La syphilis dans les publications des officiers de santé de la Marine française au xixe siècle

Résumé Fr En

Les officiers de santé de Marine, au gré de leurs affectations, ont rencontré le tréponème pâle dans des situations diverses. Ils connaissent la maladie sous toutes ses formes ainsi que sa contagiosité extrême et traitent une patientèle hétéroclite, composée de marins et de vénériens des dispensaires. Mais ils ignorent encore tout de sa physiopathologie et de son traitement. Ces médecins sont en position privilégiée pour observer la syphilis dont ils connaissent les signes cliniques mais qui les interroge dans ses formes avancées, notamment neurologiques. Ils s’intéressent aux moyens de prophylaxie, influencés par l’élan hygiéniste de l’époque, critiquent les expériences de syphilisation, discutent des traitements essayés au cours de leurs affectations, en particulier du mercure utilisé avant l’antibiothérapie. Leur volonté de partager leurs réflexions médicales se traduit par une production de littérature variée : thèses, articles, ouvrages leur permettent de se faire entendre de la communauté médicale et scientifique de leur époque. Ce travail propose une analyse de ces publications sur la syphilis de 1845 à 1875. Cette période débute après la découverte par Ricord de la différence entre syphilis et gonococcie et s’achève juste avant l’âge d’or bactériologique, initié par Pasteur et poursuivi par la découverte du tréponème pâle en 1905.

As they were appointed in all kind of places around the world, French Navy medical officers inevitably happened to be confronted with syphilis treponeme (Treponema pallidum) in a lot of different situations. These officers had acquired a great knowledge of the different aspects of the disease and had to treat various types of patients like sailors or people with venereal diseases in dispensaries. Their knowledge was based on both empirical approch and the scientific breakthroughs achieved in the 20th century. Although they were fully aware of the contagiousness of syphilis, they still were unable to handle its physiopathology as no successful treatment had been discovered yet. All this put them in a favourable position to make them ideal observers of syphilis, whose clinical symptoms had been identified but advanced forms – chiefly neurological - still puzzled them. Taking a cue from the hygienist trend of the time, they started an investigative work on disease prevention and progressively became more critical about syphilisation experiments as well as they discussed about the treatments they encountered along their different assignments. The mercury-based treatment, which was commonly administered before the advent of antibiotherapy, was particularly questioned. Determined to share their knowledge, they provided a medical literature of a great variety such as theses, articles and diverse works which eventually made them known of the medical and, broadly, the scientific community of their time. This paper proposes an analysis of these publications on syphilis which were issued between 1845 and 1875, from Ricord’s key distinction between syphilis and gonorrhea until the period preceding the golden age of bacteriology, initiated by Pasteur’s crucial breakthrough and followed by the discovery of the pale treponema in 1905.