Sicher, Sicker, Schicker, Sicca: are we Really Sure (Sind Wir Uns Wirklich Sicher) that Skull Alterations Attributed to Syphilis are Sicker Versions of Caries Sicca or is the Prepared Mind Just Seeing What it is Prepared to See? Volume 5 - Issue 2

Bruce Rothschild*

• IU Health, 2401 W University Ave, Muncie, IN, USA 47303, Carnegie Museum, 4400 Forbes Ave, Pittsburgh, PA, USA-15213

Received:September 20, 2021   Published: October 06, 2021

Corresponding author: Bruce Rothschild, IU Health, 2401 W University Ave, Muncie, IN, USA 47303, Carnegie Museum, 4400 Forbes Ave, Pittsburgh, PA, USA-15213

DOI: 10.32474/JAAS.2021.05.000210

 

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Abstract

Background: Given disparate suggestions as to the origin and geographic distribution of syphilis, it seemed appropriate to examine the premises for the speculations that have been suggested for its recognition. Those premises that were pathognomonic (definitively diagnostic) are identified as such on the basis of precise definitions. It was hypothesized that the more observations differ from the original reports that establish definitive criteria, the greater the likelihood of diagnostic uncertainty. It was hypothesized that Hackett’s attribution of various skull changes to syphilis strayed from Virchow’s original description, was purely speculative in nature and had not been subjected to independent scientific scrutiny.

Methods: New populations with clinically diagnosed syphilis were therefore examined to assess the presence of caries sicca as originally defined and for those which were claimed to be stages of the spectrum of that phenomenon. Museum collections were also examined for presence of the specimens illustrating both varieties.

Results: Caries sicca, as originally defined by Virchow, was identified individuals from populations diagnosed in life with syphilis. Other forms attributed as “stages” of caries sicca were not found in that group. Museum collections with such “stages” lacked examples of caries sicca as originally defined.

Discussion: Epidemiologic co-occurrence of Virchow’s caries sicca and “more advanced cases” was not demonstrated (Fisher exact test, p < 0.00001). It was suggested that clarity, as to the origin and geographic distribution of syphilis through time, would result from extirpation of studies which failed to utilize the above-delineated criteria as originally vetted.

Keywords: Syphilis; Paleopathology; History of Disease; Biological Spectrum

Abbreviations: Venereal Disease Research Laboratory (VDRL), Systemic Lupus Erythematosus (SLE)

Highlights

a) Classic caries sicca, as defined by Virchow and the other skull pathologies attributed to syphilis appeared to represent disparate phenomena.

b) They seemingly are not even found in the same sample.

c) Serial radiographs have not documented progression between stages

d) Perhaps clarity, as to the origin and geographic distribution of syphilis through time, will result from extirpation of studies which fail to use as originally vetted.

Abstract| Introduction| Methods| Theory/Calculation| Results| Discussion| Conclusion| Acknowledgements| Declarations of interest| References|