VD people do not forget that syphilis has a proud tradition as a subject of research and a field of medicine and public health. There is something here to counterbalance the low esteem in which VD has been held in other quarters through the ages. But with gonorrhea such low esteem has hardly ever been mitigated. Dr. Kellogg observed as what VD person has not? how the bacterial genus Neisseria, which contains as its two disease producing species N. meningitidis and N. gonorrhoeae, is customarily treated in medical textbooks and in the lecture hall. It is a little like the traditional horse and rabbit stew, made with equal parts, or one horse and one rabbit, the meningococcus being, naturally, the horse.

And in fact it is gonorrhea that seems to be the main VD problem now. There is something of a consensus that syphilis could be controlled without new techniques, if only there could be more of what there already is. More and better clinics and facilities for diagnosis and treatment, including trained VD personnel; more VD education over the whole range from physicians to schoolchildren; more honest concern with the problem in the highest places; less nonsense about shame and punishment. All of this implies more money for VD control.

Gonorrhea faces tougher sledding. One of the main resources of the syphilis control program, case finding by cluster testing, had been given up for gonorrhea because of its short incubation period; but efforts are under way to revive it. The two other main difficulties are, of course, the persisting diagnostic problem in women, and penicillin resistance. None of these obstacles is insurmountable; but when they are added to the difficulties gonorrhea shares with syphilis control, they could well account for the different incidence rates and the different emphasis that is coming to be placed on the two diseases. So hopes for control of gonorrhea cling to technical advances, especially to a workable blood test; but obviously also to a vaccine, which might sidestep the other roadblocks if we could get one.

What all this comes down to is that the core problem of VD control, allowing for technical elements with gonorrhea, entails mainly a change of attitude in the right places and the money and means such a change would provide. If the new weapons against gonorrhea now being worked on were available, they might help to change the attitude. But the change of attitude is basic, and it is no small thing.