LAUSR

Centuries ago, the term herpes referred to a group of blistering diseases. The origin of the word is derived from the ancient Greek herpein, meaning “to creep” or “move slowly,” characterizing the latent onset of the infection and the inconspicuous, recurrent spread of lesions on the skin. It was not until the late 19th century that this condition was categorized into specific subtypes—many of which are now known to infect humans. Of these, herpes simplex virus 1 and 2 are perhaps the most infamous viral dermatological conditions, known for their unsightly presentation on the genitals and lips (colloquially referred to as “cold sores”). Although subtyping of the disease occurred relatively recently, the lesions associated with herpes simplex virus have been documented for thousands of years. In fact, Emperor Tiberius (leader of the Roman empire from AD 14 to 37) banned kissing in ancient Rome because of a rampant outbreak of oral sores plaguing the populace. Herpes even transcended the English literary masterpiece Romeo and Juliet, as William Shakespeare described oral blisters in Act 1, Scene 4, of the 16th century tragedy: “o’er ladies lips, who straight on kisses dream, which oft the angry Mab with blisters plagues.” Furthermore, leading into the 1700s in France, prostitutes presented so frequently with vesicular genital lesions that it was considered a vocational disease of women. Herpes treatment was first believed to be developed in ancient Rome by the physician Celsus, who cauterized open sores with a hot iron. In modern history, British folk medicine described using gold as a remedy for cold sores, by rubbing gold wedding rings directly on lesions. Snails were also widely recognized in treating numerous diseases, having been listed in the ancient pharmaceutical encyclopedia De Materia Medica, which was translated to English in 1655. In Scotland, snail slime was said to have been used for the treatment of cold sores, although the methodology of its use was not explicitly described. Today, there is still no cure for herpes simplex virus, and more than 400 million people have genital herpes caused by herpes simplex virus 2 alone—many of which remain asymptomatic and unaware that they have the condition. Despite the benign clinical outcomes of the disease, the predominant morbidity relates to the lifelong psychosocial implications of sexual conduct and disclosure. Clearly, there is still much work to be done from both a therapeutic and social standpoint. From Shakespeare to acyclovir, the not-so-simple story of herpes simplex has yet to see its final chapter written. With novel therapies and possible vaccines being discussed, only time will tell the fate of this relatively benign age-old disease.