Birth control information and materials (an intrauterine device rather than pills, which were considered unsafe even in 1968) are freely available in hospitals and clinics, but there is no campaign to encourage their use. A sharp rise in the rate of infected abortions from 5.7 per 100,000 live births in 1959 to 30.7 in 1965 was explained "by a high ranking Ministry official" on the ground that during the first few years of the Castro regime...

The story for Cuba is a little different. Willis P. Butler, the American doctor from Hawaii, who was there for several weeks in 1968, reminds us that the Communist regime had been in existence less than a decade at the time of his visit; so that what progress had been made, allowing for an inevitable lag in the beginning, was very recent indeed.

The Soviet Union is known to take a somewhat puritan view of sex activity, presumably unrelated to the doctrine of original sin. Perhaps "puritan" is the wrong word; and perhaps a foreign observer cannot avoid measuring what he sees and reads against his own prejudices. Soviet actors and dancers do not flaunt sex as ours do; their people, young or old, are not constantly stimulated by sex on television or in display advertising.

In the more than thirty years since those words were written as we know, the U.S.S.R. has had its ups and downs, has be, through another devastating war, and has emerged as a technological and industrial power rivaling the United States. We know that it has had problems of urbanization and restless you! Somewhat like our own.

It remains to look at some Communist countries other than those on the eastern fringe of Europe, among which there is tantalizing evidence of VD control surpassing that of the rest of the world. We saw before that the U.S.S.R. seems to have had some success in control of syphilis, but less with gonorrhea; that Cuba, for which our information is meager but we are in a position to snatch at straws is reputed to have done well with gonorrhea but not with syphilis; and that China may have been so successful in controlling both diseases that Dr. Ma, who is given credit for the job, can now devote his energies to the control of other diseases.

But it is hard to escape those overtones; and it may be less ambiguous to repeat the definition rather than to use the word. However we speak of it, this is the subject we have come to.

VD is certainly a product of our habits of life and modes of conduct, and its control is likely to require that such habits and modes be changed. This seems to me self evident. The question is not whether the change is needed but what the nature of the change is to be. If we are to control VD, we must change our habits of life and modes of conduct. The question is, in what respects, and how?

Ever since Dr. Thomas Parran's time we have known what we need to do to control YD. We have no reason to doubt that he was right in what he said. Our difficulty is not lack of information or lack of means, but an inability to apply what we know, to do for all who need it what we can do for any individual.

Different methods are being tried in the attempt to make rabbit virulent Treponema pallidum harmless but still immunizing. James N. Miller in Los Angeles, working partly in collaboration with a group in the Netherlands, uses irradiation with gamma rays, which destroys the virulence of the spirochetes without stopping their movement.

Another aspect of immunity in syphilis relates to the other treponematoses, yaws, bejel, and pinta. Anyone of these diseases protects in some degree against the others, in much the same way, although usually less effectively, that each protects against itself. This fact fits the pattern we saw much earlier, being offered by Hudson as evidence for his contention that the four treponematoses, including syphilis, are all variations of one disease.

Certain things happen in syphilis that are explained by most experts in terms of immunity, although others, accepting the facts, explain them in different terms and argue that there is no true immunity to this disease. The argument has been going on since the prebacteriologic era and has never been completely resolved.