“Most physicians felt that this was a new disease, that it hadn’t been seen before in Europe, and that view tended to prevail for quite some time,” said John Parascandola, a medical historian and the author of Sex, Science, and Sin: A History of Syphilis in America. “There were certain tempting reasons for people to accept that—blame it on the others, blame it on the outsiders. Before that, the French were blaming it on the Italians, the Italians were blaming it on the French, et cetera.” (As my colleague Naomi Sharp has noted, syphilis has consistently been attributed to foreigners across the globe; it’s also gone by “the Turkish disease,” “the Polish disease,” and “the Portuguese disease.)

But in the 20th century, a second theory emerged: the pre-Columbian hypothesis, which holds that the disease already had a long history in Europe, and that the epidemic seemed like a new disease only because it had previously been mistaken for something else. Proponents of the pre-Columbian hypothesis have argued that this could have been a particularly virulent strain that made it seem unfamiliar, or that medical information became more readily available with the invention of the printing press in the mid-15th century, making it less likely that syphilis would be confused with some other disease, like venereal leprosy.

Recently, a paper published online in the International Journal of Paleopathology, subtitled “Implications for the origins of syphilis,” claims to help clarify the issue. More than anything, though, it serves as a case study for just how murky the origins of syphilis remain, and how far scientists are from reaching a consensus.

The paper describes the case of an adult male skeleton found in the Chiu Chiu cemetery, a gravesite in northern Chile dating to roughly 210 B.C. The sternum and two of the vertebrae showed evidence of a thoracic aortic aneurysm, a heart condition that can be caused by late-stage syphilis.

“We reinforce a theory that’s been suggested for some time, that venereal syphilis was present in pre-Columbian times in the Americas,” said Mario Castro, a professor of morphology at the University of Desarollo in Santiago, Chile, and the paper’s lead author. “Our main objective was to describe this very clear-cut case of an aortic aneurysm,” but taken in conjunction with another case of a similar skeleton from the same time period, found in Saskatchewan, Canada, in the 1980s, “it makes sense to say we had syphilis at the time.”

But the connection is a tenuous one, said Molly Zuckerman, an assistant professor of biological anthropology at Mississippi State University. Syphilis is part of a category of diseases known as treponemal disease, a group that also includes yaws, a skin infection found in tropical parts of South America, Asia, and Africa; the Chiu Chiu skeleton, she says, could very well have been suffering from yaws instead.