Episode 77: Syphilis [4]
Syphilis. What was the name of the pathogen again? Right, Treponema pallidum.
Hmm.
Unfortunately, that was all I could recall immediately. Syphilis… It was terrifying now, but in the twenty-first century, it was practically nothing. Especially after penicillin, it basically became a non-issue.
Still… I learned it. I studied syphilis.
Even so, syphilis and malaria remained significant diseases in modern times. Their prevalence in developing countries was still high. Of course, syphilis didn’t claim tens of thousands of lives annually like malaria, but it still killed a considerable number. In Korea, the situation was different, but it still showed up on exams.
“You can’t just kill him. Let’s try treating him first.”
“Okay. Should I call in an expert?”
“An expert? Most so-called experts on this disease are just quacks.”
“People even call them murderers. Haha.”
While I was immersed in productive thoughts, the others in the carriage were talking nonsense and laughing. Killian was in the middle of it all, but his expression was understandably grim, since he was being treated like a conman and a murderer. Especially since the man talking about murderers was the same one who had just beaten up his colleagues with a sheathed blade. Killian sat with his head down, looking like he was about to collapse. To be honest… he kind of deserved it.
No, wait… how was this disease treated back then? Surgery? Or just… “treatment”?
If it were something treatable by surgery, that would be ideal. But even then, anesthesia was rudimentary, instruments were primitive, and antiseptics were barely a thing. Still, you could try something.
But syphilis was an infectious disease. Unless you could remove only the bacteria, treatment fell under internal medicine. And in this era, internal medicine wasn’t much more than educated guesswork. Of course, that didn’t mean surgery was completely off the table…
My condolences to the patients of the nineteenth century…
I began a moment of silent mourning.
“I guess we’ve got no choice. We should call Jémel.”
“Jémel… Oh, right. That man still treats syphilis, doesn’t he?”
Meanwhile, Liston and Blundell had reached some kind of agreement. Jémel. He was the sort of doctor who would bleed a patient’s stomach for a stomachache and consider decapitation for headaches. No joke. In nineteenth-century London, though, he was considered a reputable internist… so they summoned him.
“Huh. Among us, he’s probably the best. He’s diligent and does his research, after all.”
“Yes. Jémel’s a bit better when it comes to headaches, but for everything else, he’s ahead of the curve.”
Contrary to my expectations, their evaluation of Jémel was absurdly generous. To the point that I began to question their sanity.
Anyway, the carriage soon arrived at the hospital. Considering how big London had gotten through slum expansion, and how narrow and tangled the roads were, it was a miracle we arrived this quickly. I was grateful.
The carriage was cramped. The ride there had already been tight thanks to big Joseph Lister and the hulking Liston. Now, with prisoner Killian added to the mix, we were practically stacked on top of one another. Even the horse looked like it wanted to file a complaint.
“Yes, thank you.”
We got out and headed into the hospital. Killian, clearly worried about escape, was held firmly between Joseph and Liston, his arms locked. Blundell, Alfred, and I flanked them from behind. It looked exactly like a police escort. With Liston in the lead, he might as well have been the bailiff.
“Are they going to cut off his leg?”
“You saw that?”
Killian flinched at the unexpected question. Maybe it was because of the ominous-looking knife, but when he heard “cut off your leg,” he started freaking out. In response, Liston casually smacked him on the back of the head with his palm. Honestly, I thought he was trying to kill him.
“Keuok!”
“Hey, he needs to be able to walk!”
Thankfully, Killian only fainted for a moment before coming to. It must have been that sailor’s constitution. Against anyone else, we would have been the ones flat on the ground.
Knock knock.
We had arrived at Jémel’s clinic.
“Are you inside?”
“Yes, I’m with a patient. Come in.”
Privacy? In this day and age? Of course not. We entered freely, even while a patient was being treated.
Surprisingly, the patient was completely naked. Luckily, he was a man, but still. Very, very naked. He didn’t even seem embarrassed. That was just how it was. In this era, once you entered a hospital, dignity stayed at the door.
Ah… syphilis…
Everyone else was unbothered. Only I felt embarrassed, and only for a moment. The man had syphilis. Advanced syphilis, in fact. Stage three. That meant it was terminal. Even with modern medicine, this would be difficult to treat, and death was possible. In Korea, they might have been able to save him, but complications would still be unavoidable.
“This is harsh.”
“What disease is it?”
Blundell asked a question so dumb I wanted to cry. It was obviously syphilis. If this were a university hospital, he would have been chewed out.
You idiot. You really don’t recognize syphilis?
I glanced at Jémel. The infectious disease professor back in my time was terrifying. Jémel, thankfully, wasn’t angry. Instead, he smiled.
“It’s syphilis. He needs treatment.”
“Treatment?”
“Which kind?”
Jémel answered without hesitation.
“Mercury.”
“Mercury…?”
“Isn’t that poison?”
I blurted out the question before I could stop myself. Jémel, who had acknowledged my skill thanks to the phantom limb case, now looked at me like I was a disappointment.
“Of course it is. But there’s no other cure.”
“No… wait a second.”
Did no one know what heavy metals were? Mercury poisoning? Minamata disease in 1956? The moment I heard “mercury,” a flood of memories came rushing in.
This wasn’t 2022. It was 1830. And mercury had already been used for over five hundred years to treat syphilis.
It was a terrible time. Do you know Alphonse Daudet? He wrote “The Last Lesson.” He had syphilis too and eventually died from mercury poisoning. The pain was so bad he had to take morphine every day in his final years.
Even great writers couldn’t avoid this treatment.
But why was I thinking of arsenic?
It felt like when a strange word appeared in a Naver search and led to something else. That was how arsenic came to mind. Would it even matter?
“Here we go. This is the mercury.”
I blocked out the background noise and focused.
Arsenic… 606… Salvarsan…
A memory came to the surface. I was sure this was the right direction. I wouldn’t remember such an obscure term otherwise. It had been twenty-five years since I was a student. Thankfully, I had organized a lot of my knowledge in this second life.
“Are you really giving him this?”
“Yes. But this is one of the most severe cases I’ve seen. I need to increase the dose.”
“The dose? What happens then?”
“A lot of syphilis bacteria will die.”
“And the patient?”
“That’s in God’s hands.”
“Well… syphilis is a punishment from God, after all.”
“Ah, you’re religious. I see. Personally, I disagree, but even if you do think that, there’s not much we can do.”
As I was lost in thought, the other doctors were busy saying horrifying things right in front of the patient. In short: “You’re suffering because you sinned, so you deserve this.” Even if that were true, medicine shouldn’t be about judgment. Doctors needed compassion, not righteousness.
Of course, Killian had spread an incurable disease, so…
“Ego—”
“Wait!”
I stepped in before Jémel administered anything.
“Why?”
Back in the day, Jémel would have ignored me. But now, that wasn’t possible. I was known as the genius from the East, the prodigy from Joseon.
“Arsenic. I think arsenic might be better.”
“What? Are you trying to kill this man?”
Jémel stared at me like I had lost my mind. Understandable. Arsenic was also poison. A deadly one.
“606…”
“What are you talking about?”
“Never mind. Forget it.”
The memories hit harder now. Arsenic compound 606. Salvarsan. Discovered by Ehrlich. Yes, it was still toxic and could cause heart failure, but compared to mercury, it was far superior. He even won the Nobel Prize for it.
Could we replicate that now?
It was made in the early twentieth century. About a hundred years from now. Science at this time wasn’t advanced, but perhaps I could at least lead them in the right direction… if only I were a chemist.
“What? This is weak. Here we go.”
Arsenic instead of mercury? But arsenic oxide was pure poison. I didn’t know how compound 606 was synthesized, so I had nothing to say.
In the meantime, Jémel, laughing, administered a huge dose of mercury to the patient. Even I, a non-specialist, could tell it was a lot.
Could he even survive this?
“Ugh… my head… it hurts…”
Sure enough, the patient began complaining immediately. Jémel, of course, stayed calm.
“Don’t worry, everyone.”
Shouldn’t you stop treatment when this happens?! You maniac.
“Alright. So, what brings you here?”
Not a maniac, apparently. Just Jémel. He turned to us, and Liston and Blundell motioned toward Killian.
“He has syphilis.”
“Ah… bring out the mercury, then. In the meantime, take off your clothes.”
“Oh, no…!”
Translator’s Notes
Treponema pallidum — The bacterium that causes syphilis.
Syphilis — A sexually transmitted bacterial infection. Before modern antibiotics, it was difficult to treat and could progress to severe organ and nerve damage.
Penicillin — Antibiotic that later became the standard effective treatment for syphilis.
Malaria — Mosquito-borne infectious disease that remains a major public health concern in many regions.
Internal medicine — Medical field focused on diagnosing and treating diseases without surgery.
Mercury treatment — Historical syphilis treatment involving mercury compounds. It was toxic and often harmed or killed patients.
Mercury poisoning — Poisoning caused by mercury exposure, which can damage the nervous system, kidneys, and other organs.
Minamata disease — Neurological disease caused by severe mercury poisoning, historically associated with industrial mercury contamination in Japan.
Arsenic — Toxic chemical element later used in controlled compounds for early antimicrobial treatment.
Salvarsan / Compound 606 — Arsenic-based drug developed by Paul Ehrlich in the early twentieth century as an early treatment for syphilis.
Heavy metals — Dense metallic elements such as mercury that can be toxic to the human body.
Morphine — Strong pain-relieving drug, historically used for severe pain.