I Have Landed

But to the noonday sun with upcast eyes,

  In rage threw these reproaching blasphemies.

  Syphilus cursed the sun, destroyed Apollo’s altars, and then decided to start a new religion based on direct worship of his local king, Alcithous. The king, to say the least, approved this new arrangement:

  Th’aspiring prince with godlike rites o’erjoyed,

  Commands all altars else to be destroyed,

  Proclaims himself in earth’s low sphere to be

  The only and sufficient deity.

  Apollo becomes even angrier than before (for Ilceus alone had inspired his wrath in part 2)—and he now inflicts the disease upon everyone, but first upon Syphilus who gains eternal notoriety as namebearer thereby:

  Th’all-seeing sun no longer could sustain

  These practices, but with engaged disdain

  Darts forth such pestilent malignant beams,

  As shed infection on air, earth and streams;

  From whence this malady its birth received,

  And first th’offending Syphilus was grieved . . .

  He first wore buboes dreadful to the sight,

  First felt strange pains and sleepless passed the night;

  From him the malady received its name,

  The neighboring shepherds caught the spreading flame:

  At last in city and in court ‘twas known,

  And seized th’ambitious monarch on his throne.

  A shepherd or two could be spared, but the suffering of kings demands surcease. The high priest therefore suggests a human sacrifice to assuage the wrath of Apollo (now given his Greek name of Phoebus)—and guess whom they choose? But fortunately the goddess Juno decides to spare the unfortunate shepherd, and to make a substitution in obvious parallel to the biblical tale of Abraham and Isaac:

  On Syphilus the dreadful lot did fall,

  Who now was placed before the altar bound

  His head with sacrificial garlands crowned,

  His throat laid open to the lifted knife,

  But interceding Juno spared his life,

  Commands them in his stead a heifer slay,

  For Phoebus’s rage was now removed away.

  Ever since then, these natives, the former inhabitants of Atlantis, perform an annual rite of sacrifice to memorialize the hubris of Syphilus and the salvation of the people by repentance. The natives still suffer from syphilis, but their annual rites of sacrifice please Juno, who, in return, allows a wondrous local cure, the guaiacum tree, to grow on their isle alone. The Spanish sailors, now also infected by the disease, learn about the new cure—ever so much more tolerable than mercury—and bring guaiacum back to Europe.

  Thus the imprecation heaped upon Spain by calling syphilis “the Spanish disease” becomes doubly unfair. Not only should the Spaniards be absolved for importation (because the disease struck Europe all at once, and from a latent contagion that originated well before any ships reached the New World); but the same Spanish sailors, encountering a longer history of infection and treatment in the New World, had discovered a truly beneficent remedy.

  Most people know about the former use of mercury in treating syphilis, for the substance had some benefit, and the remedy endured for centuries. But the guaiacum cure has faded to a historical footnote because, in a word, this magical New World potion flopped completely. (Paracelsus himself had branded guaiacum as useless by 1530, the year of Fracastoro’s publication.) But Fracastoro devised his myth of Syphilus in the short period of euphoria about the power of the new nostrum. The treatment failed, but the name stuck.

  We should not be surprised to learn that Fracastoro’s attraction to guaiacum owed as much to politics as to scientific hope. The powerful Fugger family, the great bankers of German lands, had lent vast sums to Maximilian’s grandson Charles V in his successful bid to swing election as Holy Roman Emperor over his (and Fracastoro’s) arch-enemy, Francis I of France. Among the many repayments necessitated by Charles’s debt, the Fuggers won a royal monopoly for importing guaiacum to Europe. (The Habsburg Charles V also controlled Spain and, consequently, all shipping to Hispaniola, where the guaiacum tree grew.) In fact, the Fuggers built a chain of hospitals for the treatment of syphilis with guaiacum. Fracastoro’s allegiances, for reasons previously discussed, lay with Charles V and the Spanish connection—so his tale of the shepherd Syphilus and the discovery of guaiacum suited his larger concerns as well. (Guaiacum, also known as lignum vitae or lignum sanctum [wood of life, or holy wood] has some medicinal worth, although not for treating syphilis. As an extremely hard wood, of the quality of ebony, guaiacum also has value in building and decoration.)

  Fracastoro did proceed beyond his politically motivated poetry to learn more about syphilis. In the later work that secured his enduring fame (but largely for the wrong reason)—his De contagione et contagiosis mortis et curatione (on contagion and contagious diseases and their cure) of 1546—Fracastoro finally recognized the venereal nature of syphilis, writing that infection occurs “verum non ex omni contactu, neque prompte, sed turn solum, quum duo corpora contactu mutuo plurimum incalvissent, quod praecipue in coitu eveniebat” (truly not from all contact, nor easily, but only when two bodies join in most intense mutual contact, as primarily occurs in coitus). Fracastoro also recognized that infected mothers could pass the disease to their children, either at birth or through suckling.

  Treating himself diplomatically and in the third person, Fracastoro admitted and excused the follies of his previous poem, written quum iuniores essemus (when we were younger). In this later prose work of 1546, Fracastoro accurately describes both the modes of transmission and the three temporal stages of symptoms—the small, untroublesome (and often overlooked) genital sore in the primary stage; the secondary stage of lesions and aches, occurring several months later; and the dreaded tertiary stage, developing months to years later, and leading to death by destruction of the heart or brain (called paresis, or paralysis accompanied by dementia) in the worst cases.

  In the hagiographical tradition still all too common in textbook accounts of the history of science, Fracastoro has been called the “father” of the germ theory of disease for his sensitive and accurate characterization, in this work, of three styles of contagion: by direct contact (as for syphilis), by transmission from contaminated objects, and at a distance through transport by air. Fracastoro discusses particles of contagion ox semina (seeds), but this term, taken from ancient Greek medicine, carries no connotation of an organic nature or origin. Fracastoro does offer many speculations about the nature of contagious semina—but he never mentions microorganisms, a hypothesis that could scarcely be imagined more than a century before the invention of the microscope.

  In fact, Fracastoro continues to argue that the infecting semina of syphilis may arise from poisonous emanations sparked by planetary conjunctions. He even invokes a linguistic parallel between transmission of syphilis by sexual contact (coitus), and the production of bad seeds by planetary overlap in the sky, for he describes the astronomical phenomenon with the same word as “coitum et conventum syderum” (the coitus and conjunction of stars), particularly, for syphilis, “nostra trium superiorum, Saturni, Iovis et Martis” (our three most distant bodies, Saturn, Jupiter, and Mars).

  Nonetheless, we seem to need heroes, defined as courageous iconoclasts who discerned germs of modern truth (literal “germs” in this case) through strictures of ancient superstition—and Fracastoro therefore wins false accolades under our cultural myth of clairvoyance “ahead of his time,” followed by rejection and later rediscovery, long after death and well beyond hope of earthly reward. For example, the Encyclopaedia Britannica entry on Fracastoro ends by proclaiming:

  Fracastoro’s was the first scientific statement of the true nature of contagion, infection, disease germs, and modes of disease transmission. Fracastoro’s theory was widely praised during his time, but its influence was soon obscured by the mystical doctrines of the Renaissance physician Paracelsus, and it fell into general disr
epute until it was proved by Koch and Pasteur.

  But Fracastoro deserves our warmest praise for his brilliance and compassion within the beliefs of his own time. We can only appreciate his genius when we understand the features of his work that strike us as most odd by current reckonings—particularly his choice of Latin epic poetry to describe syphilis, and his christening of the disease for a mythical shepherd whose suffering also reflected Fracastoro’s political needs and beliefs. In his article on Fracastoro for the Dictionary of Scientific Biography, Bruno Zanobio gives a far more accurate description, properly rooted in sixteenth-century knowledge, for Fracastoro’s concept of contagious seeds:

  They are distinct imperceptible particles, composed of various elements. Spontaneously generated in the course of certain types of putrefaction, they present particular characteristics and faculties, such as increasing themselves, having their own motion, propagating quickly, enduring for a long time, even far from their focus of origin, exerting specific contagious activity, and dying.

  A good description, to be sure, but not buttressed by any hint that these semina might be living microorganisms. “Undoubtedly,” Zanobio continues, “the seminaria derive from Democritean atomism via the semina of Lucretius and the gnostic and Neoplatonic speculations renewed by Saint Augustine and Saint Bonaventura.” Fracastoro, in short, remained true to his Renaissance conviction that answers must be sought in the wisdom of classical antiquity.

  Fracastoro surely probed the limits of his time, but medicine, in general, made very little progress in controlling syphilis until the twentieth century. Guaiacum failed and mercury remained both minimally effective and maximally miserable. (We need only recall Erasmus’s sardonic quip that, in exchange for a night with Venus, one must spend a month with Mercury.) Moreover, since more than 50 percent of people infected with the spirochete never develop symptoms of the dreaded third stage, the disease, if left untreated, effectively “cures” itself in a majority of cases (although spirochetes remain in the body). Thus one can argue that traditional medicine usually did far more harm than good—a common situation, recalling Benjamin Franklin’s quip that, although Dr. Mesmer was surely a fraud, his ministrations should be regarded as benevolent because people who followed his “cures” by inducing “animal magnetism” didn’t visit “real” physicians, thereby sparing themselves such useless and harmful remedies as bleeding and purging.

  No truly effective treatment for syphilis existed until 1909, when Paul Ehrlich introduced Salvarsan 606. Genuine (and gratifyingly easy) cures only became available in 1943, with the discovery and development of penicillin. Identification in the first stage, followed by one course of penicillin, can control syphilis; but infections that proceed to later stages may still be intractable.

  I make no apologies for science’s long record of failure in treating syphilis—a history that includes both persistent, straightforward error (the poisoning and suffering of millions with ineffective remedies based upon false theories) and, on occasion, morally indefensible practices as well (most notoriously, in American history, the Tuskegee study that purposely left a group of black males untreated as “controls” for testing the efficacy of treatments upon another group. In a moving ceremony, President Clinton apologized for this national disgrace to the few remaining survivors of the untreated group). But syphilis can now be controlled, and may even be a good candidate for total elimination (as we have done for smallpox), at least in the United States, if not in the entire world. And we owe this blessing, after so much pain, to knowledge won by science. There is no other way.

  And so, while science must own its shame (along with every other institution managed by that infuriating and mercurial creature known as Homo sapiens), science can also discover the only genuine mitigation for human miseries caused by external agents that must remain beyond our control until their factual nature and modes of operation become known. The sequential character of this duality—failures as necessary preludes to success, given the stepwise nature of progress in scientific knowledge—led me to contrast Fracastoro’s Latin hexameter with the stodgy prose of the 1998 article on the genome of Treponema pallidwn, the syphilis spirochete.

  The recent work boasts none of Fracastoro’s grace or charm (even in Tate’s heroic couplets)—no lovely tales about mythical shepherds who displease sun gods, and no intricate pattern of dactyls and spondees. In fact, I can’t imagine a duller prose ending than the last sentence of the 1998 article, with its impersonal subject and its entirely conventional plea for forging onward to further knowledge: “A more complete understanding of the biochemistry of this organism derived from genome analysis may provide a foundation for the development of a culture medium for T. pallidwn, which opens up the possibility of future genetic studies.” Any decent English teacher would run a big blue pencil through these words.

  But consider the principal, and ever so much more important, difference between Fracastoro’s efforts and our own. In an article written to accompany the genomic presentation, M. E. St. Louis and J. N. Wasserheit of the Centers for Disease Control and Prevention in Atlanta write:

  Syphilis meets all of the basic requirements for a disease susceptible to elimination. There is no animal reservoir; humans are the only host. The incubation period is usually several weeks, allowing for interruption of transmission with rapid prophylactic treatment of contacts, whereas infectiousness is limited to less than twelve months even if untreated. [Tertiary syphilis may be both dreadful and deadly, but the disease is not passed to others at this stage.] It can be diagnosed with inexpensive and widely available blood tests. In its infectious stage, it is treatable with a single dose of antibiotics. Antimicrobial resistance has not yet emerged.

  Interestingly, Fracastoro knew that syphilis infected only humans, but he regarded this observation as a puzzle under his theory of poisonous airborne particles that might, in principle, harm all life. He discusses this anomaly at length in part 1 of Syphilis sive Morbus Gallicus:

  Sometimes th’infected air hurts trees alone,

  To grass and tender flowers pernicious known . . .

  When earth yields store, yet oft some strange disease

  Shall fall and only on poor cattle seize . . .

  Since then by dear [in the British sense of “costly”] experiment we find

  Diseases various in their rise and kind

  Of this contagion let us take a view

  More terrible for being strange and new

  Thus the very property that so puzzled Fracastoro, and that he couldn’t fit into his concept of disease, becomes a great blessing under the microbial theory.

  Similarly, the deciphering of a genome guarantees no automatic or rapid panacea, but what better source of information could we desire for a reservoir of factual hope? Already, several features of this study indicate potentially fruitful directions of research. To cite just three items that caught my attention as I read the technical article on the decipherment:

  1. A group of genes that promote motility—and may help us to understand why these spirochetes become so invasive into so many tissues—have been identified and found to be virtually identical to known genes in B. burgdorferi, the spirochete that causes Lyme disease.

  2. The T. pallidum genome includes only a few genes coding for integral membrane proteins. This fact may help us to explain why the syphilis spirochete can be so successful in evading the human immune response. For if our antibodies can’t detect T. pallidum because the invader, so to speak, presents too “smooth” an outer surface, then our natural defenses can become crippled. But if these membrane proteins, even though few, can be identified and characterized, then we may be able to develop specific remedies, or potentiators for our own immunity.

  3.T. pallidums genome includes a large family of duplicated genes for membrane proteins that act as porins and adhesins—in other words, as good attachers and invaders. Again, genes that can be identified and characterized thereby “come out of hiding” into the realm of p
otential demobilization.

  Science may have needed nearly five hundred years, but we should look on the bright side of differences between then and now. Fracastoro wrote verse and invented shepherds because he knew effectively nothing about the causes of a frightening plague whose effects could be specified and described in moving detail well suited for poetic treatment. The thirty-three modern authors, in maximal contrast, have obtained the goods for doing good. We may judge their prose as uninspired, but the greatest “poetry” ever composed about syphilis lies not in Fracastoro’s hexameter of 1530, but in the intricate and healing details of a schematic map of 1,041 genes made of 1,138,006 base pairs, forming the genome of Treponema pallidum and published with the 1998 article—the adamantine beauty of genuine and gloriously complex factuality, full of life-saving potential. Fracastoro did his best for his time; may he be forever honored in the annals of human achievement. But the modern map embodies far more beauty, both for its factuality and utility, and as Fracastoro’s finest legacy in the history of increasing knowledge that we must not shy from labeling by its right and noble name of progress.

  V

  Casting the Die: Six Evolutionary Epitomes

  DEFENDING EVOLUTION

  12

  Darwin and the Munchkins of Kansas

  IN 1999 THE KANSAS BOARD OF EDUCATION VOTED 6 TO 4 to remove evolution, and the big bang theory as well, from the state’s science curriculum. In so doing, the board transported its jurisdiction to a never-never land where a Dorothy of a new millennium might exclaim, “They still call it Kansas, but I don’t think we’re in the real world anymore.” The new standards do not forbid the teaching of evolution, but the subject will no longer be included in statewide tests for evaluating students—a virtual guarantee, given the realities of education, that this central concept of biology will be diluted or eliminated, thus reducing biology courses to something like chemistry without the periodic table, or American history without Lincoln.