“Until 1504, venereal disease was unknown in China, and this was not because it had not yet been correctly diagnosed, for at that time Chinese Traditional Medicine [capitalized thus in the original] was already well advanced and hundreds of diseases had been accurately described in manuscripts which are still extant. In that year, the old colonialists introduced syphilis into Canton and it soon spread widely throughout the whole land.”

Dr. Horn speaks of his "friend Dr. Ma Hai the," and credits him with much of the material he presents. He states categorically that "active venereal disease [in the context, syphilis] has been completely eradicated from most areas and completely controlled throughout China." He adds this comment:

“The criteria for community cure were strict. They included the finding and treatment of all existing cases, a total absence of new cases appearing in the community, disappearance of congenital syphilis in new born babies, and normal pregnancies and pregnancy outcomes in previously treated mothers. When these criteria had been fulfilled and maintained for five years, the community was considered to be cured.”

Dr. Horn includes the following statistical information:

“In Peking it is impossible to find active syphilitic lesions to demonstrate to medical students. A generation of doctors is growing up in China with no direct experience of syphilis but this is of little consequence for the disease will never return. “At a conference held in the Research Institute of Dermatology and Venereal Disease of the Chinese Academy of Medical Sciences in January 1956, specialists from eight major cities reported that a total of only twenty eight cases of infectious syphilis had been discovered in their areas in the four years 1952 55. An investigation of infectious syphilis in seven major cities between 1960 and 1964 showed that by the end of this period, the early syphilis rate was less than twenty cases per hundred million of population per year [sic]; that is, it had very nearly reached the point of extinction. “In the National Minority areas, especially those where the syphilis rate had been highest, a striking fall occurred in the ten years between 1951 and 1960. In the Wulatechien Banner of Inner Mongolia, where the syphilis rate had been nearly fifty per cent in 1952, not a single case of infectious syphilis was found among 3,158 persons examined at random in 1962. In the Jerimu Banner of the Djarod League, which had shown a sero positivity rate of thirty five per cent in 1952, ninety seven per cent of the whole population was tested for syphilis and not a single new, infectious or congenital case was found.”

The meager statistical information I have been able to gather about Cuba comes from a report by an American physician living in Hawaii, Dr. Willis P. Butler, who has been to Cuba and written about its medicine and public health. His statistics are taken from Metas Directrices, MINISAP 1968 1970 (p. 28), and give the rates for 1967 per 100,000 population, for syphilis of 12.9 and for gonorrhea of 4.5. Presumably new cases are implied, but we are not told whether the first figure refers to early syphilis or all stages. Let us compare these rates with those given for the same year (1967) by WHO for the two countries for which, following Dr. Guthe, little or no correction is required:

CASES PER 100,000 POPULATION, 1967

For Denmark and Poland the rates in the first column are for early syphilis. If the same is true of the Cuban figure, it is relatively high and calls for no comment until more information is available. But the gonorrhea rate for Cuba is not merely much lower than those for the two other countries; it is also lower than the uncorrected 1967 rates for any country in the WHO ambit low enough, if true, to be phenomenal. Since Cuba is a UN member, perhaps a WHO team study made there like the one in the U.S.S.R. would tell us whether or not something is happening ninety miles from our shores that we ought to know about.

The minor venereal diseases have declined sharply in the United States since the war years. Rates for 1969, the lowest on record up to that time, were, for chancroid, 0.5, for granuloma, 0.1, and for LGV, 0.3 (per 100,000 of population). These diseases are still prevalent in undeveloped countries. Willcox reported as examples in 1967 that of 1000 VD patients in East Africa there were 99 with chancroid, and in a later paper that 164 cases of LGV had been reported in Jamaica in 1965 together with 163 of granuloma and 75 of chancroid. But in developed countries, including, in addition to those of Europe, New Zealand, Czechoslovakia, and the Soviet Union (and doubtless others for which I have no figures), the minor venereal diseases appear to have become rare.