From the Life of Julius Bettinger, the Anonymous Palatinate

Abstract

In 1855, apaperwasdelivered to theMedical Societyof thePalatinate.*Theauthorof thiscontroversial report,whichclaimed thatsecondarysyphiliswascontagious, chose toremainanonymous. Why he did so can be summed up in 2 words: Philippe Ricord. Ricord was brilliant, witty, and generous. He singlehandedly turned l’Hopital duMidi intoEurope’s center for the study of venereal diseases. On publication in 1838, his book, Traite pratique desmaladies veneriennes,wasuniversally proclaimedamasterpiece.Ricord formulated the3stagesof syphilis. He revived the distinction between syphilis and gonorrhea. An ardent advocate for unflinchingly thorough examination,Ricordpopularizedthevaginal speculumandwas particularly pleased whenever he detected an anal chancre overlooked by less diligent doctors. Ricordwasalsonotoriouslyvainglorious; evenQueenVictoriawas flabbergasted by his ostentatious display ofmedals. His readywitcould turnrapier sharp insarcasmifanyonedared to contradict him.Worst, for a self-professedman of science, Ricord refused to ever admit error. Long after other venereologists recognized the difference between hard (luetic) and soft (chancroidal) chancres, Ricord insisted on their unity. He stubbornly supported his mode of diagnosis, autoinoculation, despite overwhelming evidence against its utility. Acentral tenetofRicord’sdogmawasthatsecondarysyphiliswas not contagious.WhenWilliamWaller in 1851 first published evidence to the contrary, Ricord blithely dismissed his experiments asunethical. That sameyear, oneofRicord’s own staff at theMidi, Vidal de Cassis, confirmedWaller’s findings. Ricord charged his junior colleague with being clinically inept and morally base. Obviously, to challenge Ricord on this pointwas to invite thewrath and ridicule of theworld’s greatest syphilologist. Nowonder the anonymous author declined credit for his report. Postscript:Whileconductinghisownresearches intosyphilis, Erich Hoffmann deduced that the anonymous Palatinate was Julius Bettinger. Bettinger (1802-1887) was the respected chief of theCantonalHospital inFrankenthal, Palatinate.During his lifetime hewas awarded one of Bavaria’s highest honors, theCross of theOrder of StMichael. Posthumously, Frankenthal named a tiny, 1-block street in his memory. When confronted with Hoffmann’s suspicion, Bettinger’s son confirmed that his father was indeed the anonymous Palatinate. *The Palatinate was then a region within the Kingdom of Bavaria.