Syphilis, historical and actual: cultural geography of a disease

Nineteenth-century Russian physicians identified two forms of syphilis, venereal and endemic, which they associated with the difference between city and country life. Modern medical authorities have generally rejected Victorian ideas of nonvenereal contagion, but students of preindustrial societies have found evidence that endemic syphilis does in fact occur. Because it was hard to distinguish one form from the other, however, prerevolutionary Russian doctors allowed their cultural preconceptions to guide them where evidence was weak. Their view of syphilis thus provides the historian with a remarkable guide to attitudes toward class, gender, and social change. Modern neglect of the nonvenereal variant demonstrates not merely the progress of scientific knowledge but also the cultural restriction on our own view of the world.