He who knows syphilis knows medicine” said Father of Modern Medicine, Sir William Osler, at the turn of the 20th Century. So common was syphilis in days gone by, all physicians were attuned to its myriad clinical presentations. Indeed, the 19th century saw the development of an entire medical subspecialty – syphilology – devoted to the study of the great imitator, Treponema pallidum. But syphilis to many is a disease of old, consigned to the annals of history by infusions of mercury, arsenical magic bullets, and finally dealt a fatal blow by the advent of penicillin. The case report of a contemporary presentation of syphilitic aortitis by Aman et al. (see pages 94−6) presented in this issue is fascinating, but it seems most remarkable as a strange relic, a throwback to an era of medicine past. Or perhaps it is not.
The UK has seen an explosion in venereal syphilis in the first decade of the 21st century. There were 3,762 diagnoses of early stage ‘infectious syphilis’ (comprising primary, secondary and early latent syphilis) made in 2007, more than in any other year since 1950. The trend has continued unabated with a similar figure seen in 2008 (2009 data are awaited). Between 1997 and 2007, annual diagnoses of infectious syphilis rose more than 1,200% (figure 1).(1)