The merchant seaman has a special VD problem. Although his lot has improved since the days of sailing vessels, with voyages tending to be shorter and ships better supplied with medical facilities, the basic problem has hardly been touched. Men are without women for abnormally long intervals, often under conditions of stress.

They are, in order, sex education; the special problems of seafaring men and soldiers; prostitution and homosexuality; and the question, why do people fail to go for treatment, or run away?

There is no serious disagreement today that greater knowledge of VD is one of the essential elements of any control scheme, and that it must come early to do the most good.

VD tends to be concentrated in cities and to follow people's movements; it is aggravated by war, poverty, ignorance, and lack of public health and medical facilities. Being spread by sexual contact, it is increased as sexual intercourse increases in the population, with promiscuity an essential factor in the process.

Admittedly, then, there are technical deficiencies in VD control; but few VD experts, if any, doubt that the non technical problems are more serious. And one of the toughest is to decide just what they are. This part of the problem is social, economic, even possibly political; but sociologists, economists, and political scientists do not concern themselves with it, and very likely ought not to.

So there are factors in our failure to control VD that are due to professional ignorance, carelessness, lack of interest, negligence, and similar vices that public awareness and pressure might conceivably correct. To correct such things was part of Dr. Parran's objective.

Here in the United States whatever part of the problem is technical ought to be subject to control. Included are better diagnostic methods for gonorrhea, more easily available diagnostic and treatment facilities, and perhaps most important, better VD education of physicians.

Another search with unusual if not unique aspects was reported in The Wall Street Journal for March 30, 1970, from the VD center in Atlanta. This incident involved a single prostitute near Los Angeles who, for one thing, had a clientele made up entirely of truck drivers and, in addition, kept a diary in which she recorded the names and "home bases" of 310 customers who had seen her from early September, 1969, to mid February, 1970.

Contacts with no clinical signs of syphilis and with a negative blood test were given a single curative dose of benzathine penicillin as a prophylactic. A noteworthy feature of this outbreak was the active cooperation during its course of fifteen physicians and of the twenty six patients they reported.

This was in 1954 and was especially intended for gonorrhea, in which the incubation period is usually less than six days. Dr. Shafer says,

“Consequently, the speed zone program concentrates upon female contacts of the male gonorrhea patient within a period beginning six days before the onset of his clinical symptoms and ending at the time of his appearance in the clinic.”

DR. PARRAN SPOKE with a good deal of admiration of attempts that had been made to control VD in the Scandinavian countries before he started on his own campaign in the United States. All these efforts were begun before World War II and before penicillin. Although they have not been completely ineffectual, we know now that they have failed. Even with penicillin and with the many other advances that have been made in the great scientific upsurge since 1945, efforts at VD control in all these places have still failed.