Congenital syphilis in the past: slaves at Newton Plantation, Barbados, West Indies.

Hutchinson's incisors and Moon's molars are specific lesions of congenital syphilis. The extensive but fragmentary clinical literature on these conditions describes reduced dimensions and thin enamel in the permanent incisors and first molars, crowding and infolding of the first molar cusps, notching of the upper incisors, and apical hypoplasias of the permanent canines. A Barbados slave cemetery (ca. 1660-1820 AD) includes three individuals with these features, suggesting a frequency at birth of congenital syphilis in the population approaching 10%. These three cases show triple the frequency of all hypoplasias and more than seven times the frequency of pitting hypoplasia present in the remainder of the series. The recognizable congenital syphilis cases account for much of the remarkably high frequency of hypoplasias in the series as a whole. We infer that syphilis contributed substantially to morbidity, infant mortality, and infertility in this population. Presence or absence of congenital syphilis may account for much of the variability in health and mortality seen among nineteenth century African-American populations.