GROUP 1 Reading Questions

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Gonorrhea History to mid-20th Century http://www.news-medical.net/health/Gonorrhea-History.aspx

By Ananya Mandal, MD; edited by Beth Hutchison for use in WS370U with a few additions

from Wikipedia (http://en.wikipedia.org/wiki/Gonorrhea#History) and

https://microbewiki.kenyon.edu/index.php/Gonorrhoea_(Neisseria_gonorrhoeae)_in_the_U

nited_States#History_of_the_Name_Neisseria_Gonorrhoeae_.28N._Gonorrhoeae.29

The clap Gonorrhea has long been referred to as the clap. According to some historians the name

came about because the infected person would experience a clapping sensation that

appeared suddenly when urinating. Others say that the name originated because in order

to remove the pus-like discharge from the penis, the penis had to be clapped on both

sides.

Still others believe that the name comes from French brothels, known as les clapiers,

because men who visited them invariably ended up with the infection.

History Lacking definitive means of differentiating infections until infectious agents could be

identified through microscopes, our best information about the history of gonorrhea is

based on tracing references to its common symptoms.

Aelius Galenus, a Roman physician and philosopher (circa 200 CE), first recorded a

common symptom now recognized as characteristic of gonorrhea, naming it the "flow of

seed" (that is, semen). The term resurfaced in the sixth century when Aetius Amidenus, a

Byzantine physician and medical writer, observed pelvic abscesses which were probably

caused by the bacterium.

Early European records of the disease date from 1161 when the English parliament

enacted a law intended to curb the spread of the “the perilous infirmity of burning”

(referring to a common symptom of gonorrheal infection).

A similar law followed in 1256 during the reign of Louis IX in France; sufferers were

banished. Symptoms of the infection were also observed during the Crusades. The disease

was (and is still informally) known as "La chaude pisse," which literally translates to "hot

urine" based on the burning sensation associated with urination. After Pope Boniface (circa

1300) secularized the practice of medicine, doctors began to treat common men as well as

prostitutes for this infection. Cities hired public health doctors, who were empowered to

treat patients (especially prostitutes afflicted with “the burning”) without right of refusal.

Even if the exact cause of the infection was unknown at the time, the law demonstrates

the magnitude of the public health problem.

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In 1879, German bacteriologist Albert Ludwig Sigesmund Neisser proved the bacterium

was the causative agent of gonorrhea and named it Neisseria gonorrhoeae. He also

demonstrated that discharge and cultures of the gonococci introduced into the urethra of

healthy men caused the disease.

Pre mid-20th century Gonorrhea Treatments Before antibiotics came into being, metals including arsenic, antimony, bismuth, gold etc.

were tried against the infection. Medical instruments recovered from the English warship

“Mary Rose” (part of Henry VIII’s navy) show that several special surgical tools were used

to inject mercury into the urinary opening.

Around 1859, balsam of copaiba (or copaiva) extracted from a South American tree, and

cubebs, the dried powdered unripe fruit of an Indonesian variety of pepper, were used. The

“proof” of their effectiveness was cessation of the discharge--which unfortunately was not

proof that the infection had been cured.

During the 19th century gonorrhea was treated with silver nitrate. The use of silver nitrate

was soon discontinued, replaced by protargol, a type of colloidal silver sold by Bayer (a

German drug company) starting in 1887 and used as the main medical treatment for

gonorrhea until antibiotics such as penicillin became available in the 1940s.

Guatemala syphilis and gonorrhea experiment, 1946-1948 (http://en.wikipedia.org/wiki/Guatemala_syphilis_experiment); excerpted and lightly edited In contrast to the Tuskegee syphilis study, in which African American men already infected

with syphilis were studied to document how the disease progressed without treatment

(even after effective treatment with penicillin was available), in Guatemala, US Public

Health doctors purposely infected Guatemalan citizens with STDs in order to study the

effects of treatment with penicillin. The prostitutes, prisoners, Guatemalan soldiers and

mental patients in the study were not told about the purpose of the study and did not give

informed consent.

About 1500 people were included in the study, which only came to light in 2005, when

Susan Mokotoff Reverby was searching the Tuskegee papers and found reference to the

study, which involved multiple layers of Guatemalan government agencies as well as the

US Institutes of Health and Public Health Service.

The US formally apologized in 2010; human rights activists have called for compensation

for subjects’ families.