The early history of VD control in the United States is given authoritatively by Parran, who in fact himself made the first definitive history. Before his time, as he explains it, there was officially no VD in this country; the American Medical Association's first recorded address on VD was given in 1874 with apologies for bringing up so unpleasant a subject, and in Parran's own time a dinner guest whom he calls Mr. Blank admonished him for "stirring up a fuss" about syphilis and continued.

Establishment of the League of Nations brought its Health Organization into being, forerunner of today's WHO. For the first time the urgent job was begun of setting up international standards for biological products and tests, and an effort was made to bring order out of the growing confusion in treatment. At that time, every VD specialist had his own way of using the arsphenamines.

International control measures for infectious disease generally date from the mid nineteenth century. We have nothing but the occasional word of contemporary doctors that such measures did any appreciable good; in the beginning, at least, efforts at control over the whole field could have had little more effect than King Canute had on the sea.

It was during this period, according to Dickson Wright (Chapter 13) that Catherine the Great of Russia established the first VD hospital, a fifty bed institution in St. Petersburg.

We learn from Farran that in Denmark as early as 1788 an attempt was made to provide free medical service for YD. He quotes this regulation issued by the diocese of Aarhus: ...

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.

Vaccines for microbic diseases not due primarily to toxins tend to be second rate: useful, but far short of absolute in protective value. Venereal diseases fall into this group. So far we have no vaccines against them at all; and as we will see, it is unlikely that vaccines can ever have the degree of effectiveness against them that they have against virus diseases or those due primarily to toxins (a group which includes tetanus as well as diphtheria).

We think of "control" of infectious diseases at several levels. In the United States, cholera, smallpox, yellow fever, and epidemic typhus fever no longer exist at all, although they are still present elsewhere in the world. Polio and typhoid fever, bubonic plague and diphtheria, all continue in this country, but at varying low levels.

“Until 1504, venereal disease was unknown in China, and this was not because it had not yet been correctly diagnosed, for at that time Chinese Traditional Medicine [capitalized thus in the original] was already well advanced and hundreds of diseases had been accurately described in manuscripts which are still extant. In that year, the old colonialists introduced syphilis into Canton and it soon spread widely throughout the whole land.”

As for China, we have, of course, no WHO data at all. But there is information available, including some statistical data for syphilis. The testimony of several observers seems to me tantalizing.

Thanks especially to Buret, and in spite of Astruc (or if we accept Astruc's information and merely reject his interpretation of it), it appears that all the commoner forms of VD existed in China from very ancient times.

A group of papers on Greenland all dated 1965 indicated extensive VD among Eskimos there: 40 per cent of both males and females had had gonorrhea on more than three occasions; a quarter of the unmarried population had been infected during the preceding six months. Of 52 young women aged 16 to 19, only 5 had not had gonorrhea.