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MANUAL ON VENEREAL DISEASES

Author: Dragomir Tzachev

 

History of dermatology and venereology

The first dermato-venereological unit in Bulgaria was found in 1893 at the Alexandrovska Hospital in Sofia with physician-in-chief Dr. Stoyanovich and Dr. Bogomil Beron as intern. For the period 1894-1898 the physician-in-chief of the unit was Dr. Christo Stambolski. In 1899 head of the department was Prof. Bogomil Beron (1866-1936).

The Medical Faculty in Sofia was found in 1918 and Prof. Bogomil Beron became the first head of the Department of dermatology and venereology. He was a descendent of Dr. Petar Beron, an outstanding Bulgarian enlightener. In 1926-1927 Prof. Bogomil Beron was Dean of the Medical Faculty. In 1936 he organized and funded the construction of the building in which the activities of the department are carried out till nowadays.

Prof. Ljuben Popov was head of the department from 1937 till 1963. Sectors of dermato-allergology, mycology and a serologic laboratory were found during that time. Prof. Ljuben Popov was a scientist with international celebrity, personal fascination and high professional experience. He managed to raise the prestige of the department to a level equal to that of the best European departments at that time.

The department of dermatology and venereology could be proud of its international contacts. A great part of the activity of the department is closely related to the activities of the Bulgarian dermatological society — the first ever scientific medical society in Bulgaria. It was found on 23 rd October 1923 with the first president Prof. Bogomil Beron.

One of the best traditions of the society preserved till now is the so-called Saturday scientific sessions. During these sessions problematic patients and rare clinical cases were demonstrated, scientific reports were presented, and multidisciplinary meeting were held. Besides dermatologists and outstanding Bulgarian physicians such as Prof. Vassil Mollov, Prof. Stoyan Belinov, Dr. Haralampi Neichev, Dr. Dimo Burilkov, guests of the society have been one of the most famous Bulgarian intellectuals and artists such as Prof. Assen Zlatarov, Prof. Boyan Penev, Prof. Dimitar Mihalchev and many others.

Through the years the Bulgarian dermatology developed mainly under the influence of the German and the French dermatology. Almost all of their great representatives were guest-lecturers of the society. In 1923 Prof. Rhiele from Leipzig came to Bulgaria at the invitation of Prof. Bogomil Beron. Among the French dermatologists should be mentioned Prof. Pautrier (Strasburg) in 1936, Prof. Jeanselme (Paris) in 1939, etc.

In the last decade close relations were established with dermatologists from the USA. The first American guests of the Bulgarian dermatological society were Prof. Walter Lever, Prof. Larry Prutkin and Prof. Rieves in 1990.

The Bulgarian dermatological society has its own official "Dermatology and Venereology" journal, which have been issued regularly since 1963.

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History of syphilis

From its first confirmed appearance in the 15th century, syphilis has been the inspiration for innumerable treatments and discoveries along the winding road that led to modern medicine. From basic ointments laced with arsenic substances to the discovery of bacteria to the invention of penicillin, syphilis saw it all.

The origins of syphilis — whether it came from the old world or the new world — have been widely debated. There are several descriptions by ancient Greek and Roman authors that could indicate that syphilis saw the dawn of civilization, but none are specific enough to be sure.

In the 16th century Europeans were quick to blame it on their neighbours and it was variously referred to as the Venetian, Naples and the French disease. Others pointed to Christopher Columbus — “The first fruit the Spaniards brought from the new world was syphilis,” wrote Voltaire.

What is clear was that syphilis had a secure foothold in Europe by the middle of the Renaissance period. Referred to as a “mysterious affliction,” it made its way across Europe, aided by the movement of armies from country to country. Its symptoms were the mark of its movement — all three stages of which were on record by the 1530s.

Primary syphilis, which begins within 21 days of infection, is marked by the appearance of painless chancres or blisters at the point of contact, usually on the genitals, rectum or mouth. Secondary syphilis appears as a rash, like measles or chicken pox on the body, and often includes chancres that grow into moist ulcers teeming with infectious spirochetes. The final phase, Tertiary syphilis, attacks the cardiovascular system, central nervous system and the brain, ultimately turning it to mush; an altogether fatal progression, leading to eventual insanity or death.

In the 16th and 17th centuries, school children were given tours to public syphilis treatment facilities to teach them what happened to those who were unable to control their “lusty passions.” By 1890, syphilis was well established as a venereal disease and with that conclusion came the stigma that only prostitutes and sinners were susceptible.

In 1905, the culprit was finally identified: the bacteria Treponema pallidum. In 1908, Nobel-prize winning researcher Paul Ehrlich discovered that the drug arsephen-amine attacked the syphilis bacteria and was heralded as the ultimate cure.

It took a year to come up with an accurate dosage — between 20 and 40 small dosages a year to cure syphilis — as the initial high dose injection was proving to be lethal, and frequently the symptoms would reoccur within one year. This medicine was named Salversan, the first effective cure. A more common name for it was Treatment 606 as it was reportedly Ehrlich’s 606th attempt at finding a cure.

Penicillin was developed in 1928, and was on the market in 1945 curing syphilitics everywhere. But an effective treatment hasn’t stopped the spread of the disease.

 

Syphilitic curiosities

• Famous historical syphilitics allegedly include Al Capone, Czar Ivan The Terrible, King Henry VIII, Friedrich Nietzsche, Heinrich Heine, Queen Elizabeth I, Oscar Wilde and Lenin.

• King Louis XV suffered from cypridophobia, a fear of syphilis, and took to sleeping with young girls between the ages of 14 and 19 to reduce his chances of catching it.

• Prior to the 1700s, it was public policy to whip women infected with syphilis unless they could prove infection from their husbands or soldiers.

• During the 18th century, Van Swieten’s liquor, a combination of mercury and brandy, was touted as a cure for the disease and used by the upper class.

• In 1793 Benjamin Bell discovered that syphilis and gonorrhea were different diseases after experimenting on himself and his med students.

• It’s believed that the popularity of the cod-piece during the Renaissance was in part due to the fact that it concealed the greasy ointment and bandages used to counter syphilis.

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Addendum: We should adhere briefly to some biographical notes on Prof. Bogomil Beron — founder of dermatology and venereology in Bulgaria. Although he was a descendent of Dr. Petar Beron, an outstanding Bulgarian enlightener, sources on this distinguished Bulgarian scholar are scanty and we could point out with certainty only two of them: 1) information contained in the Almanac of Sofia University; and, 2) obituary on death occasion from the Annual of Bulgarian Academy of Sciences.

There is an excellent study on the genealogy of Beron's family from Dr.Vasil Bakurdjiev, which should be also consulted. Here we see a pedigree line extending from Jeyna Beron, sister of Dr. Petar Beron — to Vasil Hadjistoyanov-Beron, son of Jeyna Hadjistoyanova-Beron — to Prof. Bogomil Beron, son of Vasil Hadjistoyanov-Beron — to Dr. Vasil Beron, son of Bogomil Beron. We see here several generations from the Beron's family extending from the early Renaissance of the 1800s to the end of the 20th century and further. (N.B., Dr. Petar Beron, grand-son of the bulgarian Revivalist, is today a well-known politician and professor-speleologist).

Bogomil Beron was born in Bolgrad, Bessarabia, where his father was Director of Secondary School (1866). He attended to undergraduate studies in Sofia, and from 1885 to 1889 studied medicine in Wurzburg, Germany. Specialized for 2 years in Vienna and Paris (1893-1894). He got his Dr. Med. diploma from Breslau and Berlin with specialty of dermatology and venereology, some early studies on etiology and prophylaxis of syphilis (published in German). Being for many years member of the Bulgarian Medical Union (1903) and full member of the Bulgarian Academy of Sciences (1907), Prof. B. Beron was among the founders of the Medical Faculty, Sofia, as head of Department of Dermatology (1918). First president of the Bulgarian Dermatological Society from 1923. Dean of the Medical Faculty in academic year 1926-1927. Honorary member of several International Medical Associations. Died in Sofia, aged 70 (1936).

Prof. Bogomil Beron's scientific publications are mainly in foreign languages, German and French. Besides his many articles published in Bulgarian language (more than 50, which are scattered in various journals), we should point out 2 important monographs: 1) Prostitution in Bulgaria, 128 pp., (1910); and 2) Basic Dermatology, 313 p., (1928). We don't have these books at hand and took them as reference from the Almanac of Sofia University.

Besides the strictly scientific activity, Bogomil Beron was engaged in wide public propaganda activities through forums of the Bulgarian Dermatological Society. Many famous bulgarian intellectuals visited the sessions of the society. From standpoint of our booklist, we wish to appreciate Beron's contacts with professional translators (i.e., Haralampi Neichev in the first place) that were instrumental at introducing popular best-selling books to the lay bulgarian public. Among those important monographs are works from A. Forel, O. Weininger, I. Bloch and more recently two more books from the pantheon of world knowledge — particularly, 1) "Reinhold Gerling. Questions and Answers from Sexual Life, 1919, 167 + 152 pp.", translated by Naeman Taxier; and, 2) "Brunold Springer. Genial Syphilitics, 1926, 144 pp.", translated by Dragomir Tzachev. The latter book was incriminated by Adolf Hitler because of its author too liberal attitude towards the racial question and implications for Negro blood incest in many famous historical personalities.

Last word on the book at hand. It is a compilation work from the last years of Prof. B. Beron, being written by a German author and translated with notes in Bulgarian language. Appended to the book is the newly promulgated "Law for Fight against Venereal Diseases" (1936) which was the last attainment of the professor. Coincidentally, he died one year after premature death of his beloved son Vasil Beron — himself, an established attorney with good practice. Tuberculosis took his life at early age of 31. He was consultant in Community Property Law and among other things helped his father to coin several juridical articles in the prophylaxis and prevention of prostitution, venereal diseases, and other social vices, ditto.

 

Pictures 1, 2 & 3: Sample illustrations on the text above.

(i). Prof. Bogomil Beron (1866-1936), founder of dermatology and venereology in Bulgaria.

 

(ii). Auditorium at dermato-venereological clinic, where sessions of Bulgarian Dermatological Society were held.

 

(iii). "Law for Fight against Venereal Diseases", promulgated firstly in 1936.

 

 

Copyright © 2009 by the author.