Before the advent of penicillin it was difficult to think of controlling VD by treatment, although Surgeon General Parran did think in such terms, the sulfonamide drugs having added a means of approaching gonorrhea to the use of arsphenamines for syphilis. But penicillin introduced a prospective means into the control scheme so strikingly new that it seemed to change the whole picture. There was also, at the same time, the historical dividing line of World War II. Accordingly the period before the war and before penicillin is a separate chapter. This early period, as we look back at it now, is one in which we could hardly have hoped for success in VD control.

The first is made up of attempts to control prostitution, which was recognized from very early times as a major source of venereal infection, as it still is. The second consists of efforts at VD control by various local, national, and international bodies, culminating in the United States in the efforts spearheaded by Dr. Parran as the pre penicillin era closed.

A French doctor, E. Lancereaux, in a two volume Treatise on Syphil~ published in 1869, gives us details of early attempts to control prostitution. He says that in ancient Rome, with its "unbridled libertinism," nothing was done "to prevent the effects of debauchery," there being concern only "to watch over the cleanliness and dress of prostitutes, and over the luxurious and comfortable fitting up of the privileged houses." But by the time of the emperor Constantine, in the early fourth century, there were introduced harsh, punitive, or "draconic" measures to restrict prostitution, including confiscation of furniture, clothing, and houses, whipping, and banishment. These measures were continued under Charlemagne (eighth to ninth century) but, evidently proving ineffectual, were abandoned during the four following centuries "despite the greatest immorality." From the time of Louis IX (Saint Louis), in the thirteenth century, who saw the failure of an attempt to prohibit prostitution, efforts were made to tolerate and regulate the practice. Since that time,

“special neighborhoods have been allotted to prostitutes. A vignon, Toulouse, and many other towns had, like Paris, Venice, and London, their prostitution districts and special laws in reference to prostitutes.”

Astruc quotes from the Rules and Ordinances of the Stews of Southwark in London of about 1430, which mention the occurrence of VD among the women.

At the time of the fifteenth century epidemic to continue Lancereaux's account:

“The sequestration of syphilitics was the law of that period. The rich were compelled to remain in their houses, the poor were driven away and threatened with death, and abandoned even by the physicians, who felt themselves unable to combat the disease. ...”

A severe measure was adopted at Strasbourg in 1495 and sanctioned by the Parliament of Paris on March 6, 1496, which ban ished all foreigners affected with the great pox. James IV of Scotland, in 1497, also ruled that syphilitics must leave Edinburgh or be branded on the cheek with a hot iron.

In the same year of the Southwark ordinances, 1430, Lancereaux tells us, regulations were also in force in London affecting men who frequented licensed houses of prostitution; and at some unspecified but still early date similar measures seem to have been applied in Hamburg. But although suggestions of medical or sanitary regulations of such houses date in Paris from as early as 1714, the same author gives them more explicitly as beginning half a century later:

“In 1762, Aulas required that the persons who kept tolerated houses should be made responsible for the sanitary condition of their women, and that all, without exception, should be subjected to constant visits made by surgeons attached to the police and under the direction of a head surgeon. Gardane in 1770, and Bourru in 1771, each expressed a wish for the establishment of public offices, or of special hospitals, for the treatment of venereal diseases.” (see VD CAN BE CURED PART II)