Syphilis was perceived to be a new disease in Europe in the late 15th century, igniting a debate about its origin that continues today in anthropological, historical, and medical circles. We move beyond this age-old debate using an interdisciplinary approach that tackles broader questions to advance the understanding of treponemal infection (syphilis, yaws, bejel, and pinta). How did the causative organism(s) and humans co-evolve? How did the related diseases caused by Treponema pallidum emerge in different parts of the world and affect people across both time and space? How are T. pallidum subspecies related to the treponeme causing pinta? The current state of scholarship in specific areas is reviewed with recommendations made to stimulate future work. Understanding treponemal biology, genetic relationships, epidemiology, and clinical manifestations is crucial for vaccine development today and for investigating the distribution of infection in both modern and past populations. Paleopathologists must improve diagnostic criteria and use a standard approach for recording skeletal lesions on archaeological human remains. Adequate contextualization of cultural and environmental conditions is necessary, including site dating and justification for any corrections made for marine or freshwater reservoir effects. Biogeochemical analyses may assess aquatic contributions to diet, physiological changes arising from treponemal disease and its treatments (e.g., mercury), or residential mobility of those affected. Shifting the focus from point of origin to investigating who is affected (e.g., by age/sex or socioeconomic status) and disease distribution (e.g., coastal/ inland, rural/urban) will advance our understanding of the treponemal disease and its impact on people through time.

中文翻译：

---

推动对过去和现在对脊椎疾病的了解。

梅毒在15世纪后期被认为是欧洲的一种新疾病，引发了关于其起源的争论，这一争论在人类学，历史学和医学界一直持续到今天。我们采用跨学科的方法，超越了这个古老的辩论，该方法可以解决更广泛的问题，以加深对耳蜗感染（梅毒，偏航，贝耶尔和品脱）的理解。致病生物与人类如何共同进化？梅毒螺旋体引起的相关疾病如何在世界各地出现并在时空上影响人们？苍白锥虫亚种与treponeme引起pinta有什么关系？审查了特定领域的学术现状，并提出了促进未来工作的建议。了解椎体生物学，遗传关系，流行病学，临床表现对于当今疫苗开发以及调查现代人群和过去人群的感染分布至关重要。古病理学家必须改善诊断标准，并使用标准方法来记录考古人体遗骸上的骨骼病变。必须对文化和环境条件进行充分的背景介绍，包括对海洋或淡水水库影响进行任何校正的地点定年和理由。生物地球化学分析可以评估水生食物对饮食的影响，以及因甲状旁腺疾病及其治疗方法（例如汞）引起的生理变化，或受影响人群的迁徙。将重点从起源转移到调查谁受到影响（例如，按年龄/性别或社会经济状况）和疾病分布（例如，沿海/内陆，