In April 2018 an interdisciplinary group of scholars in fields ranging from paleopathology and anthropological genetics to tropical medicine met in Santa Fe, New Mexico at the invitation of Gillian Crane-Kramer and Brenda J. Baker, and under the auspices of the School for Advanced Research. They wanted to discuss the state of research on the history and dissemination of treponematosis, including syphilis, a topic long debated in their community. This fruitful initial exchange led to two important events in March 2019: a symposium organized by Baker, “The Evolution of Syphilis: A New Approach,” held at the 88th Annual Meeting of the American Association of Physical Anthropologists, and a workshop organized by Baker, Charlotte Roberts, Maciej Henneberg, and Ann Stodder on “Diagnosing Treponemal Disease” for the annual meeting of the Paleopathology Association. The result of all this effort was an article published in January 2020 in the Yearbook of Physical Anthropology, “Advancing the Understanding of Treponemal Disease in the Past and Pres-ent.” Significantly for an academic publication, the authors listed their names alphabetically to signify their equal par-ticipation in this latest effort to understand the origin and spread of treponemal disease, among other topics. This short book is a response to a question posed in the article: Why have historians working with traditional manuscripts and works of art not found evidence of treponematosis before the sixteenth century?

An earlier version of this book was published as an article entitled “Evidence for the Presence of Treponemal Disease, Including Syphilis, in Late Medieval Europe” in issue 7.2 of the journal The Medieval Globe in 2021. I am grateful for the assistance of Carol Symes, Monica Green, and Arc Humanities Press in making it accessible here to a wider readership. For those wishing to explore this topic in greater depth, a full bibliography (unlike the Past Imperfect series's normal selective list of Further Reading) has been provided.

I also am indebted to Clive Holmes for commenting on the original version of this paper and encouraging me to publish it. Brenda J. Baker and Charlotte Roberts offered advice on compiling a list of cases of treponematosis, a delicate undertaking that they will undoubtedly say has not yet been successful. In addition, I appreciate the criticism of the anonymous referees, which encouraged me to solidify my evidence on a number of important points. Any remaining errors or weaknesses are, of course, my own.