One of the earliest accounts of venereal disease appears in the Hippocratic Corpus, a collection of medical texts attributed to Hippocrates (460–c. 375 BC) and his followers, which describes genital ailments involving symptoms such as urethral discharge, dysuria and fever.1 There was accurate observation but little differentiation between types of venereal and urological diseases and no recognition of an association with sexual contact. Various treatments were employed to mitigate symptoms or purge the body of the disease. The Greek physician Galen (129–216 AD) also documented a range of genital diseases, which he attributed to imbalances within the body’s humours. The influential ‘humoral theory’ held that the body comprised four fundamental ‘humours’—black bile, yellow bile, blood and phlegm—and that disease arose if they fell out of balance. ‘Disease’ was seen as specific to each individual rather than as a pattern of recognisable symptoms and signs. Medical teachings of the time recommended treatments, often based on plants and other measures, to re-establish humoral balance and restore health.

Syphilis was first documented in medical literature in 1495, following a major outbreak among French troops besieging Naples. Large numbers of soldiers fell ill with severe syphilis, causing great alarm. The presentation included fever, widespread skin and genital lesions and intense pain and was more acute and rapidly debilitating than typically seen today. The outbreak forced the French army to retreat. As remission after the acute phase brought false reassurance to both patients and doctors, syphilis spreads rapidly across Europe.2 By the early 16th century, syphilis was recognised as an STD without an effective cure and was seen as a divine retribution for uncontrolled or illicit sexual behaviour. Sufferers and those believed to be responsible were ostracised and vilified, with women mainly blamed for spreading the disease. Notably progressive for his time, the …