LETTER TO THE EDITOR A brief pictorial and historical introduction to guaiacum – from a putative cure for syphilis to an actual screening method for colorectal cancer Correspondence Dr med Patrick Eppenberger, Institute of Evolutionary Medicine (IEM), University of Zurich, Winterthurerstrasse 190, 8057 Zürich, Switzerland. Tel.: +41 (0) 44 635 05 43; Fax: +41 (0) 44 635 01 12; E-mail: patrick.eppenberger@iem.uzh.ch Received 15 February 2017; Accepted 25 February 2017 Patrick Eppenberger, Francesco Galassi and Frank Rühli Institute of Evolutionary Medicine (IEM), University of Zurich, Zürich, Switzerland Keywords cancer, effectiveness, general medicine, herbal medicine Table of Links LIGANDS Heme β-haemoglobin This Table lists key ligands in this article that are hyperlinked to corresponding entries in http://www.guidetopharmacology.org, the common portal for data from the IUPHAR/BPS Guide to PHARMACOLOGY [1]. Having re-emerged on a global scale during the last few decades, with an estimated incidence in adults of 10.6 million cases in 2008 [2], syphilis (Lues venerea), a bacterial infection caused by Treponema pallidum, was first mentioned in European medical writings in the 1490s, as a consequence of the return of Columbus’s crew to Europe in 1492 and the later epidemic during the French invasion of Naples in 1495. While the presence of the disease in the Old World prior to Columbus’s voyages has long been at the heart of a heated palaeopathological debate [3], reconstructing the historical presentations and evolutionary history of the disease and its treatment can be achieved both via analysis of ancient human remains as well as consultation of literary and artistic sources [4, 5]. With respect to the latter, we would like to highlight an engraving by Philip Galle (1537–1612), reproducing the artist Jan van der Straet’s (1523–1605) painting, dating back to the late 16th century, of a scene depicting a wealthy man receiving treatment for syphilis by means of Guaiacum officinale (Figure 1). From a pharmacological perspective, this denotes the immense reputation that this plant acquired as a putative cure for syphilis in the course of the 16th century. It was the first drug administered to treat syphilis in Europe, after being first imported in 1508 from the Dominican Republic. Its use became widespread due to its alleged miraculous effects, much discussed by physicians and prominent victims, such as the humanist Ulrich von Hutten (1488–1523) [6]. The then widespread belief that remedies could be found where their target diseases originated is likely to have facilitated its entrance into the European pharmacopoeia. Guaiacum treatment requirements were diarrhoea induced by enemas and profuse sweating by resting for 40 days in a dark and British Journal of Clinical Pharmacology Br J Clin Pharmacol (2017) •• ••–•• 1 © 2017 The British Pharmacological Society DOI:10.1111/bcp.13284