Lastly, results demonstrate that gender, but not socioeconomic
status influenced access to
mercury treatments, indicating that women may have had more
equitable access to
treatment than documentary evidence indicates or that they pursued
undocumented
avenues for access to treatment. This study is the first to address
the social and ecological
aspects of syphilis in a large skeletal sample using multiple lines
of evidence and joins a
small but growing body of literature that uses skeletal evidence to
elucidate the evolution
and ecology of infectious disease.
Table of Contents
Table of Contents
Abstract........... 4
Acknowledgements........... 6
Dedication........... 10
Chapter One: Introduction ........... 1
Introduction........... 1
Background........... 4
Chapter Two: Research Design ........... 17
Materials........... 17
Skeletal Individuals: Pathological Sample........... 20
Site descriptions........... 24
Hypotheses........... 39
Methods........... 53
Trace Element Analysis........... 61
Chapter Three: Sex Gets Less Dangerous? Investigating the Evolution of ........... 62
Virulence in Syphilis ........... 62
Introduction........... 62
Background........... 65
Study Aims........... 77
Materials and methods........... 78
Analysis........... 81
Results........... 82
Discussion........... 83
Significance........... 90
Chapter Four: The Effect of Biological Sex on Manifestations of Syphilis in the Pre-Antibiotic Era ........... 92
Introduction........... 92
Background........... 99
Materials........... 123
Methods........... 125
Analysis........... 125
Results........... 126
Discussion........... 127
Chapter Five: Overall Health and the Pathophysiology of Tertiary Syphilis ........... 135
Introduction........... 135
Background........... 139
Materials and Methods........... 149
Analysis........... 152
Results........... 153
Discussion........... 153
Significance........... 159
Chapter Six: Mercury in the Midst of Mars and Venus: Treatment of Acquired Syphilis with Mercury in 17th to 19th century England ........... 161
Introduction........... 162
Background........... 165
Methods and Materials........... 181
Analysis........... 187
Results........... 187
Discussion........... 188
Significance........... 196
Chapter Seven: Conclusion ........... 197
Appendix: Tables and Figures ........... 202
Cited References ........... 259
About this Dissertation
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