Is there any evidence of STD's in ancient times?

Are there any ancient texts that show or imply that their authors knew that certain diseases were spread through sexual activity? It seems like sexual contagion was recognized in the 16th century during the height of the syphilis epidemic. I have even read that it contributed to closing of some brothels and the rise of Puritanism.

I am more interested if anyone in Rome, Greece, or the Middle East realized a connection between sex and disease during the Bronze Age or the Classical period. There were plenty of commercial brothels in the Roman Empire and plenty of temple prostitutes in the ancient Middle East. Is there any evidence of STD epidemics from then?

I realize that germ theory would not be around until the nineteenth century, but a ancient historian or philosopher still could have noticed a correlation.

Famously, the Ancient Egyptians knew a lot about sexuality, gynecology and genitourinary infections. Nevertheless, according to this article, there are no unambiguous description of STD's in the medical papyri of Ancient Egypt (though many reported symptoms suggest gonorrhea and some suggest pelvic infections). The same source notes that the Old Testament describes an epidemic-more precisely, a plague-which is clearly temporally and causally linked to sexual relations and for which Moses provides a technically correct solution: kill everyone but the virgins (see here, verse 16 and 17 for instance).

The oldest written record of STD are probably the Sumerian clay tablets.

from History of venereal diseases from antiquity to the renaissance

That some genital disturbances were observed and some form of urethritis was present is within the range of probability, especially if one reads the poetry dedicated to Innana (or Ishtar), the goddess of sexual love and fertility, or about the promiscuous life of Gilgamesh, King of Uruk.

Recently writings by scholars on Mesopotamian medicine give more information about contagious diseases and STDs among the ancient people of the region, and describe urethral and vaginal discharge (dribbling from the vulva) possibly caused by Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis, as well as cases of herpes genitalis, if the patient had “babu'tu” i.e. vesicles on the genitals.

As the other answer mentioned we also have some records from ancient Egypt. Once we get to the Classical antiquity of Greece and Rome we get plenty of medical texts or other references to sexual health from various authors.

At least syphilis is thought to not have existed in Europe but having been introduced there by the returning discoverers from the voyages of Columbus.
Many other diseases have found their way from one continent to another through similar means, think of the plague and HIV…
Of course there are many diseases that can be transmitted through sexual contact, and many of them would not have been recognised as such at the time. Think Herpes, which has several vectors, only one of them being sexual intercourse.

Is there any evidence of STD's in ancient times? - History

The practice of jus primae noctis (“right of the first night”) is, in simplest terms, the right of the local noble to deflower local peasant brides on their wedding night before their newlywed husbands. Precedence for this practice supposedly goes back for many thousands of years, with the first reference of something like it going all the way back to the Epic of Gilgamesh from over four thousand years ago. This practiced (apparently) reached its crescendo during the Middle Ages in Europe, and today is popularly depicted in Hollywood in such films as Braveheart.

But did it really ever happen?

Numerous historians have studied the subject and the result is that it turns out there is no solid evidence of this practice happening in reality at all. Not a single well documented incident recorded, nor a single victim’s name passed down. It could be argued that women in these periods, in general, would not be considered noteworthy, especially peasant women, but with a practice spanning (supposedly) thousands of years, and the presumable rage it would induce in the peasant populace, not to mention occasional bastard offspring and perhaps a boatload of secret weddings to avoid the issue, odds are at least a few documented cases would manage to make it down through posterity. Or even just a record of the law in some court case, as there are such records of numerous other laws. But any such evidence simply doesn’t exist outside of fictional works or, for instance, cases where people were trying to rally the peasant class against their lords using the supposedly former practice of jus primae noctis to whip the mob up.

In fact, the very first mention of this in the Epic of Gilgamesh, we see the hero Enkidu, who was sent by the gods to stop Gilgamesh after the people cried out to the gods for aid, physically blocking a wedding place to challenge Gilgamesh over this appalling abuse of power.

In another early account (in the 5th century BC), Heraclides Ponticus describes how the king of the Island of Cephalonia instituted this practice. Once again, the commoners weren’t pleased and one man went ahead and dressed himself as a bride and subsequently murdered the king when the monarch tried to exercise his lordly right. For his efforts, the cross-dressing man was made the new king by the overjoyed masses.

There’s also the matter of disease to consider. While these girls were all (supposedly) virgins on their wedding day, that didn’t mean they were free from diseases that frequently devastated life through most of history. And, let’s face it, these lords weren’t just sleeping with these women, but many others to boot. If the lords were truly sleeping with many or all of these women in their little fiefdoms, beyond spreading diseases to every corner of their lands, jus primae noctis would have been a deadly law for a lord of a fiefdom of any real size, assuming he chose to enforce it.

So it should come as no surprise then, that while it’s possible there exists a few rulers in history who actually tried something like this at some point, as mentioned, most historians think the vast majority of accounts are pure fiction or exaggeration. For instance, Louis Veuillot writing in France during the 19th century stated: “Nothing, absolutely nothing, in the archives of Justice authorizes us to say that our forefathers ever made a crime into a law. If we search the evidence and the literature we find the same silence everywhere. The Middle Ages had never heard of the droit du seigneur [aka jus primae noctis].”

Other European scholars shared Veuillot’s opinion. Germany’s Karl Schmidt penned a thorough treatise on jus primae noctis in 1881, and came to the conclusion that is was “a learned superstition.” Over and over again historians from then to now have tried to find hard evidence of this occurring and come up empty, despite the numerous accounts, sometimes explicitly fictional and other times thought to be, throughout written history in nearly every major culture. For instance, famed philosopher Hector Boece in the 16th century described this practice perfectly during the reign of the Scottish king Evenus III and claimed the practice went on for centuries. It turns out, though, no such king ever existed and much of Boece’s accounts concerning many of the legendary kings of Scotland are thought to be pure fiction. Similar fictional trends are seen elsewhere concerning this supposed law.

Back to Europe and the middle ages, what is true is that in many feudal societies, peasants were required to get permission from their lord to marry. This requirement was called the culagium. This often involved payment of a fee to be granted such permission (some claim this law replaced jus primae noctis, but while there is hard evidence of culagium, not so much with jus primae noctis, as mentioned). Besides an extra source of revenue, another purpose of the culagium was the nobles safeguarding their investment by making sure they didn’t lose their valuable serfs to a neighboring lord for nothing. In essence, jus primae noctis in some cases functioned as a tax due when a serf’s daughter married a man not on the lord’s estate. By requiring the tax, it also made it easier to track such movements in populace, as well as perhaps deny it when prudent.

In addition, in some areas the Church also demanded payment of a fee to get the couple out of a three day waiting period before consummating their union. (One can only imagine how they tracked this.) During that three day waiting period, the betrothed were supposed to be deep in prayer to prepare themselves fully for their physical (and spiritual) union. Of course, payoff your local clergy and you could go forth with a clear conscience.

In the end, let’s face it, life was brutal for peasants, and especially peasant women, in this era. When they weren’t being wiped out by some pandemic, humiliation and subjugation were just accepted facts of life for those born into the lower social orders. Jus primae noctis or not, female serfs were at the mercy of their lords (and others), who really didn’t need an excuse, a law, or a wedding to rape or assault the serfs inhabiting their land. The peasant class didn’t appreciate this (or many other such abuses) one bit, and so it’s no surprise that they would rally around a concept like jus primae noctis during various uprisings and instances of political discourse. In slightly more modern times, this was, for instance, a favorite weapon against nobility and clergy used by the great enlightenment thinker Voltaire. (Voltaire also, incidentally, made his fortune by helping to rig the lottery.)

As J.Q.C. Mackrell states in his book, Attack on Feudalism in the 18th Century France, “the Philosophes used the Droit [jus primae noctis] as a ploy to exaggerate the specter of oppressed Serfs. (For them) no charge was too absurd…” It should be noted here that at this time in France it was also said that lords used to claim the right of droit de prélassement (right of lounging), a right of a lord to use one of his subject’s entrails, freshly ripped from the body, to warm the noble’s feet… No charge too absurd indeed.

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  • Besides the lordly right to first night, the fourteenth century Sir John Mandeville claims during his travels he encountered an island “Where the custom is such that the first night that they be married they make another man to lie by their wives for to have their maidenhead…for they of the country hold it…so perilous for to have the maidenhead of a woman.. I asked them the cause why that they held such custom: and they said, that of the old time man had been dead for deflowering of maidens, that had serpents in their bodies that stung man upon their yards [penis], that they died anon.”
  • Despite most movie fans connecting the nickname “Braveheart” with William Wallace because of the award winning film with Mel Gibson (1995), in real life the specific nickname actually belonged to one of the semi-bad guys depicted in the film- Robert the Bruce. While Robert (then the Earl of Carrick) really did switch sides several times during the Wars of Scottish Independence, there is no record of him betraying Wallace and the Battle of Bannockburn wasn’t waged spontaneously as it seemed in the movie. He had been battling the English for nearly a decade up to that point. Robert ultimately became the King of Scots from 1306 and held that title until his death in 1329.


This whole “right of the first night” thing is as much an urban legend as chastity belts. No historical references for them either.

I think people just make this stuff up because it sounds like something the unenlightened people of the past would do. Gotta make ourselves feel superior so we accuse them of all sorts of things that aren’t true.

Oh, chastity belts existed, all right. I saw one in the Tower of London museum when I was 13 years old and I’ve had nightmares about that horrific thing ever since. It’s too horrible to describe, but let’s just say they had all the bases covered. I imagine that any woman unfortunate enough to have to wear that awful thing made friends with the locksmith pretty quickly!

Okay, so add this to the historical inaccuracies in Braveheart I already knew about…and that film is just complete hogwash from beginning to end. I hate it when they make a “historical” movie and then change all the important facts. They should have just made it a fantasy movie, thrown in a few dragons, while they were at it.

While there is no evidence of it occurring, it does not mean it didn’t happen. There are historians who have read accounts that it did happen. It is not quite so black and white. Also the movie for the most part is pretty accurate because it is based on a poem that actually depicts William Wallace’s life.

I believe the part about the church’s fees is inaccurate. You are referring to the banns which had to be published (i.e read from the pulpit) for three consecutive holy days (normally Sundays) so it meant keeping it in your pants for weeks. A marriage license (which you paid the church for) gave you license to marry immediately.

The “right of the first night” was real. The Turks of the Ottoman empire inforced it in their conqured lands but it was a great shame for the catholic and ortodox christian women and their husbands so it was rarely spoked of. Especially if 9 months later the woman gave birth to a slightly darker child. People from Greece, Bulgaria, Romania, Serbia, Montenegro, Bosnia and Herzegovina, Croatia, Hungary and others know this from stories that were past down through generations. It is also one off the reasons people from the Balkans don’t like muslims very much. I know this from a story of a conflict my family had with the Turks when a local Turkish nobel came to inforce the rule on one of my ancestors. The short story is my ancestor (Croatian Herzegovinian) chopped off the Turks head and the whole village had to move from Turskish ruled Herzegovina to Venetian Dalmatia because the penalty for that was burning the village and killing all of it’s people but at least he didn’t get his wife haha. But unfortunately most people weren’t so close to the border so they had to endure the shame.

I read also stories that many medieval European counties

I heard similar story about the “first night right” from Ottoman occupied Greece. A friend of mine whose father was greek, told me that it was common for Turks to show up at weddings and decide whether to take the bride away or not, if they liked her. It sounded absurd and repulsing, but I guess it might be true. Just out of curiosity: Do you know how did your family cope with living in Dalmatia under the Venetian rule? Since part of my family comes from Veneto area in Italy, this is one of my main fields of historical interest.

Similar stories are told of times when there was muslim rule in northern India. It was said muslim gangs would abduct Hindu brides and gang rape them and it per they legal. To this day Hindu wedding cremonies in North India are conducted at night, though night is considered inauspicious time in Hinduism.

Sorry, but Biljana Plavšić is not a historian.

Are you sure? Statuory rape might be in common, but in whole Serbian, Croatian and others history, there is nothing that’d support such a claim. Also, we don’t like muslims due to bad history between each other.

Hi, greetings from Hungary! As far as I know it was a practice in Hungary – but I did not know that it came from the muslim Turkey. Thanks for the information

“Voltaire also, incidentally, made his fortune by helping to rig the lottery.”

Your linked article is in conflict with this click bait. Voltaire didn’t “rig the lottery.” He and others ran a scheme to win because the lottery was stupidly designed. Geez…

Of course, because if there were such a practice of among feudal lords, surely we’d have some written account of it from the victims, just as we do from slaves of the degradations they suffered, or all the accounts of domestic violence we have from women of all stations considered property in their time….oh wait, slaves and peasants didn’t generally tend to read or write, nor one would think, tell each other stories of things that for them was just a part of the life of the subjugated, especially the humiliating and painful aspects they’d want to forget. Nor do we have accounts from even literate high-born women of domestic violence, and only know about the treatment of women from accounts of men, either boasting of their exploits or lamenting what they were forced to do to disobedient wives, daughters, or sisters who forgot their place.

But still, the author is probably right, about “the bastard offspring and perhaps a boatload of secret weddings to avoid the issue, odds are at least a few documented cases would manage to make it down through posterity. Or even just a record of the law in some court case.” Except that there have been untold numbers of bastards in modern times that were simply raised by other men, and since these were women had just been married, it’s perfectly logical that their husbands would simply raise the bastard children as their own, just as was the case of the husbands of mistresses to kings who raised bastard children with royal blood. Why would they need “secret weddings” if they were newly married? About the rage the author contends it would induce: Does the author understand how subservient and demoralized these people were? What kind of horrors, humiliations, degradation, and deprivations they suffered generation after generation? How few uprisings there were of the billions of subjugated throughout the millennia? Rage was a luxury they couldn’t afford, and certainly couldn’t to act upon it. Suicide was a more common means of escape. Everything about the author’s line of thinking on this defies logic, particularly the “secret weddings,” for newly wed peasant women.

As for writing the law down, feudal rights didn’t need to be written down, because the entire point of feudalism is that serfs have no rights, and nobles were throughout much of history, above the law where serfs were concerned. Look what the Marquis de Sade had to do before being punished, precisely because he only abused peasants, and that was during a period of relative prudishness compared with earlier times. And considering that King Henry the VIII was ravaged by syphilis, and who knows what other STDs, after sleeping his way through the court and the palace servants, which was presumably the case with other monarchs and nobles as well, I don’t think STDs were a major concern among feudal lords. And by the way, Henry the VIII wasn’t young when he died, not for life expectancy for the time, and until the advent of AIDS, STDs weren’t an imminent death sentence, unlike the plague, small pox, TB, cholera, typhoid, typhus, and influenza that were far more apt to kill one than an STD. Additionally, the author is ascribing a promiscuity to young peasant women who would’ve been kept under close scrutiny, since loss of virginity would’ve meant her parents would be stuck with her forever, and examinations performed by midwives wasn’t unusual. Also, the feudal lord presumably wasn’t required to sleep with every newlywed peasant woman, since the law portion would’ve applied to the peasants being forced to submit, for the lord it would’ve been a right—meaning he could decide who and how many, or not to participate at all. Feudal lords were THE deciders. It was the right of monarchs to decide who would marry and who wouldn’t, but wasn’t written. Men were permitted to beat their wives, but laws weren’t written stating that until people began living in close proximity to one another. The sounds of distress from women being beaten disturbed their neighbors’ peace, so laws were instituted stating men could only beat their wives during daylight hours, becoming illegal once the sun set, up until the sun rose again. The author is applying modern thinking and assumptions to periods in which they simply didn’t exist, and is mistaken about the lethality of STDs.

Louis Veuillot wrote in 19th century France that: “Nothing, absolutely nothing, in the archives of Justice authorizes us to say that our forefathers ever made a crime into a law.” As far as I know, rape of peasant women wasn’t against the law. Peasants in general were viewed as little more than beasts of burden, only a small step above slaves, and women in general were the property of men, so peasant women had absolutely no rights and were considered to be of less worth than some animals. Note that all the historians listed, and I’m guessing the others among the “numerous historians” who have studied this, were all men, of whom would want to believe that their male predecessors were capable of such behavior, especially Veuillot, who was writing during a period when Victorian morality was spreading outside Britain, across the continent and the Atlantic. Frankly, I’m surprised the author of this is a woman since it sounds as if it’s written from the male perspective, one with little insight into the reality of the experiences of women centuries or millennia ago, which though different, have underlying commonalities in the way in which women are viewed today, views that didn’t substantially shift until the last century, and the patriarchal ethos that persists in modern cultures, even in Western cultures. There have been accounts, either written or handed down verbally, that were dismissed because modern people couldn’t imagine their predecessors being capable of things they came to view as abhorrent, including genocide, and even well documented accounts of the Holocaust that are being repudiated by some historians, albeit ones that are on the fringe, due to biases. A century from now, the Holocaust may be considered a hoax. It’s human nature to reject the worst acts of humanity, particularly if perpetrated by those of the same gender, race, ethnicity, or nationality. There are still those who try to justify slavery and the American civil war fought to perpetuate it.

I’m not contending that it was an actual tradition among feudal lords for millennia, it may very well not have been, but the arguments presented here aren’t conclusive or particularly persuasive, some aren’t even logical, ignore the realities of the relevant time periods, most are based upon the opinions of male historians, some of whom were from earlier centuries and almost certainly had a biased and skewed perspective because of the views and morality of their time, and none of which is at all sufficient to definitively pronounce that such a practice never existed, or that it’s completely absurd to even consider the notion, which seems to be the position of the author, judging by the tone of this piece.

The point is we know about all the stuff you mentioned already through other means because it wasnt that long ago and its been documented through other means anyway. Plus im sure some slaves and a lot of domestic abuse victims have in fact written and documented thier treatments plenty.

We have to go by what evidence we have, period. Otherwise we’re only assuming and speculating based on here say and weve all played the phone game in kindergarten so we sll know how that goes. And fortunately there is no evidence of this behavior no matyer how much you might hate men, sorry.

Also, study up on your diseases, STD’s could be quite the death sentence, especially before the advent of antibiotics and decent hygene such as the middle ages… Try looking up syphilis first…

I think rather than looking to books genetic may provide a clearer answer. As I understand it one of the most dominant Y chromosomes in the world is trace to Genghis Khan homeland and was spread by him and his relatives in their conquests. Women were offered up or taken. I don’t think you will find record of this in the law library. That it is in the history books is testament to our writing it and not the Huns.

Virginity tests have been debunked as valid indicators of anything, because hymens can tear, from intercourse or other causes, and they can also simply stretch and spring back, depending on the individual’s tissue elasticity etc. So examining the hymen is just invasive and meaningless and always was.

I think it’s more about sexual fantasy of moderns. Imagine the fantasy some men have of being a woman’s first. Particularly if it’s a king or nobleman.

The poor peasant husband has to “wait it out” on their wedding night while the nobleman gets to have his way with his Christian woman bride. Imagine what goes through her husband’s mind as she voluntarily surrenders to him, letting him be her first and the first to “educate” her on how to please a man and what would be “expected” of her.

The nobleman not only gets to be the firstin her, he is, “by law,” allowed to spend the entire night with her giving her all those new sensations and “introducing” her to sex through all those positions he tries with her. He warns her when he is about to ejaculate deep into the depths of her Christian innocence, providing her the royal seed she wants.

The child they conceive, when it is delivered and raised, the couple knows it’s not the husband’s and she isn’t as sexual with him as she might have been had she not given the nobleman or king her Christian innocence. As a woman never forgets her first, all through their marriage she always “looks back” and “compares” the way her husband attempts to satisfy her with how that nobleman did.

Though reluctant in the first part of their time together that fateful night she was about to give the nobleman her virginity, she soon became more relaxed and dropped her self-imposed religious restrictions when he held and kissed her and began to seduce her. She comes to enjoy his passion and tells him she loves him. Imagine the nobleman paid her some other visits in the future when he wanted to express his love to her in that special way and “re-enact” that special night they spend together.

6 Tentacle Rape - Late 18th Century

We love to mock "tentacle porn," and Japan for inventing it. If this is your first day on the Internet, just know tentacle porn is one of the Internet's most beloved methods of making young people terrified of sex, and it is precisely what it sounds like: women being raped by tentacles (usually in cartoons).

The modern tentacle rape genre was created by Toshio Maeda, whose manga Urotsukidoji "created what might be called the modern paradigm of tentacle porn," which we suppose in Japan is actually seen as an accomplishment rather than grounds for a sexual assault conviction. According to Maeda, he started the practice in order to get around Japan's strict censorship laws, which forbade the depiction of a penis but did not forbid penetration by anything else.

For men, the fetish appeals to those who enjoy seeing women humiliated and subjugated by something that isn't even human. For women, the fetish appeals to those who've secretly always wanted to have sex with Squiddly Diddly.

While Maeda may have created the modern tentacle rape, he wasn't the inventor--not even close. Maeda was preceded by Katsushika Hokusai, an artist from the late 18th and early 19th century. Hokusai was the artist of the "Thirty-Six Views of Mount Fuji," an internationally recognized series of prints that earned him fame both locally and globally. Also: he liked him some tentacles.

Hokusai's "The Dream Of The Fisherman's Wife" is speculated to be the first instance of tentacle erotica, so by all means don't click that link if you're at work, there are children present or you have a soul.

But before you go calling Japan a nation of psychotic fish diddlers, check out "Tentacles of Desire: The Man Who Loved Cephalopods." Contained within is the story of Joshua Handley, an English artist in the late 19th century whose travels to Japan resulted in an obsession with tentacle erotica.

Moabite Stone/Mesha Inscription – “House of David”

The Moabite Stone, also known as the Mesha Inscription. Photo Credit: Public Domain / Wikimedia Commons

In 1994, epigrapher Andre Lemaire proposed that the famous Moabite Stone also contained the phrase, “House of David.” The Moabite Stone contains an inscription by Mesha, King of Moab, who boasts about his successful rebellion from the King of Israel, an event described in 2 Kings 3. The stone was intentionally broken by locals in Jordan, where it was discovered, but not before squeezes of the inscription were taken. The inscription in question is difficult to read because of a break in the stone, and a crucial letter is missing in Line 31. Lemaire concluded, “My own examination of the stone and the squeeze, which is now being restored and cleaned of accumulated dust, confirms that t follows the b. I would now, for the first time, reconstruct the missing letter as a d (d). The result: bt[d]wd (dw[d]tb), the ‘House of [D]avid!’” 4

In 2019, Israel Finkelstein, Nadav Na’aman, and Thomas Römer published a paper in the Journal of the Institute of Archaeology of Tel Aviv University analyzeing Line 31 on the Moabite Stone. They argue that there is a vertical stroke which indicates a transition between two sentences and that the letter bet should be read as the start of a name (Balak), rather than Beit (House). 5 Around the same time, Michael Langlois, a scholar with the French Researcher Center in Jerusalem, published an article in the Journal Semitica, which supported Lemaire’s initial reading of “House of David.” He claims there is no such vertical stroke in the image, but that the line break comes later. Langlois has spent years using high resolution images, computer algorithms to perform Polynomial Texture Mapping (PTM) of the stele to create a 3-D image. Recently he used Reflectance Transformation Imaging (RTI) – photos of the stele itself and the original squeeze from various angles and in different lighting, to create a high-resolution backlit image of the inscription. In his article, Langlois argues that the new technology shows a previously overlooked dot, the customary way scribes at that time indicated a break between words, which comes exactly after the area interpreted “House of David,” confirming Lemaire’s initial reading. 6

New imaging techniques by scholar, Michael Langois, improves the reading of the “House of David” inscription on the Moabite Stone. Image courtesy of Micahel Langois,


There is wide agreement about the effects of diseases and epidemics associated with European contact. 16 , 17 The first well-documented, widespread epidemic in what was to become New Mexico was smallpox in 1636. Shortly thereafter, measles entered the area, and many Pueblos lost as many as a quarter of their inhabitants. 18 After the founding of Spanish settlements and missions, there was substantially more contact, and throughout the 17th century, epidemic disease was repeatedly imported.

Osteologic data demonstrate that native groups were most definitely not living in a pristine, disease-free environment before contact. Although New World indigenous disease was mostly of the chronic and episodic kind, Old World diseases were largely acute and epidemic. Different populations were affected at different times and suffered varying rates of mortality. 19 Diseases such as treponemiasis and tuberculosis were already present in the New World, along with diseases such as tularemia, giardia, rabies, amebic dysentery, hepatitis, herpes, pertussis, and poliomyelitis, although the prevalence of almost all of these was probably low in any given group. 14 Old World diseases that were not present in the Americas until contact include bubonic plague, measles, smallpox, mumps, chickenpox, influenza, cholera, diphtheria, typhus, malaria, leprosy, and yellow fever. 19 Indians in the Americas had no acquired immunity to these infectious diseases, and these diseases caused what Crosby referred to as “virgin soil epidemics,” in which all members of a population would be infected simultaneously. 20

It is important to look not only at the effects of specific events like epidemic outbreaks but also at longer-term processes that influence the age and mortality structure of populations. Kunitz and Euler stated that “one does not need to invoke large-scale dramatic epidemics prosaic entities like malnutrition and infectious diarrhea are more than sufficient to do the job.” 6 Neel likewise cautioned that, to understand the influence of introduced diseases on indigenous peoples, we must first know the longer history and 𠇎pidemiologic profile” of the populations. 21 This points to the value of incorporating the information on precontact health as a precursor to understanding the effects of contact.

Syphilis: Far from Ancient History

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Article Sections

Rates of primary, secondary, and congenital syphilis are increasing in the United States, and reversing this trend requires renewed vigilance on the part of family physicians to assist public health agencies in the early detection of outbreaks. Prompt diagnosis of syphilis can be challenging, and not all infected patients have common manifestations, such as a genital chancre or exanthem. The U.S. Preventive Services Task Force recommends screening for syphilis in all patients at increased risk, particularly those who reside in high-prevalence areas, sexually active people with HIV infection, and men who have sex with men. Other groups at increased risk include males 29 years or younger and people with a history of incarceration or sex work. All pregnant women should be screened for syphilis at the first prenatal visit, and those at increased risk should be screened throughout the pregnancy. The Centers for Disease Control and Prevention recommends the traditional screening algorithm for most U.S. populations. Penicillin is the preferred treatment across all stages of syphilis, although limited research suggests a possible role for other antibiotics in penicillin-allergic patients with primary or secondary syphilis. Pregnant women with syphilis who are allergic to penicillin should undergo penicillin desensitization before treatment.

Syphilis is a chronic bacterial infection caused by the spirochete Treponema pallidum . This disease has been known for hundreds of years, and its predictable clinical stages and well-established treatments made it a candidate for global eradication at several points during the 20th century. However, the incidence in the United States is currently increasing.1 , 2 Control efforts have been hindered by clinicians' lack of familiarity with clinical presentations, diagnosis, and treatment options. Additionally, the stigma associated with syphilis makes timely diagnosis and partner notification a challenge.


In the United States, rates of primary and secondary syphilis have increased nearly every year since 2001, with the 35,063 cases reported in 2018 representing a 71% increase from 2014.


U.S. Preventive Services Task Force recommendation based on a systematic review of high-quality patient-oriented evidence

U.S. Preventive Services Task Force recommendation based on a systematic review of high-quality patient-oriented evidence

Consensus guidelines in the absence of high-quality evidence from studies in low-prevalence populations

Expert opinion and consensus guidelines in the absence of high-quality patient-oriented evidence

Consensus guidelines in the absence of clinical trials

A = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to


U.S. Preventive Services Task Force recommendation based on a systematic review of high-quality patient-oriented evidence

U.S. Preventive Services Task Force recommendation based on a systematic review of high-quality patient-oriented evidence

Consensus guidelines in the absence of high-quality evidence from studies in low-prevalence populations

Expert opinion and consensus guidelines in the absence of high-quality patient-oriented evidence

Consensus guidelines in the absence of clinical trials

A = consistent, good-quality

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The Authors

JASON RICCO, MD, MPH, is a faculty physician at the University of Minnesota North Memorial Family Medicine Residency Program and an assistant professor in the Department of Family Medicine and Community Health at the University of Minnesota Medical School, Minneapolis. .

ANDREA WESTBY, MD, FAAFP, is a core faculty physician at the University of Minnesota North Memorial Family Medicine Residency Program and an assistant professor in the Department of Family Medicine and Community Health at the University of Minnesota Medical School.

Address correspondence to Jason Ricco, MD, MPH, University of Minnesota Medical School, 1020 W. Broadway Ave., Minneapolis, MN 55411 (email: [email protected]). Reprints are not available from the authors .

Author disclosure: No relevant financial affiliations.


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It is commonly believed that women married at a much younger age in colonial America than they do today. This isn&rsquot true as a rule, although there were some that married quit young. Arranged marriages remained quite common, and though some women were promised in marriage while still in their mid-teens, the wedding was usually delayed until a more suitable age was reached. Women were often promised in negotiations which discussed the acquisition of property as part of the marriage, particularly as the class system based on wealth hardened in the colonies.

Among the moneyed class, young men and women were expected to bring wealth, reputation, and real property to a marriage. This posed several problems for men wishing to marry. Property was often handed down to the eldest son, younger brothers often received lesser estates, or smaller amounts of money with which to build their own. But the eldest was beset with difficulties by this system as well, forced to wait for his father to dispense his largesse before bringing a strong negotiating position to the bargaining table with his proposed in-laws.

The system often presented a dilemma to the couple whether they were entering a purely arranged marriage or if there was loved involved. Human nature being what it is, frequently one or the other, or both parties to a marriage arranged by the parents, found themselves attracted to parties outside of the arrangement. The situation was rife with potential for what would be termed illicit sexual behavior. Virginia&rsquos George William Fairfax was married to Sally Cary in a marriage arranged by their parents. Sally was the first true love of George Washington, and there is evidence that she reciprocated his feelings. But she remained true to her marriage.

George Washington was considered by Sally&rsquos father to be beneath the class of the Cary&rsquos, as the heir to the Washington family fortune and lands was his older half-brother Lawrence. Such niceties of detail in arranging marriages were common in Virginia among the landed families, and no doubt contributed to the many incidents of dueling which were common as well.

It wasn&rsquot only the man who needed to bring value to the negotiations for marriage. The bride&rsquos family needed to provide a dowry. Upper class fathers needed to keep their wits about them when their daughters selected a suitor on their own, particular if the gentleman in question was from another area and relatively unknown, a visitor from England for example. Previously arranged marriages prevented their daughters from being taken by a disreputable son of a broke English nobleman, hiding from debtors in America, hoping to marry into money.

Herpes Simplex Recognized

Even though herpes dates back years and even centuries ago, it was in 1893 when Vidal defined and recognized the transmission of this infection from one person to another. Following this discovery, scientists started actively researching the herpes simplex virus. During the 20th century, the research blossomed when scientists defined the giant multinucleated cells associated with this infection.

Later on, in 1919, the scientist Lowenstein confirmed what Shakespeare originally suspected – that the herpes is an infectious disease. After this, scientists started studying the natural history of the virus and in the 1920’s and 1930’s, they discovered that the virus affects the nervous system, too.

Latency was characterized in the 1930’s when scientists examined the host immune responses to this virus. By the 1950’s, research continued and revealed a lot about the many diseases primarily caused by HSV. This was the beginning of the discoveries regarding treatment and antiviral research, HSV vectors and vaccines, etc.

Unexpected dalliances

Here were two clearly distinct species, separated by up to 700,000 years of evolution, yet the remnants of their sexual proclivities are captured in the DNA of the majority of people alive today. What’s more, it soon emerged that our ancestors weren’t only getting it on with Neanderthals.

Just as Pääbo was finishing sequencing the Neanderthal genome, a parcel landed on his desk. It contained a tiny fragment of a finger bone from the Altai mountains in Siberia. The piece was 30,000 to 50,000 years old and was thought to be from another Neanderthal. His team was in for a big surprise. The DNA analysis revealed an entirely new group of archaic humans, now dubbed the Denisovans, which split from a common ancestor with Neanderthals some 500,000 years ago.

Once again, comparisons with modern human genomes showed that the two interbred. Genetic studies reveal this to have happened in Eurasia. They also show that Denisovans ranged from Siberia to South-East Asia, and that at least one of their genes helps modern Tibetans to live at high altitude. The idea that our ancestors hybridised with other hominins was once dismissed. Now it was starting to look as though they would mate with anything vaguely human.

Denisovans are nearly ghosts: we have that one finger bone and a few molars as a physical testament to their existence, but no more. Then in 2016, a true ghost emerged from the genomes of 44 individuals who lived in the Middle East between 14,000 and 3400 years ago. Their DNA held genetic markers indicative of a distinct group of ancient H. sapiens based in the region more than 45,000 years ago. The members of this population are now known as Basal Eurasians, and they present a conundrum. Their DNA, which is still found in modern Europeans, shows none of the telltale signs of interbreeding with Neanderthals. This came as a surprise because ancestral humans mated with Neanderthals very soon after leaving Africa 60,000 years ago in the migration that was to give rise to all people of non-African heritage alive today.

The most-likely explanation is that soon after that migration, a group of humans became isolated while the rest bumped into and mated with Neanderthals. “If you like, it’s a third branch,” says Chris Stringer of the Natural History Museum in London – a branch that is distinct from the humans who had stayed in Africa and the ones who were gradually spreading out across Eurasia, Australia and eventually into the Americas. Because there are no known fossils belonging to Basal Eurasians, it is impossible – for now – to say why they were isolated. Perhaps it was just down to where they settled, far from other groups. Or maybe they developed cultural differences. Either way, these ghosts didn’t mix with the rest of humanity for millennia – long enough to evolve distinct genetic markers.

The Basal Eurasian research showed that rich insights into human history can be gleaned from DNA alone. But, like the Neanderthal and Denisovan studies, it relied on obtaining DNA from fossils, something that remains a huge challenge. DNA degrades with time, so it takes special fossils and special skills to extract it from very old bones, particularly ones that have spent thousands of years buried in hot climates. However, in the mid-2000s, geneticists were already discussing another approach. Among others, Jeffrey Wall, now at the University of California, Los Angeles, and Vincent Plagnol, now at University College London, suggested that it might be possible to spot signs of extinct populations in the DNA of modern humans, simply by using clever statistics.

The broad idea is that all DNA is subject to random mutations that accumulate over millennia and are passed down from generation to generation. By looking at mutation patterns in modern populations, it is possible to spot segments that don’t match the usual H. sapiens pattern. These are presumed to come from populations that evolved separately from our own species for thousands of years before mating with humans. Statistical modelling can then produce estimates of when the two groups mated and how different the other population was from our ancestors.

The past few years have seen several attempts to refine these methods and apply them to Africa – the birthplace of our species and the setting for a slice of our history that we know very little about. This new research has revealed the presence of at least one ancient ghost on the continent.

When Sexual Assaults Made History

Nearly as long as people have been recording history, they have documented sexual assaults. From the writings of ancient Greece to the Bible to the letters of early explorers, sexual violence has long been a brutal part of the human story. Some assaults have even changed the course of history. And, like all history, what we know about sexual assaults of the past is generally what was told by the victors—mostly men.

“Women are erased,” says Sharon Block, professor of history at University of California, Irvine and the author of Colonial Complexions: Race and Bodies in Eighteenth-Century America. “The historic rapes that ‘mattered’ are the only ones where men saw themselves damaged.”

Wars, especially, have been linked to egregious sexual assaults, from mass rape committed by Soviet soldiers as they advanced into Germany during World War II to sexual violence amid the genocides in Rwanda in 1995. In fact, the ubiquity of sexual assault in wars makes those crimes a category unto themselves.

With the understanding that no list could ever be comprehensive, below are sexual assaults that have both influenced history and those that, notably, did not.

1. The rise of Alexander the Great

The assassination of King Philip II.

Heritage Images/Getty Images

An act of sexual violence may have contributed to the rise of Alexander the Great, according to Greek historians Diodorus Siculusਊnd Plutarch. Their accounts were written hundreds of years after the event was supposed to have taken place, but the story goes like this: In 336 B.C., Pausanias of Orestis, a member of the bodyguard of King Philip II of Macedonia (and possibly his lover), was invited to a banquet by Philip’s father-in-law, Attalus. There, he was raped by Attalus’s servants. When Philip refused to punish the attackers (he did give Pausanias a promotion), Pausanias murdered the king, paving the way for the ascension of Philip’s son, Alexander the Great.

2. The rape of the Sabine women

The Rape of the Sabine women. 

Fine Art Images/Heritage Images/Getty Images

The Roman historian Livy, writing during the first century, traces Rome’s origins to the mid-8th century B.C., when the warrior tribe was facing a shortage of women. “Population growth was the most difficult thing to achieve in antiquity,” says Thomas Martin, author of Ancient Rome: From Romulus to Justinian. According to Livy, the Roman leader, Romulus, held a religious festival and invited the neighboring Sabine tribe, (𠇏ree food and drink,” notes Martin.) At Romulus’s signal, the Romans attacked and killed the Sabine men at the festival and carried off the women. In the resulting bloody war, the Sabine women called a halt to the hostilities, making allies of the tribes and allowing the Romans to multiply. As with the rape of Lucretia, and then Virginia, both recounted by Livy, there is disagreement among historians as to the veracity of this story. "It&aposs a myth," contends Mary Beard, historian and author of SPQR: A History of Ancient Rome.

3. Boudicca’s fight for independence

Boudicca, Queen of the British Iceni tribe, who led an uprising against the occupying forces of the Roman Empire.