The origins of syphilis are a matter of debate for historians and scientists. Did it, as was long claimed, appear suddenly in Europe in the 1490s as a result of transmission from the Americas? Or was it endemic in Europe long before that? The issue is compounded by the fact that the bacterium which causes syphilis, T. pallidum, has various different symptoms and modes of expression (as syphilis, bejel, or yaws) depending on means and age of infection. Some work with aDNA in recent years has shown the presence of T. pallidum in skeletal remains in Europe that pre-date the Columbian Exchange, but such evidence cannot yet conclusively show whether this is proof of syphilitic infection or another treponemal disease. Marylynn Salmon argues that treponemal disease was more widespread in medieval Europe than has previously been thought, and that some of that was in its expression as syphilis.

The most useful part of this book is the initial section, in which Salmon lists out all the known cases of treponemal/possibly syphilitic infections identified from skeletal remains in medieval Europe. The subsequent parts are less convincing. Salmon argues first that contemporary accounts of the death of Edward IV of England as having occurred "after fishing" should be understood as metaphorical—fish/mermaids could be understood as euphemisms for sex in the Middle Ages. I mean, perhaps? But I didn't find this particularly winning as an argument. Then she brings together various different images from high/late medieval Western Europe and suggests that they are depictions of or inspired by people with late stage syphilis. Trying to diagnose an illness from a manuscript illustration is a really dubious proposition, and I just wasn't convinced by the images Salmon reproduced here. (Particularly since she doesn't grapple with the fact that a couple of the illustrations she cites as showing characteristic facial differences almost certainly have antisemitic undertones—cross-referencing with Sara Lipton's work would have been useful here.)

Future research may prove Salmon right, and I'm glad that the Past Imperfect series provides a forum for deliberately provocative/speculative work like this book. I just wasn't won over here. ( )