Gonorrhea lacks the peculiar immunity problem of the treponematoses, and for the present at least there is no threat that a vaccine would interfere with diagnosis of gonorrhea as it probably would with syphilis. This problem may arise if a blood test for gonorrhea comes into use, but it is not likely to be the same as in syphilis; and anyway, as we will see in a moment, means may be in the offing to sidestep this whole problem.

Dr. Leslie G. Norins, the young chief of the VD Research Laboratories, was trained in the flourishing field of immunology, which was born out of bacteriology but has developed its own family of subsciences ranging from the earliest applications of blood grouping and forensic blood tests to auto immune diseases, organ transplantation, and a whole area of basic chemistry which both explores and uses the increasingly subtle and sensitive ramifications and devices of antigen antibody reactions. One of the things we have known for some years is that antibodies begin to develop in man and animals within a day or so after the first antigenic stimulus, even though ordinary tests may not show them for three weeks or more. Sensitive methods are available to disclose and measure this early antibody response. The gap between science and its applications shows up in the fact that nobody seems to have thought of applying these relatively old techniques to so mundane and practical a matter as the diagnosis of disease. Dr. Norins is exploring this question.

He thinks it might be feasible to develop diagnostic (blood) tests for syphilis (and for gonorrhea, too) that would reveal incipient disease long before the first symptoms appeared. With such a test early treatment could scotch the disease before it started and obliterate the possibility of contagion. A person who thought he had been exposed to VD could then go for testing two or three days after exposure, before either the disease or most of its associated shame had developed.

Together with this fascinating idea is another: the ramifications of antigen antibody subtlety are such as to raise the possibility of evading the bugbear that a vaccine would interfere with blood tests, if it can be shown that immunity and diagnosis are or can be based on different antibodies.

How does it feel to be working on what people think of as a dirty subject and one that keeps getting worse? Maybe the question is already answered. The research people in Atlanta have the characteristic enthusiasm of all research people, growing out of the often tacit assumption that the problem can be solved and is worth solving. They are helped rather than hindered by knowing that they are, in Dr. Norins's phrase, "mission oriented"; they are doing scientific work toward an important practical objective. It is my strong impression that there are not enough of them, and that they don't have the resources they and their problem deserve; but I found among them no hint of the pessimism that seemed to come to me from Dr. Guthe in Geneva. The same was true in Dr. Brown's immediate area. Venereal disease is disease and ought to be dealt with as such; dirtiness is an attribute applied by outsiders, strangers to the problem.