History of Medicine

    REVEALING THE AGENT OF SYPHILIS:

SCIENCE AND CONTROVERSY

      

         

         In late nineteenth century Germany, reforms in the attitude toward venereal diseases, in the form of better public education, improved statistics, and more government funding, ensured frequent headlines in the press. It was also a time when scientists were uncovering the role of bacteria in numerous diseases that previously defied understanding. Naturally, a search for the agent of syphilis was of great importance. 

One investigator, John Siegel, followed an oblique pathway. During an epidemic of an unknown disease characterized by ulcers in the mouth, Siegel, a general practitioner, wondered if the disorder was a human form of foot and mouth disease. Working in a home laboratory, he failed to find a bacterium behind foot and mouth disease and wondered about parasites. After further training under Prof. Franz Schulze, a respected parasitologist at the Zoological Institute in Berlin, he published papers claiming that protists in the genus Cytorrhycetes were the cause of foot and mouth disease as well the cause of variola/vaccinia, syphilis, and scarlet fever. Such broad assertions aroused skepticism, but the prominence of Schulze, his mentor, prevented outright disbelief. The Imperial Health Office (Kaiserliche Gesundheitsamt), alarmed by an increase in venereal disease in military troops, wanted confirmation of Siegel’s claim for syphilis and asked Fritz Schaudinn to investigate.

Schaudinn, born into a prosperous East Prussian farming family in 1871, had studied at the Friedrich-Wilhelm University in Berlin, where his talent in zoological studies attracted the attention of the same Franz Schulze who had mentored Siegel. Schulze encouraged Schaudinn to study protists and before long the latter earned a name for new

Fritz Schaudinn (Wikipedia)

 discoveries and superb microscope skills. He was asked to participate in a malaria project in the Dalmatian coast, where Germany maintained a marine research station at Rovigno. Schaudinn and his team, using quinine and anti-mosquito measures, cleared the area of malaria. While there, he founded a journal, the Archiv für Protistenkunde. Among other projects, he described new protozoa, distinguished  Entameba histolytica from Entameba coli  microscopically, and determined the pathogenicity of one ameba from the other by experiments on himself. It was a productive period (though he also made an erroneous microscopic observation that delayed knowledge of the malaria parasite’s liver stage).

He returned to Berlin as chief of a new department of protozoology in the Imperial Health Office, from where he was asked to assess the findings of Siegel. Schaudinn obtained the assistance of Erich Hoffmann of the dermatology service at the Charité Hospital (dermatologists were the syphilis specialists at the time). In March 1905, Schaudinn demonstrated, for the first time, slender spirochetes in syphilitic lesions and in lymph nodes adjacent to lesions, all carefully prepared by Hoffmann. Schaudinn saw the spirochetes both with and without staining, noting the pale blue coloring with Giemsa stain (thus the name Spirochaete pallida, later changed to Treponema pallidum). He did not say the organisms caused syphilis, only that he saw them, and in lymph nodes he saw no others. 

How did Schaudinn see what others had failed to see for so long? Two explanations have been offered. First, he was an expert microscopist, often known to spend all night peering through his instrument. Second, he had a new Zeiss apochromatic microscope (the lens corrected for three colors of light rather than the two of achromatic lenses, improving clarity). In later papers, after consistently finding spirochetes alone in syphilitic lymph nodes, he maintained that they were the causative organisms, though attempts at culture had failed. Schaudinn and Hoffmann presented their findings before the Berlin Medical Society in May 1905 and were surprised to be met with a hostile skepticism, one member huffing that spirochetes could be added to the 25 previous causes of syphilis that had been alleged.

Photos of treponema from Schaudinn and Hoffmann's original paper (Hathi Trust)

           Meanwhile, many other workers saw the organisms. Metchnicoff and Roux, recently able to transmit syphilis to apes, saw the slender organisms. Organs of infants born with congenital syphilis showed them. Robert Koch, informed while performing tropical disease research in Africa, wrote Schaudinn from Dar es Salaam, congratulating him. Mail applauding him came from the bacteriologist Carl Fraenkel, the dermatologist Karl Herxheimer, Aldo Castellani (the discoverer of the trypanosome of African sleeping sickness), and the chemist/bacteriologist Gustav Giemsa, whose stain Schaudinn had used.

Schaudinn received invitations from the Universities of London and Cambridge, but eventually accepted a position as protozoologist at the new Bernard Nocht Institute for Tropical Medicine in Hamburg. Shortly after this, the Kaiser invited him to attend the International Congress of Medicine in Lisbon in 1906. A committee of the Congress had unanimously chosen Schaudinn to receive a prize for his work, but the German medical establishment intervened, objecting that Schaudinn lacked an MD degree and was too young to qualify for such a prestigious award. The award eventually went to Alfonse Laveran for his discovery of the malaria parasite in 1880. He was 86. The dermatology section of the Conference, provoked, hosted an extravagant tribute in Schaudinn’s honor, which touched him deeply.

Schaudinn had suffered for some time from perirectal abscesses. Heading home by ship from Lisbon, he became quite ill with pain and fever, requiring emergency surgery aboard ship. After landing, his condition worsened. An abscess the size of a “small child’s head” was opened but he developed overwhelming sepsis, perishing in June 1906. He was 35 years old, his brilliant career cut short. 

Schaudinn left behind a wife and two children, whose grief may have been softened by the creation at the Bernard Nocht Institute for Tropical Medicine, his last research home, of the Schaudinn Medal, awarded every two years for excellence in protozoan research. 

 

Remember: A list of prior history of medicine entries with corresponding links is available at: https://museumofmedicalhistory.org/j-gordon-frierson%2C-md

The website for the SSVMS History of Medicine Museum is: https://museumofmedicalhistory.org

SOURCES:

 

Kuhn, C, Aus dem Leben Fritz Richard Schaudinns. 1949, Georg Thieme Verlag, Stuttgart.

 

Mollenhauer, D, “Founder of Archiv für Protistenkunde: Fritz Schaudinn - his Unfinished Life.” 2000; Protist, 151: 283-7.

 

Lindenmann, J, “Siegel, Schaudinn, Fleck and the Etiology of Syphilis.” 2001; Stud Hist Biol & Biomed Sci, 32(3): 435-55.

 

Thorburn, A L, “Fritz Richard Schaudinn, 1871-1906: Protozoologist of Syphilis.” 1971; Brit J Vener Dis 47: 459-61.

 

Medina-de la Garza, C E et al, “Fritz Schaudinn: zoólogo y protozoologo.” 2012; Medicina Universitaria, 14(57): 231-8.

 

Risse, G, “Schaudinn, Fritz Richard,” Dict of Scientific Biog, 1981.

Schultz, O T, “Fritz Schaudinn: A Review of his Work.” 1908; Bull Johns Hopk Hosp 19: 169-173.