VD 
MANUAL FOIT TEACHERS VD mANUAL COR TE-ACMlRS 
Prepared by 
VENEREAL DISEASE DIVISION 
Board of Health 
DIVISION 01 .IE L\n nil jC xlhT 
Department of Public Lusfcructioi 
Territory of Hawaii 
19U 
JUNE JOHNSON, School Health 
Education Administrator .$f 
the Board of Health; SAMUEL 
D. ALLISON, M. D., Venereal 
Disease Control Officer of 
the Board of Hor1th; W.TATE 
ROBINSON, Director, Health 
Education, Department of 
Public Instruction* ELMER 
J. ANDERSON, Acting Director 
Public Health Education of 
the Board of Health. 
Published by: Board of Health,’Territory of Hawaii 
Charles L. Wilbar, Jr,, M. D., President 
Distributed by: Division of Health Education 
Box 2360, Honolulu U, Territory of Hawaii CONTENTS 
I. THE VD PROGRAM 1 
II. VD INFORMATION 
Venereal Diseases 15 
Syphilis 15 
Gonorrhea 33 
References 41 
III. TEACHING AIDS - 45 
Suggested Outline 45 
Some Representative Questions 46 
Suggested Tests 49 
Lantern Slides 57 
Films 58 
Poster Facts 66 
Transcriptions 69 
Radio Talks ?6 TWE- VD PROGRAtTl 1 
Foreword 
The VD program, as planned for the secondary schools of 
Hawaii, represents a coordinated effort on the part of several 
agencies—particularly the Territorial Board of Health and the 
Department of Public Instruction. Previous to 1943, there was no well- 
defined VD program in existence in the schools although VD work was 
done by individual teachers in a few scattered instances. A few schools 
had already incorporated VD work in their school programs, but taken as 
a whole, Hawaii could be said to be now territory for VD work. 
Because there has been so little teaching of this subject, it 
is likely that the prepared material will be more readily acceptable, 
especially since the material now presented has the dual advantages of 
supervision and checking by the Division of Health Education of the 
Department of Public Instruction and the Venereal Disease Control 
Division of the Board of Health. The program here presented has been 
built upon the best philosophies and practices known in the United 
States. 
To summarize the attention paid to VD: 
1942-45 was the first year "or groundbreaking year" 
when the Venereal Disease Control Officer in a 
series of lectures to school faculties focused 
attention on the problem* 
1945-44 was the second or preparatory year when 
school contacts were made and tentative materials 
were prenared* 2 
1944-45 is the third year when, with better equip 
ment, the program will be directed toward the 
Territory’s young people, both on the high school 
level and to a certain extent on the intermediate 
level* 3 
Introduction 
The School VD Program 
Where in the school program should ID be taught? 
The presentation of venereal disease educational work will 
vary somewhat according to the school set-up, curriculum, and other modi- 
fying circumstances. Two criteria should be not-the school administra- 
tion should plan to include this work so that it is effective and will 
reach most of the students before they leave school to participate in 
community life. 
The most logical place for VD work and the ono best suited by 
teacher training in method and subject matter is in the science or 
health education program. However, some modification or deviation will 
have to be made in certain schools because of local situations* Experi- 
ments carried out in some schools this past year have shown that VD work 
may be taught successfully in departments ordinarily thought to be foreign 
to health teaching as, for example, English. 
The teacher is the key to the success or failure of the work. 
The students’ reception and reaction to VD instruction will be dependent 
upon the teacher’s knowledge of the subject, her understanding and appre- 
ciation of the problem, and her attitude toward it. 
Staff education along general lines is valuable first as a 
means acquainting the school faculty with the scope of the problem 
and then the need for educational attention to be paid to it. Staff 
education, along specific departmental lines for those who will do the 
classroom work, must necessarily be of a different nature. Component parts of VD instruction are the accumulation of a sound informational 
background, acquaintance with the available teaching aids, and the 
development of effective teaching procedures. The folio, in- pages arc 
offered as suggested aids to the tcacher handling VD work. Of necessity, 
more material is included than would be used by a single teacher, so as 
to appeal to all tastes and situations. It is not meant to create con- 
fusion or cause dismay by inferring that all of t.ho material in this 
manual must be used. 
Objectives of the VD Educational Program 
1. To inform students concerning the nature and seriousness of those 
diseases. 
2. To develop a sound scientific understanding and better attitude 
toward the problem of venereal diseases. 
3. To acquaint students with the community program, agencies and 
resources for the diagnosis, treatment and control of these 
diseases. 
4. To develop the concept that the venereal diseases are communicable 
diseases, to be considered in the same manner as other communica- 
ble diseases as, for instance, TB. 
5. To work towards divorcing these diseases from, such biases as "sinful 
attitudes, hush-hush, and sex." 
6. To develop attitudes favorable for physical examinations, including 
a blood test. 
7. To develop attitudes against promiscuous sox relations* 8. To develop an understanding that venereal diseases are preventable, 
communicable, controllable, and curable. 
9. To show our youth that venereal diseases are diseases of young adult- 
hood. 
10. To show our youth that venereal diseases are costly to the nation and, 
in these days, ones that seriously hamper our war effort. 
11. To develop an understanding that these diseases can be diagnosed 
and treated only by physicians, and to develop an attitude against 
quackery. 
12. To gain support for programs aimed at controlling and preventing 
these diseases, such as premarital laws and repression of pros- 
titution. 
13. To develop an appreciation of the value of health with respect to 
freedom from venereal disease in marriage and parenthood. 
14. To inculcate a sense of personal responsibility either as a patient 
or as a citizen towards oneself and others with respect to venereal 
disease. 
15. To correlate the program so that venereal disease education will 
become an integral part of the communicable disease work in 
health education. The Whole School Program in VD 
MOKE EFFECTIVE 
! LESS EFFECTIVE 
Teaching VD as an integral 
I 
Using sex education alone to 
part of the work in communicable 
present the work in VD. 
diseases, and correlating it 
Note: Sex education should 
with the school health education 
stress the normal, desirable rela- 
program* 
| tionships between the sexes; VD 
is an abnormal, undesirable aspect 
of sex relationships. 
Handling tho school program 
Presenting of venereal 
in venereal diseases by the 
disease work entirely through 
science or health teachers. 
| lectures by outside persons, as 
- 
doctors and nurses. 
Allowing sufficient time for 
adequate presentation. 
One easy lesson. 
Planning the school program 
Inserting the work in the 
so that most of the students are 
school program with the result that 
reached before leaving school. 
only a small percentage of students 
is reached. Some Criteria of VD Teaching in the Classroom 
MOTS INFECTIVE 
i LESS EFFECTIVE 
Thorough knowledge of the 
i 
Uncertainty concerning basic 
facts so as to present sound and 
facts or retention of "old wivesT 
accepted scientific information 
tales" and erroneous information 
and to correct mis info mat ion or 
about VD. 
exaggerated notions. 
1 
Presentation of a well- 
Sketchy, incomplete and par- 
rounded, overall picture to stm- 
tial consideration of the diseases 
dents, with attention paid to both 
syphilis and gonorrhea, pointing 
out their parallel aspects. 
either together or separately. 
Presentation of the VD prob- 
Omission of some essentials 
lem so that it is clear and 
or presentation of a too detailed, 
restricted to essentials. 
technical, or clinical picture 
which may prove confusing to the 
students. 
Viewing the venereal 
Perpetuating prejudices by 
diseases in the same light as . 
teaching that venereal diseases 
other communicable diseases. 
are "disgraceful" and "sinful." Some Criteria of VD Teaching in the Classroom (Continued) 
MORE EFFECTIVE 
| 
1 LESS .EFFECTIVE 
Stressing the more hopeful 
Use of "fear” or "scare" 
aspects of the VD problem, that 
psychology. The overstressing of 
it is a preventable, controllable 
morbid or clinical aspects. 
and curable one. 
Note: This method has not 
proved an effective deterrent and 
what is more, it may result in 
syphilophobia in which condition 
a person thinks that every cold 
sore or pimple is a possible VD. 
Unemotional presentation — 
0 ve rd ram tiaation — 
’"There is no need for melo- 
"Overdramatization leaves the 
drama; the facts are dramatic 
impression that the whole subject 
enough in themselves.” 
has been exaggerated." 
—-N. A. Nelson & G. Crain 
—-N. A. Nelson fr G. Crain 
Alertness in linking and 
Presentation of such "gutter" 
substituting scientific VD terms 
or vulgar terms so as to create 
for the colloquial ones already 
an unfavorable attitude in the 
possessed by students as, for 
students and to bring community 
example, "clap” may be a disease 
known to students whereas 
"gonorrhea” is an unknown one# 
criticism on the school program# Some Criteria of VD Teaching in the Classroom (Continued) 
MORE EFFECTIVE 
j LEGS EFFECTIVE 
A careful selection from 
i 
Indiscriminate use of any or 
available materials for class pre- 
1 
all VD materials with no attention 
1 
sentation with attention paid to 
j paid to class abilities and limita- 
effectiveness for the particular 
| tions# 
group and situation concerned. 
1 
Consideration of the problem 
Teaching wholly from the angle 
as a community and individual one 
that the students may be future 
with responsibilities to be assumed 
\ 
patients. 
by all citizens as well as those 
that may become infected. 
Correlation of Work in Venereal Diseases 
Jith Various School Departments 
The most logical and recommended place to teach VD in a school 
program is as a topic in a unit on communicable disease in a science or 
health course. In this way, it becomes a part of the school program in 
its natural setting and has the desirable features of consideration from 
the public health angle and requires but little additional training in 
VD facts by the teacher personnel. The teaching force, as a whole, is 
more likely to accept the inclusion of venereal disease education into the school program as under these conditions it would more likely ho 
treated scientifically and unemotionally. It is the consensus of health 
educators that venereal disease work should become a regular part of the 
health education program of the school. 
At times it may be desirable and necessary to include other cU 
partments of the school by correlating activities that have a bearing 
on venereal disease education. 
In Chemistry, attention may be drawn to the way a scientist works 
as shown by Ehrlich’s G06 experiments resulting in salvarsan; 
the sulfa drugs; Fleming’s work on penicillin; and others. 
In Social Studies, the community and governmental aspects of 
control and the study of existing and proposed laws may be 
studied. 
In English classes, themes on various phases or topics of 
venereal diseases might be written and books such as "Microbe 
Hunters," "Men Against Death," "Idols and Invalids," "Ghosts," 
by Ibsen, and the autobiography of Benvenuto Cellini are some 
that have VD references that could bo used for outside reading 
and reports. 
In Art classes, posters, charts and graphs for school use might be 
reproduced or original designs created. 
In Shop classes, displays and exhibits might be made. Mechanical 
drawing classes could do the lettering for such a project. 
In Mathematics, graphs and statistics of various sorts might bo 
utilized in problem work. 11 
In Homemaking, classes can stress the value of health for happy 
home life, with venereal diseases exposed as a prime destroyc 
The school paper can run articles written by students. 
Photography classes can make lantern slides and film strips. 
Dramatics classes can reproduce radio broadcasts dealing with YD 
and also write original ones for school assemblies or for pre 
sentation over public address systems. With a recording 
machine, transcriptions for classroom use can be made. 
Physical Education classes can stress the "Keep Physically Fit" 
theme with the complete physical examination including blood 
test* 
While the science and health classes arc usually most suitabl 
for VD instruction, all departments or any special one can carry out 
certain phases of venereal disease education. 
Suggested Supplementary Activities for the Classroom 
1. Use of films, slides, radio transcriptions and other recordings 
which may be obtained from the health department. 
2. Use of local speakers, as doctors and nurses. 
3. Attention paid to National Social Hygiene Day — the first Wednesday 
in February of each year. 
4. Making of scrapbooks of newspaper references on venereal diseases. 
5. Special reports such as biographies of men who have contributed to 
our knowledge of venereal diseases. 12 
6* Collection of data on various phases of the local venereal disease 
problem. 
7. Setting up exhibits. 
8. Panel discussions. 
9. Quiz programs. 
10. Reproducing mainland or local radio programs on venereal diseases or 
writing original ones. 
11. Theme writing on some particular topic of the venereal disease 
problem.# 
12. Locating superstitions and erroneous infoimation on venereal disease. 
13. Developing contrasting items as facts and fallacies on venereal 
disease. 
14. Critical examination of current magazine and newspaper articles on 
venereal diseases with respect to their scientific worth and 
accuracy. 
15. Preparation of charts and graphs such as bar and rotary sector ones 
to display statistics. 
16. Preparation of articles for the school newspaper. 
17. Book reports as "Microbe Hunters," "Men Against Death," and others 
dealing with phases of VD. 
18. Serological tests either on a large scale survey basis, as all-school 
or all-class, or on a small scale within the classroom for demon- 
stration purposes. The serological test on either the intermediate 
or senior high school level should not be thought of as a case- 
finding device. Rather, the blood test should bo used as a means 
of arousing initial interest or as a climax to the VD work. It 13 
is not educational in itself but must be made so by the teacher. 
It is a rather expensive and time-consuming method so if it is 
used at all, it must be made educational. 
Attention to VD Programs on Two Levels 
In the division of material and attention paid to VD on the 
intermediate and senior high school levels, certain considerations need 
to be borne in mind. 
The VD Program in the Intermediate School 
If a very complete and thorough presentation is given in the 
intermediate school, the repetition of the same material later in the 
senior high school will load to justifiable criticism, and complaints by 
the students. The immaturity of the students should be considered and 
the presentation restricted to a brief coverage of the essential facts 
with attention paid to simplicity. 
It is felt that the booklet on venereal diseases designed for 
the intermediate student, as a rule, will suffice. The teacher can use 
whatever classroom method and aids she prefers to project the work with 
attention paid to the abilities and interests of the group. 
Why should any attention be paid to the venereal diseases on the 
intermediate level? A number of students do not continue on to the senior 
high school. Many of these students will be those who will need this in- 
formation. Experimental studies in certain island intermediate schools 
show that VD work can be successfully included in the science work of the 
school. The VD Program in the Senior High Schoo 1 
On the senior high school level, a wider choice of materials 
can be used and the entire subject can be expanded. A greater use of 
visual aids and other supplementary measures is indicated as more time is 
likely to be allowed in the course for the work in VD. The vista of the 
possibilities is limited only by the capabilities of the students, and the 
teacher’s own particular interests in the presentation. 
As high school students are more mature and approaching the age 
when there will be a greater interest in community and personal problems, 
the booklet designed for the senior high school student necessarily 
includes more material than the one for the intermediate student. VD INPORIDATION Venereal Diseases 
The venereal diseases are very serious communicable diseases 
spread usually by intimate body contact. The most common ones found 
in Hawaii are syphilis and. gonorrhea. Other ones, uncommon to Hawaii, 
are chancroid, granuloma Inguinale, and 1 yoipnot. ranuloi.ia venereum. 
Each of these diseases is a separate and distinct disease 
with its own cause, symptoms, diagnosis, and treatment. A person may- 
have one or more of these diseases at one time. Having these diseases 
once does not insure the person against contracting them in the future 
Immunity ayainst them is almost nonexistent. 
The point in common about these five diseases and the reason 
they are called "venereal" is their mode of transmission, usually that 
of sex contact. 
Syphilis 
Histon/ 
1493 - Columbus’ sailors were treated in Barcelona, Spain for a 
"new” disease contracted from tne women of the West Indies 
There was no previous historical or scientific evidence as 
to the presence of syphilis in Europe before then. 
1494 - The disease spread from infected Spanish soldiers to the 
army of Charles VIII 'while in Italy, then to France, when 
he returned there, and finally to the whole of Europe. 
1495 - Emperor Maximilian I called the disease "the evil pox.” 
The disease was known as the "French disease,” the "Portu- guese disease," the "Neopolitan disease" and a number of 
other names. Each country blamed its enemy and named the 
disease after it. From 1495 on, tne disease swept Europe 
as a plague. It is interesting to note that the medical 
term for syphilis is lues, which means plague. 
1530 - Fracastor published his poem, "Syphilis sivc Morbus Galli- 
cus" (Syphilis or the French Disease) in which a shepherd 
named Syphilis was afflicted with the disease. Since that 
tine, sypnilis has becoiae tne name generally used for the 
disease. 
1786 - Hunter, an English surgeon, inoculated himself and "proved" 
that gonorrhea and syphilis were but variations of the same 
disease. So for fifty years, the two diseases were erron- 
eously thought of as one disease. 
1831 - Ricord, a French physician, proved that hunter's precise 
was false. Syphilis and gonorrhea were shown to be two 
separate and distinct diseases. 
1901 - Bordet, a Belgian bacteriologist, with Gengou, a French 
bacteriologist, discovered the principle of "complement 
fixation." 
1903 - Metcanikoff, a Russian biologist, and Roux, a French bac- 
teriologist, transferred syphilis to a chimpanzee. 
1905 - Schaudinn and Hoffmann, German scientists, discovered the 
cause of syphilis, Treponema pallidum. 
1907 - Wassermann, & G-erman-scientist, used tie principle of "com- 17 
plement fixation” and worked out his blood best for the 
disease. 
1910 - Ehrlich, a German scientist, after 605 experiments, found 
that salvarsan, an arsenical compound, was effective in 
treatment of the disease. Salvarsan became known popularly as 
60b. 
1917-- Wagner-Jauregg, a Viennese physician, used the fever of 
malaria as a means of treating the insanity caused by syphilis. 
1921 - Levaditi, a French scientist, used bismuth as part of the 
treatment of syphilis. 
Since then— 
Walter Simpson, an American doctor, and diaries Kettering of 
General Ilotors Corporation developed the ’’fever” machine which gives 
an artificial fever which is used as a supplemental treatment for the 
insanity caused by late syphilis, 
Tne original serological test has been modified and other 
blood tests have been devised by a number of men as Kolmcr, Kline, 
Kahn, Eagle and Hinton. 
The original treatment with salvarsan has also been modified. 
New arsenical and bismuth dru-s are now in use. 
So, in the long search for tne treatment, diagnosis, and cure 
of the ’’Great Pox,” scientists from many nations have made contribu- 
tions toward the control of this one-time dread disease. Syphilis 
Syphilis is a very serious disease which, in the early years 
of its course if it is untreated, is extremely contagious, but subsides 
in about five years into a chronic, noncomuni cable disease. It pur- 
sues a very insidious and variable course in its victims, producing 
symptoms and effects imitative of many other diseases. For example, 
there are at least IJj shin diseases which secondary7- syphilis may resemble 
Cause: Treponema pallIdum or Splrochaeta pallida. Descrip- 
tion of the organise!: It is a corkscrew shaped, microscopic orgahisia 
with 5-20 spirals, motile, very delicate, and easily killed by dry- 
in-; and mild antiseptics. However, when it once enters the body, it 
becomes a very stubborn and resistant organism. It cannot be stained 
very successfully, hence, the usual method of staining for observation 
cannot be used in diagnosis. In the chancre stage of early syphilis 
tne presence of tne living organism is shown by means of the darkfield 
microscopic attachment. The biological characteristics of the organism 
are suen that it can be acquired only through intimate contact such as 
sex relations or kissing. The organism may attack any part of the body, 
although it more frequently attacks the cardiovascular system and cen- 
tral nervous system. 
Note: Schaudinn first called the organism, Spirochaeta pallida. 
Today, the classification of the organism as 'Treponema pallidum is favored 
Spread: Syphilis is 
most generally spread by close and intimate body contact 
as sexual intercourse and kissing. 19 
- often spread in marriage by an infected mate and in preg- 
nancy by an infected mother bo her unborn child. 
- rarely spread by indirect means such as drinking -lasses, 
dishes, lipstick, razors, and toilet seats. 
Symptoms: Acquired Syphilis - The germ of syphilis enters 
the body through a break in tne skin or unbroken mucous membrane. The 
break in the skin, however, needs only to be very tiny. The organisms 
travel by the lymphatics to the bloodstream and to every part of the 
body where they multiply rapidly. The incubation period raiy.es from 
10 - 90 days with an average of 3 weeks. Left alone and untreated it 
becomes a chronic systemic disease. It may be communicable to others 
for about 5 years if surface lesions are present♦ Beyond that period 
of time the infection usually persists in tne person for many years 
but the communicability of the disease to ethers is almost nonexistent 
with the possible exception of the untreated syphilitic mother who may 
infect her unborn child. 
Stages Iii The Development of Syphilis 
A - Early -- Prinary stage 
- Point of entry of the organisms into the tody develops an 
open sore called the chancre. 
Chancre: 
- this is the first lesion of syphilis and is usually painless 
- it appears from lu - 90 days after sexual or other exposure 
with an average time of 3 weeks, 
- in a woman it may be internal and hidden and thus escape 
her notice. 20 
- it is more obvious in a male as his sex organs are 
external. 
- the nearby lymph glands may be swollen. 
- the chancre may last from several days bo several weeks 
but will eventually heal spontaneously. 
- the organisms from the chancre which have been distributed 
throughout the body by the blood, have been multiplying 
all this time. Then appears— 
Secondary sta^e: 
About 4-8 weeks after the chancre, signs may appear such 
as a skin eruption or rash, which iay be marked, or slight, 
or not even appear to oe noticed by the victim, 
- other signs or symptoms that may appear: 
- mucous patches usually found on the genital organs or 
in the mouth (these patches are especially dangerous as 
they swarm with organisms: hence, kissing if mucous 
patches are present is often a means of spreading the 
disease.) 
- sore throat 
- headache (of the "splitting” variety) 
- fever 
- pain in the bones acid joints 
- swollen lymph glands 
This stage of syphilis varies in both appearance and intensity 
in different persons. In sone persons there may be no noticeable signs 21 
or symptoms. When present, these signs and symptoms will disappear of 
their own accord after a period of weeks. They may recur however, over 
a period of about five years. 
These two stages comprise the most contnunicable and most 
curable periods of Infection. 
The body, as is usual in infectious diseases, tries to build 
up defenses against the disease. In syphilis, these defenses are not 
so strong as in some diseases and future immunity is almost nonexistent. 
This may be the reason why scientists have not been able to develop an 
immunizing procedure such as we have for smallpox. 
The blood also reacts to the organisms and, gradually, changes 
appear which can be detected by special tests, Tne blood is negative 
during the period before the chancre and becomes positive gradually 
about a month later. 
If treatment is started, trie process of whatever body resis- 
tance is being built up is interfered with; hence, when treatment is once 
started, it should continue without a breals until the patient is consi- 
dered cured by the doctor. 
B - Latent 
The disease, after the symptoms have disappeared, goes into 
a stage of quiescence for years. 
This period is called tne latent stage. The only means of 
detecting the presence of the disease then is by tne blood test which 
will be positive. 
In about one-half of the untreated cases, and even in a few of those under treatment the disease may show itself in severe damage 
to any part of the body, any organ, or any tissue, 
C - Late 
The manner of striking late in the course of the disease is 
usually that of slow deterioration which may result in death from 
heart disease or insanity with little or no warning. 
The disease in this stage produces disastrous effects, of 
which some are: 
- to the brain, causing insanity (paresis.) 
- to the spinal cord, causing a peculiar stumbling walk, 
(locomotor ataxia or tabes dorsalis.) 
- to the heart, causing a form of heart trouble, 
- to the eyes, causing blindness. 
These late damages often become a cause of death. 
Congenital Syphilis 
Congenital means "to be born with." This type of syphilis 
is found in a baby born of a syphilitic mother. Another term sometimes 
used is prenatal syphilis. 
A mother may very easily infect her baby if her syphilis is 
early and untreated. Even if she has been treated, there is a possible 
chance that her baby may not be adequately protected. That is why a 
syphilitic woman is usually treated during each succeeding pregnancy. 
Doctors usually don't want to take a chance of having the tragedy of a 
syphilitic child. By the fifth month of pregnancy, condition of the placenta 
is such that the organisms of syphilis can oenetrate the wall and thus 
infect the unborn child. Treatment started by the fifth month and car- 
ried on through the remainder of the pregnancy usually assures the mother 
of a live baby free of syphilis. 
Effects of an untreated pregnancy may be: 
- abortion 
- miscarriage 
- stillbirth 
- or birth of a syphilitic baby. 
Babies born with syphilis react much as do adults with various 
intensities. Some have or develop the characteristic symptoms of syphilis 
soon after birth; others show no si ns, and evidence may appear only 
later in adolescence, manifested in deafness, blindness or insanity. 
Congenital syphilis is preventable. If every pregnant woman 
who has sypnilis would be treated adequately and early during her preg- 
nancy, congenital syphilis would practically disappear. 
Diagnosis: Sjpphilis is usually diagnosed by the doctor by several means 
as: 
a. History of patient— 
- with the cooperation of the patient, ranch help can be 
had from answers to pertinent questions. 
b. examination-— 
- by a careful physical examination the doctor notes evi- 
dence of the disease such as any present. - by this, he is helped in the diagnosis of the stage or 
type of syphilis present. 
c. examination— 
- the special darkfield microscopic attachment is used. 
- the live organisms will be seen as pale moving organ- 
isms against a black background. 
- specimens are secured from chancres, mucous patcnes, or 
any early lesion. 
- useful for diagnosis in the early weeks of the disease, 
as the blood, then, is usually negative. 
In the usual laboratory method of examining organisms under 
the microscope, they are placed on a slide and stained by means of vari- 
ous techniques so as to distinguish them. In the ordinary microscope, 
light passes up through the slide and germs and then through the lenses 
to the eye. In the case of the syphilis organisms, which cannot be 
stained successfully, it becomes necessary to use another means of 
viewing then. This is accomplished by means of the darkfield micro- 
scopic attachment. 
The darkfield microscope is made up of a regular compound 
microscope with an added attachment - the darkfield condenser. This 
condenser, by r,leans of its special arrangement of lenses, doesn’t let 
the light go up through the organisms but throws the light across them. 
The apirocnetes reflect this light and, as a result, appear as light 
organisms against a black background. This same effect is seen in a 
room when a slanting ray of light shows up the dust particles in the air 
along trie beam of light. 25 
d. Serolo ical or blood test_— 
- many types of blood tests are used. Any stadard one is 
acceptable. 
- after o few weeks, changes in bho blood due bo bhe or- 
t: mis.is, show uo and tne blood ives a positive reaction. 
- repeated tests are rede on persons showing positive 
tests bo rule out any possible error. 
e ' Social fluid tests-— 
- especially useful to deter.due rtietner the central ner- 
vous system is affected. 
- every person with syphilis should have a spinal fluid 
test done to prevent the damaging effects to the central nervous system 
of late syphilis. 
Usually, a combination of the above means is used to determine 
the presence of the disease, to follow tne progress of treatment, and 
to deter .line cure, 
From this discussion we can see that s elf-di a,,no sis and treat- 
ment is dangerous and foolhardy. 
Only a doctor _can diagnose. Only he has the iaeans and ability 
to_ observe and interpret si-ns and symptoms of __disea_se_. 
The quack, the druggist, friends, or oneself cannot do it. 
Treat lent: 
- early syphilis is curable in almost 100$ of the cases, 
- in the late stages, treatment prevents further damage to 
the body. "The encouraging point is tiiat by use of tme newer 
treatments, patients with paresis now recover .men- 
tally at five times the rate they did in 1926. 
The death rate has been cut in half since the in- 
troduction of fever therapy,1*— Parran and Vonderlehr 
regular treatment is important in order to prevent a 
flare-up of the disease (called a relapse), and damage 
due to late syphilis. 
as symptoms disappear early in treatment, the patient may 
be misled into thinking, ne is cured. Discontinuing treat 
nent then is dangerous as tne disease is still entrenched 
in the body. 
untreated and inadequately treated syphilis are both, dan- 
gerous . 
drugs used are compounds of arsenic, given by injection 
into a vein of the arm, and bismuth into the hip muscles. 
These are usually given by weekly or semi weekly injections, 
the plan of treatment varies according to the individual 
case and the stage of the disease. 
length of time for cure of early cases is usually from 6 
months to 1-1/2 years, however, it is only by repeated 
checking by the doctor that cure is determined, 
other treatment plans of shorter length arc not in general 
use at present as they require special treatment facilities 
and need further scientific investigation. These include 
the so-called "short” cures and the use of new drugs such 
as penicillin. In Hawaii 
Number of Cases of Some Communiccble Pisenses 
in the Territory of Hawaii for the Flscrl fours 
Ending June 30 of the 8-Year Period — 1937-1911. 
Influenza 38,069 
Measles 19,763 
Mumps 10,052 
Gonorrhea 8,656 
Whopping Cough 8,050 
Chicken Pox 7,811 
jSyphi 11 s 7,051 
Tuberculosis (Respiratory) 6,353 
Pneumonia (Lobar) 1,809 
Dengue 1,569 
Diphtheria 770 
Typhus fever 656 
Tuberculosis (other forms) 612 
Typhoid Fever 126 
Leprosy 3-t2 
Poliomyelitis (Infantile Paralysis) 255 
Scar]et Fever 206 
Tetanus 179 
Ophthalmia Neonatorum 12 
(Gonorrhea inflammation of the eye of 
the newborn) 
— Figures secured from the Board of Health 
There were 133 deaths from syphilis out of a total of 1,155 
deaths from all communicable diseases in the 8-year period (1937-11) 
- 1 out of every 7 blind persons is blind because of a 
venereal disease. 
1 out of every 10 persons admitted to the Territorial Ilospi 
tal was there because of syphilitic damage to the brain. 
:'0f all first admissions (a total of 3,253) to tiio 
Territorial Hospital from July 1, 1923, to June 30, 
1910, the percentage with syphilis in one form or 
another was 17.9%*n 
"10% of all admissions were in the hospital as a 
direct result of syphilis— Kepnor 
This last percent coincides with the national figure Control and Prevention: 
By legist.ation: 
- prenatal - In 1943, the Territorial legislature passed a 
prenatal law providing for compulsory blood tests for 
syphilis of all pre-nant women. In Hawaii the year before, 
more than $0 syphilitic birtns were recorded in the 
Territory. The new law will help correct this needless 
condition. 
oremarith-l - requiring blood testing for syphilis before 
marriage of tne parties concerned. Hawaii, at present, 
does not have this lav/. 
- others: 
as providing financial support of programs that include 
clinics, free dm s, tne control of quackery, and the 
elimination of prostitution, on national, state or ter- 
ritorial and community levels. 
•‘Under the National Venereal Dise se Control Act 
of 1933, Federal funds naj be used by the state health 
departments for the purchase and distribution of 
drugs to physicians for the care of their patients 
suffering v/itn syphilis or gonorrhea. In the past, 
the cost of these dru s constituted one of the most 
serious obstacles to treatment of tne low-income 
patient.”— Parran and Vondelehr 
By health services: 
laboratory and clinic facilities; finding cases and keeping 
them under treatment. 
By education: 
- of the physician and nurse concerning new medical develop- 
ments. 
- of youth in schools. - of the adult public, 
- of the patient. 
"The first job in syphilis control is to teach," 
— Parran. 
Effects and Costs: 
Syphilis: 
- is responsible for a lar_e percentage of insanity, paralysis, 
heart disease (late syphilis of the cardiovascular and ner- 
vous systems.) 
- nay cause blindness (from interstitial keratitis of con.eni- 
tal syphilis and also optic atrophy of acquired syphilis.) 
- may damage other parts of the body as bones, liver, kidneys, 
(late syphilis.) 
- is the cause of nany children being born dead or diseased 
(congenital syphilis.) 
"Like tuberculosis, tne disease strikes at the most 
vigorous and productive ape — that of tne wage 
earner, the young mother, tne poung professional 
man or woman. There is more of it among men, at the 
rate of 6 for every 4 women infected. One-half of 
all new infections occur in the aee group 20 to 30." 
— Parr an and Vonderle.hr 
- causes loss of time from work o.ue to illness from the 
disease or time needed for treatment. 
- costs of the long treatment are rather high. 
- costs for free clinics must be borne by the taxpayer. 
-costs are paid as taxes to maintain institutions necessary 
for its victims ana for the national, state, territorial, 
and community control programs. ftTnis is a public problem since 9 percent of 
ail persons receivin'.- hospital care for paresis 
are in tax-supported institutions — Federal, 
state, county, and city.” — Parram and Vonderlehr 
"Paresis is an economic problem since the esti- 
mated annual loss in this country is 77*074 years’ 
work of men in the productive period of life and 
24,597 woman-years. Loss of income, based on 
the earnin.s of patients before they became in- 
capacitated, is estimated at pill,OoO,000 each 
year. Because many of tne women were not wa6e 
earners, no attempt was made to put a money 
value on their loss of income while sick with 
paresis.” — Parran and Vonderlehr 
- causes financial losses to industry throu n compensation 
and hospital costs of accidents caused by syphilitic workers 
- causes loss of income during illness especially from the 
damages of late syphilis. 
- lessens our war effort throu hi decreased man power — 
a. in the first 2,000, .mo selectees, 90,000 were found 
to be syphilitic. 
b. loss of time from active service of the armed forces 
ill or under treatment. 
c. loss in production due to lessened efficiency. 
- is a threat to the happiness of the home by affecting hus- 
bands, wives, and children. It may become a cause of 
breaking up the ho ie. 
The Scandinavian Example. The Scandinavian program of finding 
infected cases, treatment of tnem, and public education was thoroughly 
carried out before the war. This pro was successful in raduciir the 
venereal disease rate to a new low level. The Scandinavian lee'/ makes 
treatiicnt mandatory. Force has been unnecessary in the control of 
syphilis perhaps because the Scandinavian a as a hi-.h regard for law. In 1788, in Den,lark, the first le al steps were taken to 
control syphi1i s. 
In l?9o, free treatment ’.ms provided. 
In 1874» treatment was nude compulsory. 
In 191o, treat’vsit was made compulsory in Sweden. 
By 1933, the rate for syphilis in Scandinavia had fallen from 
the 1919 rate as follows; 
Eatje Per 100,000 jPojpuldhJLon 
.19,19 1232. 
Denmark 119 20 
Sweden 97 7 
Oslo, Norway 300 30 
What Can Be Done? 
Syphilis and gonorrhea are weverybody’s justness.* We need tc 
know about these diseases so that all of us can . ive support to programs 
ained at oontrollin them. We should also know that tax money is being 
used for the financial support of institutions for the vie tins of vener- 
eal disease. It should also be mentioned here that syphilis and gonor- 
rhea are saboteurs of our 'ur effort by reducing the striking force of 
the armed services and the productive capacity of industry. We should 
support legislative measures deal .nod oo control tmese diseases with our 
votin power. Oreater cooperation is needed from tne public if we are 
to succeed in the fi ht against those serious menaces to our co.maunity 
health# 35 
Diagnosis: 
a. Clinical examination and the taking of the person’s nis- 
tory by the doctor. 
b. Smear — microscopic examination — 
A Gram stain is made of the slide on which a little of 
the pus is placed. Diagnosis is made by finding the 
characteristic organisms. 
c. Culture — 
This is a further aid to diagnosis. The organisms are 
grown on special media in the laboratory and chocked 
further by special tests. 
Treatment: 
Early cases: The use of penicillin, which, is given 
by injection, quickly gives remarkable curative results. The 
sulfa drugs, which are given by mouth, also are used in the 
treatment of early cases. Chronic or resistant cases: The 
fever treatment gives good results for this type of case. 
The cessation of the discharge does not necessarily 
mean that the patient is cured. So long as the organisms are 
present, the person is infectious. By repeated examinations 
the doctor determines cure. 
The sulfa drugs are potentially dangerous and may 
cause damage to the body such as damage to the blood or kidneys. 
A doctor carefully checks patients who are given sulfa drugs so 
that damage will not be caused. Self-treatment, or dependence 
on druggists or friends for advice in place of a doctor is a 
dangerous and foolhardy thing to do. 
Untreated chronic gonorrhea may become very resistant 
to treatment. 3o 
Extent and Seriousness of the Problem: 
In the United States 
- 1,000,000 estimated new cases yearly. 
- A very common disease, estimated to be 2-3 times more 
common than syphilis. 
"Actually more people in the United States suffer 
from gonorrhea than from any other dangerous 
disease. Only measles and the common cold are more 
prevalent. Like syphilis, it runs in epidemics by 
intimate contact from person to person." — Parran 
and Vonderlehr 
In Hawaii 
In the 8-year period 1937 - 1947- • 
- Gonorrhea ranked number 4 in the list of all communicable 
diseases. 
- 8,656 cases reported during that time. 
- In the Territory of Hawaii for the fiscal year 1942-43, 
there were approximately five new cases of gonorrhea 
to one early case of syphilis reported to the Board of 
Health, (4*3 to be exact) — Board of Health 
- 10 deaths were recorded, of which 2 were from Ophthalmia 
neonatorum (gonorrheal inflammation of the eyes of the 
newborn.) 
Effects and Costs: 
- It is a cause of lator invalidism in women and the cause of 
many operations. 
- It is an important cause of sterility in infected men and 
women through the closing of the passages for the sperma- 
tozoa or ova. 
- It is a cause of blindness in newborn babies through infection 
of the eyes at birth. It nay cause blindness in adults -,n 
J i 
throu, n accidental infection of tne eyes, 
r It may disable by affecting tne joints, or by duia.mng the 
, heart. 
- It causes great loss of tine from work with accompanying 
loss of earning power as it is a very common disease. 
- Gonorrhea uoesn’fc often kill. 
In many respects, gonorrhea has many features, which parallel 
those of syphilis. Their node of transmission is similar. Measures 
previously described for the control of syphilis are also applicable for 
gonorrhea. In a control program, education •couples a very important 
position. In both diseases, tne individual is expected to assume his 
share of tne responsibility in getting under treatment and protecting 
~ J * 
others from these diseases which have both individual and social impli- 
cations. 
Things Worth Emphasizing About Gcnvrrnea: 
- Women are not so apt to be aware of tne presence of th® 
disease as are men because their sex organs are internal, 
and the urinary passage is separate from the genital passage. 
- Men are more aware of tne presence of the disease because of 
„ the painful urination, as their sex and urinary passages 
are the sane. 
- Untreated'gonorrhea becomes chronic and may cause serious 
effects in the body. 
- There is danger of blindness to babies bom to mothers with 
. gonorrhea. V 
o 
- Gonorrhea, unlike syphilis, is contagious throughout the 
course of the disease. 
- There is no accepted blood test for the detection of the 
disease as is the case for syphilis. 
’’Research roes on constantly to find a test for the 
detection of acute and chronic gonorrhea which is as 
adaptable to public use as the blood test for syphi- 
lis. Tf— Parran and Vonderlehr 
- Host cases respond to the sulfa dru.s with quick cure. 
Penicillin cures even more quickly. 
- 0nl3r a doctor can determine the presence of the disease 
and treat it. 
- Quackery, self-treatment, and reliance for help from friends 
are dangerous and ill-advised. 39 
Summary of Some Points Worthy of Emphasis Concerning VD 
1. The usual method of transmission of venereal diseases is 
by intimate contact: the danger from nonsexual contacts is slight. 
2. The diseases are serious because of their damaging effects 
when either untreated or poorly treated. 
3. These are "tricky” or insidious diseases with symptoms 
often confused with other diseases. In many cases, the usual symptoms 
are slight and may be even lacking. 
1. Reliance should be placed on adequate diagnosis and treat- 
ment by a qualified private doctor or clinic and not by self-treatment, 
advice from friends, druggists, or quacks. 
5. Along with the teaching of sound facts, some reteaching 
to correct students in respect to erroneous information must be done. 
6. The present generally accepted methods of treatment are 
the longer ones but the future may see possible modification. 
7. The appearance of symptoms following illicit or promiscuous 
sex or other intimate contacts should be suspected. 
8. VD is "everybody’s business” in a community, not just the 
business of the person who contracts the disease. 
9. VD should be considered as a communicable disease problem— 
communicable, preventable, controllable and curable. 
10. Congenital syphilis is one type of syphilis that can easily 
be prevented, 
11. The weapons are at hand to fight these diseases. It is up 
to the public to insist that VD be reduced to minor significance.  
Trie individual must assume his snare of responsibility and Trip 
to break tne chain of infection. 
Can the venereal diseases be reduced to very minor significance? 
Yes—the weapons are at hand: 
We know the cause. 
We can prevent then. 
We can detect their presence. 
We can cure then. 
What is needed now is the full use of every available resource. 
Only through cooperation can we hope to relegate tries© diseases to a 
place of minor significance. 41 
References 
A References starred are recommended especially for teacher use. 
A. Books: ■ 
A NELSON, N. A., M.D., and Crain, Gladys L., R.N. - 
"Syphilis, Gonorrhea and the Public Health” - MacMillan 
Company, New York, 1933 ($3.00) 
A PARRAN, Thomas, M.D. - "Shadow On the Land” - American 
Social Hygiene Association, New York, 1937 (Educational 
Edition, $1.00) 
A PARRAN, Thomas, M.D. - and Vonderlehr, R. A., M.D. - 
"Plain Words About Venereal Disease," Reynal and Hitchcock, 
New York, 1941 ($2.00) 
A , PUSEY, William Allen, M.D. - "The History and Epidemiology 
of Syphilis," Charles C. Thomas, Springfield, 111., 1933 
HISC0CK, Ira V. - "Community Health Organization" Common- 
wealth Fund, New York, 1939 ($2.50) - Ciiapter on syphilis 
control. 
SNOW, William F,, M.D. - "The Venereal Diseases: Their 
Medical Nursing and Community Aspects." - Funic and Wagnalls, 
New York, 1937 (35?) 
THOMEN, August A., M.D. - "Doctors Don’t Believe It—Why 
Should You?" (Facts and fallacies about health with prac- 
tical guidance for the layman.) Simon and Schuster, New 
York, 1941 ($2,50) - Chapter on venereal diseases, 
van WYCK, William - "The Sinister Shepherd," Primavera 
Press, Los Angeles, 1934 4*- 
B. - Booklets; 
A BIGELOW, Maurice, Ph.D., - "Some Dangerous Communicable Diseases,” 
American Social Hygiene Association, New York, ($.10) 
Pub. No. A. - 531 (A manual for teachers and students, 
planned as a project in visual education.) 
EXNER, M. J., II.D. - "What You Should Know About Syphilis and 
Gonorrhea,'1 American Social Hygiene Association, New 
York, ($.10) Pub. No. A. - 186, 1937- 
RICE, Thurman B., M.D. - "The Venereal Diseases," American Medi- 
cal Association, 535 N. Dearborn St., Chicago, 111., 
($ • 25). revi sed, 1939 • 
STIMSON, A. M., M.D. - "Communicable Diseases," Sup’t of Docu- 
ments, Wash., D.C., 1935» ($.25) - Miscellaneous 
Publication Number 30. 
Local 
HOLMES, W. John, M.D* and HAMMAN, Grace C. - "Causes of Blindness 
in Hawaii," Reprint from Archives of Ophthalmology, 
April 1941, American Medical Association, 1941 ~ 
In Teacher’s Kit. 
KEPNER, Richard, M.D. - "Syphilis and Neurosyphilis in Hawaii," 
Hawaii Medical Journal, November, 1941. 
C ~ IfegQgine Articles: 
COLLIERS - Nov. 6, 194-3 - "Victory Over Syphilis" (Penicillin) - 
J. D. Ratcliff. 
March 11, 1944 - "New Orleans Cleans House" - 
J. D« Ratcliff. C. Magazino Ar bidoe 1 
HYGEIA - March 1943 - ’’Syphilis - The Great Tragedian" - 
Greer Williams. 
Jan. 1944 - "Your Blood Test” - M. J. Khisely. 
April, 1944 - ’’Penicillin” - Professor H. W. Florey 
and E, Cha in. 
LOOK - May 16, 1944 - "The War Against Venereal Disease” - 
Thomas Parran, M.D. 
READER’S DIGEST - July, 1936 - ’’Why Don’t We Stamp out Syphilis?” 
Thomas Parran, M.D. 
April, 1937 - ’’Syphilis Can Be Stamped Out” - Thomas 
Parran, M.D, 
Nov. 1937 - ”A Compulsory Test for Syphilis before 
Marriage" - Pro and Con Arguments. 
Aug. 1940 - "Progress in the War Against Syphilis” 
Thomas Par ran, M.D, 
March, 1941 - "Chicago Against Syphilis” - Paul de Kruif. 
Dec. 1941 - "The Army Fights Venereal Diseases” 
Francis Sill Wickware. 
May, 1943 - "Trouble on the Street Corners” - Eleanor 
Lake. 
TIME - May 15, 1944 - ’’20th Century Seer” - (Dr. Alexander 
Fleming and Penicillin.) 
WOMAN’S HOME COMPANION - March, 1944 - "V.D. - Menace and 
Challenge" - Patricia Lochridge, Local Magazine articles; 
HAWAII - July 31, 1942 - "Facing the Facts" - Samuel D. Al- 
lison, M.D. 
Aug. 31, 194-2 - "Fight Against Syphilis" - Samuel D. 
Allison, M.D. 
Feb, 194-3 - "In Step With the Times" - Editorial 
July 17, 1943 - "Shadow Off the Land" - W. H. Wil- 
kinson, M.D. 
PLANTATION HEALTH - July, 194-3 - "Lessening ’The Shadow On 
the Land. ’ " 
a) "Syphilis on Hawaii’s Plantation"....A Challenge 
by S. D. Allison, M.D. and W. L. Zink, H.D. 
b) ;,The Program Against Syphilis on One Hawaiian Sugar 
Plantation" - H. M. Patterson, M. D. 
c) Management of the Syphilitic Clinic on Lamai" - 
W. H. Wilkinson, M.D. T&ACWING A I f.'A 45 
Suggested List of Items 
to be Covered in Venereal Piseases 
!• What are the causes of syphilis and gonorrhea? 
II. How may they be spread? 
III. (a) What are their symptoms? 
(b) On what signs and symptoms and following what types of 
contacts should adequate medical advice be sought? 
IV. How are these diseases diagnosed? 
(a) What laboratory methods are used? 
V. (a) How are these diseases treated? 
(b) Why must they be treated? 
(1) What are some of the effects of syphilis and gonorrhea 
on the individual? 
VI. Why do these diseases constitute so serious a health problem 
here and on the mainland? 
(a) How prevalent are they0 
(b) What are some of their costs to the individual, the community 
and the nation? 
VII. What measures can be used to control these diseases? 
(a) Why is education a vital and necessary weapon to combat them? 
(b) What has been the story of the Scandinavian countries in 
venereal disease control? 
(c) What are the ways the community and nation can combat the 
venereal diseases? 
(d) Have we the means to wipe thorn out? 
VIII. What responsibility does an individual have to oneself and the 
community with respect to these diseases? 46 
Some Questions Often Asked 
About Venereal Diseases 
Some representative questions frequently asked by teachers and 
students on both th university and secondary levels arc given below. 
In most cases, the answers are incorporated in the material given in the 
section on ID infenmlatior. The questions and their answers as such are 
to be found "in the Teacher's Kit, or may bo secured from the Division of 
Health Education, Department of Public Instruction, Honolulu 4, T* H. 
1. What are the venereal diseases? 
2. Are there other venereal diseases besides syphilis and gonorrhea? 
3. What is syphilis? 
4. How fast does syphilis spread if it gets into the body? 
5. From the time the germs of syphilis get into the body, how long 
does it take before the symptoms appear? 
6. How can a person tell if he has syphilis? 
7. Could people have syphilis and not know it? 
8. What are the symptoms of syphilis that should cause a person to go 
to a doctor? 
9. When the symptoms of early syphilis disappear, is the person cured? 
10. What happens to a person with syphilis if he never gets treatment? 
11. Does treatment stop the spread of syphilis in the body of the 
person with the disease? 
12. If it is true that after treatment of syphilis is started a person 
is safe so far as others are concerned, why does he need to take 
such a long treatment? 
13. If a penmen has syphilis and is taking treatment, could he give it 
to another person? 
14. If a person has syphilis and has completed his treatment, could he 
give it oo another person? 
15. After syphilis has been cured, will it flare up again? 
16. Can a person with syphilis cure himself? 
17. When does a person know he is cured of syphilis? 47 
18. What are the so-called "short cures" for syphilis? 
19# Is syphilis hereditary? 
20. Is syphilis related to leprosy? 
21. What is congenital syphilis? 
22. How does a mother pass on syphilis to her unborn baby? 
23. If a mother doesn’t have syphilis, can the baby be bom with syphilis? 
24. What are the effects of congenital syphilis on the baby? 
25. If a baby has congenital syphilis, could others get syphilis 
from him? 
26. How is congenital syphilis treated? 
27. Can congenital syphilis be cured? 
28. How can congenital syphilis be prevented? 
29. If a child in school has congenital syphilis, can others get syphilis 
from him? 
30. If a child with congenital syphilis grows up and has never had any 
treatment, can he give his congenital syphilis to others? 
31. Why, then, should he take treatment? 
32. Can a mother who has congenital syphilis pass it on to her unborn 
child? 
33. Is a pregnant woman in Hawaii required by law to have a blood test 
for syphilis? 
34. What is gonorrhea? 
35. From the time the germs of gonorrhea get into the body, how long 
does it take before the symptoms appear? 
36. How can a person tell if he has gonorrhea? 
37. Could people have gonorrhea and not know it? 
38. When the discharge of gonorrhea stops, is the person cured? 
39. When does a person know he is cured of gonorrhea? 
40. Can a person with gonorrhea cure himself? 4B 
41* If a person has gonorrhea and is taking treatment, could he give it 
to another person? 
42* After gonorrhea has been cured, will it flare up again? 
43. What happens to a person with gonorrhea if he never gets treated? 
44. Why is it that a man with gonorrhea often has different symptoms and 
effects from a woman? 
45. Why is gonorrhea called the crippler? 
46. Mat are the effects of gonorrhea on a newborn baby? 
47. Does syphilis ever turn into gonorrhea? 
48. Should a person go to a druggist to seek treatment for either 
syphilis or gonorrhea? 
49. If a person cannot afford to pay a doctor, where can he get treatment? 
50. Are all venereal diseases contracted from sexual contacts? 
51. Can syphilis or gonorrhea be contracted from kissing, dishes, towels, 
or toilet scabs? 
52. Does a person with syphilis or gonorrhea have to be isolated? 
53. Which is worse — syphilis or gonorrhea? 
54. Mat are some other names for syphilis? Gonorrhea? 
55. Is case reporting and follow-up required of venereal diseases? 
56. Is venereal disease kept confidential between the doctor and the 
patient? Suggested for Senior High School Level: 
Test on Venereal Diseases 
The following tests are not designed to be considered as standard 
ones but to present some various types, suggestive and to be adapted by 
teachers for various teaching needs. 
Note: In questions 1 to 12, inclusive, there may be more than one 
correct answer to each question. 
Check those items that are correct. 
1. Syphilis can be diagnosed by: 
a. darkfield microscopic examination 
b. Gram smear 
c. culture of pus 
d. blood test 
2. The germ causing syphilis is called: 
a. Staphylococcus albus 
b. Neisseria gonorrhoeas 
c. Treponema pallidum 
d. PI a smod i urn vi vax 
e. Streptococcus haemolyticus 
3. This drug is used to cure gonorrhea: 
a. mapharsen 
b. bismuth 
c. boric acid 
d. penicillin 
e. atabnine 
Gonorrhea is important because: 
a. it produces disability in its victims 
b. it is the ’’great imitator” 
c. it is very prevalent 
d. it kills thousands yearly 
5. In educating about syphilis and gonorrhea, we should: 
a. regard these diseases as preventable, cont no liable, curable 
b. consider them to be a sin and a disgrace 
c. learn the facts about them 
d. speak in a hushed voice about them 
6. The drugs used in the treatment of syphilis are: 
a. arsenical drugs 
b. quinine 
c. bismuth 
d. sulfanilamide 
e. epson salts 50 
7. Early syphilis: 
a. responds quickly to treatment 
b. is conffiiunicable 
c. can be cured by drugstore remedies 
d. may go unnoticed because of lack of symptoms 
Mark with an X those items that are true, and with anJD,_those that 
are false. 
B. If a person has had untreated syphilis for 15 years: 
(0) a. he is considered in a contagious stage 
(X) b. he should be checked for damage to his nervous system and 
heart 
(X) c. there is a possibility that he may have shown no effects 
from the disease 
(X) d. treatment will stop the progress of the disease 
9. In early syphilis, those are the symptoms often seen: 
(X) a. rash on body 
(0) b. high blood pressure 
(X) c. sores 
(0) d. insanity 
(0) e. stumbling walk 
10. With congenital syphilis in a newborn baby: 
(X) a. care should be taken as the sores are contagious 
(X) b. treatment is necessary and should be given 
(0) c. it means the mother did not have syphilis 
(0) d. silver nitrate drops will prevent blindness due to syphilis 
11. Some effects of gonorrhea on its victims are: 
(0) a. insanity 
(X) b. inability to have children 
(0) c. deafness 
(X) d. blindness in newborn babies 
12. These are common signs of gonorrhea: 
(X) a. pain on urinating (men) 
(0) b. a discharge of blood 
(X) c, a discharge of pus 
(0) d. a cough 
(0) e. rash on the skin 
Opposite these statements, write the letter S if it refers to 
syphilis; or write the letter G if it refers to gonorrhea. 
13. Often called the ngreat imitator” S 
14-. Often called the "great sterilizer" G 
15. Kills many thousands yearly S 
16. May cause deafness and blindness in children born with it S 
17. Treatment usually takes 70 weeks S 
IB. Usually noncontagious after 5 years S 51 
19- Spiral, moving organisms S 
20. Mother infects her child before birth through her blood S 
21. Presence of the chancre S 
22. Silver nitrate drops in the eyes prevent blindness in babies due 
to it __G 
23. Its germ attacks only the mucous membranes G 
24* Its germ may enter through broken skin 3__ 
25. If untreated, may cause insanity in later years S 
26. Diagnosis made by smears and cultures of the pus G 
27. Blood test used for diagnosis S 
28. Spinal fluid tested to see if the germs are causing damage to the 
central nervous system 3 
29. One symptom is a discharge of pus G 
30. Prenatal laws S__ 
31. Treatment by injections S usually, G (penicillin) 
32. Beanshaped germs occurring in pairs G 
Matching. Place the number in the parenthesis ( ) which matches 
the person with hifs work. 
33* Thomas Parran (39) made a blood test for syphilis 
34-• John Hunter (37) brought syphilis to Europe 
35* Albert Neisser (36) proved gonorrhea and syphilis two sep- 
36. Philippe Ricord arate diseases 
37* Columbus (33) Surgeon General 
38. Ehrlich (31) confused syphilis and gonorrhea 
39* Wassermann (35) discovered the germ of gonorrhea 
10. Schaudinn (10) discovered the germ of syphilis 
(38) found a cure for syphilis 
True-False. In the space to the left of each statement, write in 
the words true or false. 
P 11. The germ which causes syphilis lives a long time when exposed 
to air and drying. 
F 12. Syphilis is a disease found only among the poorer people. 
13* All cases of venereal diseases are caused by sox contact. 
T 11. If a woman has syphilis, she can give it to her unborn child. 
F 15. Syphilis is hereditary, that is passed on for generations. 
T l6. Syphilis is most commonly spread by intimate sex contact. 
T 17* The germ of syphilis is a corkscrew shaped organism. 
T IS. The symptoms of early syphilis will eventually go away even 
if no treatment is taken. 
F 19. After 10 years, untreated syphilis is still communicable. 
50. Kissing is another common way of spreading the gems of 
syphilis. 
T $1. If a mother with syphilis takes treatment from the fifth 
month of pregnancy on, she will have a good chance of a healthy 
child free from syphilis. 
F 52. Sores and rashes can always bo found on people who have syphilis. 
T 53* IT there arc syphilitic sores on the lips, kissing will spread 
the germs. 
T 54* IT no treatment is taken, the sores and rashes oT early 
syphilis will disappear. 5'- 
55* A doctor can always tell if a person has syphilis by nis looks, 
F 5&* If a person has gonorrhea once and is cured, he will never 
get it again for he has become immune to it, 
F 57- The treatment of gonorrhea is a very long one. 
T 58. Syphilis and gonorrhea are two separate diseases. 
F 59* Venereal diseases are frequently spread by means such as 
toilet seats, drinking cups, lipstick, and towels. 
60. If a person has syphilis once, lie can never get the disease 
again. 
_T 61. Gonorrhea, if it is not treated, may sometimes make men and 
women unable to become parents. 
T 62. Congenital syphilis is not communicable to others after 
about five years. 
F 63. A woman with congenital syphilis will have syphilitic 
children. 
T 6k. If a person cannot afford to pay for treatments for syphilis 
or gonorrhea, it is possible for him to get free treatment. 
T 65. Syphilis can usually be cured if treatment is given early. 
66. A mother with untreated syphilis usually gives birth to a 
healthy baby. 
T 6?* Late syphilis often attacks the heart or the brain, 
68. It is estimated that there are more cases of gonorrhea in the 
United States than syphilis. 
F 69. All persons in Hawaii who get married must have a blood test 
before they can get a license. 
T 70- Hawaii has a law which requires a blood test of a pregnant 
woman when she first gees to a doctor. 
T 71* Records of venereal diseases are kept confidential between 
doctor and patient. 
T 72. Untreated syphilis carries' on its unnoticed work of damaging 
the body for years. 
F 73* A person will always know whether he has syphilis. 
7k* Some people may have syphilis without any symptoms. 
75* Gonorrhea may be a very painful disease. 
76. The greatest number of cases of venereal diseases is acquired 
in the age group 18-23• 
F 77* It is true that "gonorrhea is no worse than a bad cold.7’ 
T 78. It is possible for a person to have syphilis and gonorrhea 
at the same time. 53 
Questions 
1. Which one of the two most common venereal diseases is caused 
by Treponema pallidum? 
2. (a) What is congenital syphilis? 
(b) Acquired syphilis? 
3. What does the abbreviation VD mean? 
h. How does the estimated number of cases of gonorrhea compare 
with that of syphilis in the United States? 
5. What was the contribution of each of these men in the scien- 
tific fight to control syphilis and gonorrhea? 
(a) Wassermann 
(b) Ehrlich 
(c) Schandinn 
(d) Neiswor 
(e) Ricord 
6. How can congenital syphilis be prevented? 
7. List several ways a doctor may use to diagnose syphilis. 
8. (a) How long is a case of untreated syphilis considered to 
be contagious to others? 
(b) Gonorrhea? 
9. How dangerous are toilet seats as a means of spreading syphilis? 
Gonorrhea? 
10. Can syphilis be inherited? 
11. Why are silver nitrate drops put in the eyes of newborn babies? 
12. What are the years when syphilis is most commonly acquired? 
13. Name 3 effects of untreated syphilis in the late stage in the 
victim. 
lh. How are venereal diseases most commonly spread? 
15* (a) What drugs are generally used to treat syphilis? 
(b) Gonorrhea? rA 
Answers 
1. Syphilis. 
2. (a) Syphilis passed by the mother to the baby before birth. 
(b) Contracted after birth, usually in early adulthood. 
3. Venereal disease. 
1. Estimated to be 2-3 times more common than syphilis. 
5. (a) Worked out a blood test for syphilis. 
(b) His arsenic compound, salvarsan or 606, was a cure for syphilis. 
(c) Discovered the cause of syphilis. 
(d) Discovered the germ causing gonorrhea. 
(e) Proved syphilis and gonorrhea to be two separate diseases, 
6. Blood test early in pregnancy and if positive, sufficient, regular 
treatment during remainder of pregnancy, 
7. (1) patient’s history 
(2) physical examination 
(3) darkfield microscopic test 
(4.) blood test 
(5) spinal fluid test 
8. (a) up to 3 years 
(b) so long as the germs of gonorrhea are present. 
9. Very seldom a cause of spreading venereal disease. 
10. No. If a woman is adequately treated, her children will be free from 
the disease. Syphilis, if it is found in children, is considered to 
be a prenatal infection. 
11. To prevent blindness resulting from the gonorrheal infection at 
birth from the mother. 
12. 18 - 25 years 
13. Insanity, paralysis, heart disease 
11. Sex contact 
15. (a) compounds of arsenic and bismuth. 
(b) sulfa drugs; less frequently, penicillin 55 
Suggested for the intermediate school level; 
What Do You Know About VenerealPiseascs? 
1. What is meant by VP? 
2. What are the most common venereal diseases? 
3. What is the cause of syphilis? Gonorrhea? 
1. What are some common symptoms of syphilis? Gonorrhea? In cases 
of the diseases, do these always appear? 
5. How are the venereal diseases spread? How dangerous are drink- 
ing glasses, handshaking, and toilet seats in the spread of syphilis 
and gonorrhea? 
6. Why is a blood test useful? 
7. Show why syphilis and gonorrhea are serious diseases. 
8. Why should an expectant mother have a blood test? Poes Hav/aii 
require this? 
9. Why do many states require a blood tost of persons getting 
married? Poes Hawaii do this? 
10. Are there many cases of syphilis and gonorrhea in Hawaii? 
11. What is congenital syphilis? 
12. What may happen to a person who has syphilis and isn’t taking 
treatment? 
13. If gonorrhea is not treated, what may happen to the person? 
11. Can syphilis and gonorrhea be cured? 
15. What is being done to control these diseases? 56 
Test On Venereal Diseases 
1. Are syphilis and gonorrhea the same disease? No 
2. Can syphilis turn into gonorrhea or gonorrhea into syphilis? Ho 
3. Can syphilis be cured if treatment is started early? Yes 
4. If a woman has syphilis and isn’t taking treatment, could she 
give syphilis to her baby before it is born? Yes 
5. Does Hawaii have a law requiring a blood test for syphilis of 
every pregnant woman when she first visits her doctor? Yes 
6. Does Hawaii have a law requiring a blood test for syphilis of 
persons getting married? No. 
7. Can one tell by a person’s looks if he has syphilis? No 
8. Are syphilis and gonorrhea often spread by toilet seats, shaking 
hands, and drinking glasses? No 
9. A person can get cures for both syphilis and gonorrhea from a 
druggist or home remedies. No 
10. If a pregnant woman with syphilis takes regular treatment from 
the fifth month of her pregnancy, will she hav$ a good chance of a live 
baby born free of syphilis? Yes 
11. Can people have syphilis without knowing it? Yes 
12. Are these the early signs of syphilis — a sore where body con- 
tact was made and later a rash appearing on the body? Yes 
13. Can untreated gonorrhea make a man or woman unable to become, a 
parent? Yes 
14* If a person with syphilis stops taking treatment before the 
doctor says ho is cured, may he later develop such serious things as 
blindness, heart trouble, insanity, and crippling? Yes 
15. Does gonorrhea usually have a discharge of pus and causes pain 
when the person passes urine? Yes 
Answer these statements with the right word or words: 
16. Syphilis and gonorrhea are also called the venereal diseases. 
17* Gonorrhea can be cured by penicillin, sulfa drugs. 
18. One way a doctor finds out if a person has syphilis is by 
physical examination with blood test, darkfield examination. 
19. Two parts of the body often affected by untreated syphilis which 
has been in the body a long time are the heart and central nervous system 
(brain and spinal cord.) 
20. In your community, where can a person who has syphilis and is 
unable to pay get treatment? Hind out from Board of Health, the clinics; 
government physician. 57 
Lantern Slides 
The slides listed below are available without charge at the 
Division of Health Education, Department of Public Instruction, Honolulu 4, 
T. H. 
SET I -« One set of 60 lantern slides (2" x 2”) 
black and white, consisting of printed 
material and illustrative material, 
follows the text of "Some Dangerous 
Communicable Diseases," a manual for 
teachers and students from the 
American Social Hygiene Association* 
SET II — Another set of 15 lantern slides (2" x 2") 
in color, shows symptoms and some 
effects of syphilis. The typed set 
of legends that will accompany these 
slides should be used with them. 5o 
Films 
The films listed below may bo borrowed without cost from the 
Public Health Education Office. Beard of Health, Honolulu, Ti H., 
(Phone 5490±; local 23v). or from, the Board of Health offices at Hilo, 
Hawaii; Wailuku. Maui, and Lihuo, Kauai. 
On Oahu, an operator and projector are also available if 
arrangements are made in advance of the proposed showing. 
Fight Syphilis 
A one-reel, 16 mm. motion picture with sound; running time 
approximately 12 minutes; suitable for mixed groups of high school age; 
produced by the U. S. Public health Service. 
This picture has a strong overtone of the relationship of 
syphilis to national defense. A disabled veteran of World War I, who was 
struck down by the enemy — the spirochete of syphilis — is shown wist- 
fully watching a parade of World War II soldiers. Whore the fight against 
this enemy is carried on — in the laboratory with its tests and in the 
doctorfs office and clinic with its treatment — is shown. The weapons 
by which the disease can be fought are given. 
Some aspects of the community problems, as the spread of the 
disease by the tavern and the pick-up, and the problem of the quack with 
his useless medicines are contrasted with the venereal disease clinic 
whose treatments will prevent the casualties from syphilis on the home 
front of blindness, insanity and disability. 
Clearly syphilis is shown as an important saboteur of the war 
effort. In 1917, the fact that 7-000,000 man days were lost from active 
duty because of syphilis is given. 
We are advised that people must learn to go to the proper 
places for medical aid. The waste caused America from this disease must 
be stopped. The picture closes with the statement that we can lift the 
"Ishadow on the land* from the homes of America if we fight syphilis. 
Discussion Leads 
These questions are suggested as a means of encouraging class- 
room discussion following the showing of the film. 
1. What had happened to the veteran of World War I as shown in the 
picture? 
2. Whore is the fight against the disease syphilis carried on? 59 
3. What weapons are used to fight syphilis? 
4. Why is syphilis considered a saboteur of our war effort? 
5. In the last World War, how much time was lost by the army because 
of syphilis? 
6. What is meant by the“shadow on the land"? 
Suggested Pamphlets for Further Heading 
Venereal Disease and National Defense - U*S. Public Health Service. 
Gonorrhea and Syphilis—Saboteurs of Our National Industry - 
Massachusetts Society for Social Hygiene. 
Fight Syphilis 
(Expanded SO-minute version) 
This film, produced by the U. S. Public Health Service, is a 
longer version of a film with the same title. It is a one reel, 16 mm* 
motion picture with sound; running time approximately 20 minutes. It is 
suitable for mixed groups of high school age. 
The tragedy of congenital syphilis resulting in a dead baby is 
shown in a dramatic, forceful way in the opening scenes by the two fathers 
in the hospital waging room* Another portrayal shows the effect of 
syphilis on the inert resulting in sudden collapse. 
The film develops the theme that syphilis is a community 
problem and as such must be fought "among the people and by the people*" 
The facilities which may be provided by the community as clinics, blood 
tests, follow-up workers and education are given as ways of fighting the 
disease. The payments that are exacted by syphilis in the relief programs, 
and the cost of maintaining institution;/ for the blind, insane and 
crippled victims of the disease bear out the statement that "it takes more 
money not to cure syphilis than to cure it.” 
Syphilis is shown as a sniper behind the lines by causing a 
lessening of the war effort in industry and the armed forces. Since the 
disease is acquired in the community and not in the camps, syphilis must 
be fought in the community and by the community in order for us to main- 
tain production, have security, do work, and attain the joy of living. 
Discussion Leads 
These questions are suggested as a means of encouraging class- 
room discussion following the showing of the film* 60 
1. What would have prevented the tragedy of the baby born dead in the 
opening episode of the picture? 
2. Who are the ones "who promise cure but never cure"? 
3. What is the community's job in the fight against syphilis? 
4. What facts are given in support of the statement: "It takes more 
money not to cure syphilis than to cure it.” 
5. How is syphilis a drain on the nation's manpower? 
Suggested Material for Further Heading 
Out in the Open - VD Education Institute, Raleigh, N.C. 
Some Questions and Answers on Venereal Disease - Division of 
Health Education, Department of-Public Instruction, Honolulu 4, T« H. 
Some Facts and Figures on Various Phases of Venereal Diseases - 
Division of Health Education, Department of Public Instruction, Honolulu 4, 
T. H. 
Health Is A Victor 
The story of the fight against gonorrhea — one-reel motion 
picture with sound, 16 mm.; running time approximately 12 minutes; 
suitable for mixed groups of high school ago. This production was 
supervised by a special committee of the American Social Hygiene Associa- 
tion. 
The story opens with the employees of a large industrial plant 
gathering to hear a doctor explain briefly the facts in the fight against 
gonorrhea. He stresses the importance of knowledge as a weapon against 
this serious, dangerous disease. Some of the different coccus type of 
germs are shown in relationship to the various diseases they cause. 
The gonococcus, the germ of gonorrhea, is described more fully 
as to characteristics and behavior. The historical highlights in the search 
for facts about gonorrhea arc given. 
The doctor explains the symptoms and effects of gonorrhea and 
shows by diagrams why this disease is thewgreat sterilizer.” How gonorrhea 
is spread is illustrated by diagrams. The"prevention of blindness in the 
newborn by placing drops of a silver solution in the eyes is shown. The 
treatment of gonorrhea by the sulfa drugs and fever treatment is carefully 
explained with emphasis on the danger of the sulfa drugs in self-treatment. 6l 
The avoidance of quacks is brought out. Good sound advice is given as to 
the need of adequate medical help. Gonorrhea can now be cured quickly as 
a rule. 
The seriousness of gonorrhea as to incidence is shown by compari- 
son with diagrams of other diseases as tuberculosis, scarlet fever and 
diphtheria. 
The need to replace ignorance with sound facts and for the public 
to consider this disease as a serious, dangerous one is emphasized. 
Discussion Leads 
The following questions are suggested as a means of encouraging 
classroom discussion and emphasizing some of the important points following 
the showing of the film. 
This film portrays facts and figures in the fight against 
syphilis. 
1. What is the cause of gonorrhea? 
2. Why is this disease called the "great sterilizer"? 
15. What are some of the effects of this disease on its victims? 
4. Why was the silver solution put into the baby’s eyes? 
5. What part did Hunter, Ricord, and Heisscr play in the search for 
knowledge about gonorrhea? 
6. Is gonorrhea curable? Of what docs the treatment consist? 
7. How is this disease spread? 
8. How serious a disease is gonorrhea? How docs it compare with some 
other diseases? 
9. What does the doctor in the film have to say about self-treatment and 
quacks? 
Suggested Pamphlets for Further Reading 
Facts About Gonorrhea - American Social Hygiene Association. 
20 Questions on Gonorrhea - U. 3. Public Health Service. 
Gonorrhea - Massachusetts Society for Social Hygiene. 
Gonorrhea the Crippler - U. S. Public Health Service. 62 
Know for Sure 
(Revised Version) 
This is the revised version of the adult male film of the same 
name. 
A one-reel, 16 mm* motion picture with sound; running time approx- 
imately 12 minutes; suitable for mixed groups of high school age; produced 
by the U. S* Public Health Service. 
In a dramatic, forceful story of the ravages of syphilis, well- 
acted by professional Hollywood actors* four episodes — Tony and his son 
that syphilis killed; Steve and the sore that wouldn’t heal; Jerry, the 
athlete, who took a chance and lost; and Mr. Spencer whose legs didn’t get 
any better — are unfolded. 
The doctor in tho story relates each episode to tho various 
aspects of syphilis as symptoms, spread, effects, treatment and control of 
the disease. He brings out the fact that many human tragedies as so-called 
heart attacks, mental breakdowns and such may be rightly laid to the door 
of syphilis. The need to break the chain of infection, as each case results 
in more, is clearly brought out. Quackery with its approach and methods 
used to fool the public is shorn. The advice that no quack can euro and 
only a doctor can diagnose and cure syphilis is given. 
Discussion Leads 
1* What is congenital syphilis? How was che story of Tony related to 
this? Why were Tony and his wife so willing to follow the doctor’s 
advice and continue treatment? 
2. What is tho value of a blood test as shown by the story of Steve? 
3. What are some of the effects of untreated syphilis on its victims? 
4. What are quacks? Can they cure syphilis? 
5. What does a darkfield examination show? When is it used in the 
diagnosis of the disease? 
6. How may syphilis be spread? 
Suggested Pamphlets for Further Reading 
Syphilis—Tho Groat Imitator - Metropolitan Life Insurance Co* 
What You Don’t Know Can Hurt You - U. S. Public Health Service. 
You Can End This Sorrow - U. 3. Public Health Service. 
Are You Being Played for a Sucker? - IT. S. Public Health Service* 63 
Let’s Open Our Eyes 
This film on syphilis is a one-reel motion picture with sound, 
16 ram., running time approximately 12 minutes and suitable for mixed 
groups of high school age. 
The opening scenes of this picture deal with two items that have 
proved obstacles in the fight against syphilis — false modesty and the 
hush-hush policy. Hindrances to real cures as indifference, morbid fear 
and drugstore treatments are shown. Facts and figures are given to show 
the seriousness of the disease and the need for attention to it. 
A chancre, the first sign of the disease, is shown with the 
performing of a darkfield examination on it. The value of a darkfield test 
is compared with the blood test. 
Answers are given to these questions; Is cure possible? 
How can the disease be conquered? What are some of the effects and costs 
of the disease? How can we control syphilis? 
This film, though not one of the recent ones, has an excellent 
sound track and presents a well-rounded picture of syphilis. 
Discussion Leads 
The following questions are suggested as a means of encouraging 
classroom discussion and emphasizing some of the important points following 
the showing of the film. 
This film deals with the problem of syphilis. 
1. What is mentioned as the biggest factor in the spread of syphilis? 
2. What is the first sign of syphilis? What is its appearance? 
3. How is the presence of syphilis detected by the doctor? 
4. Why is a darkfield examination of such groat importance? Compare it 
with the blood test. 
5. What are the chances of cure in early syphilis? 
6. How can the disease bo conquered? 
7. What are some of the effects and costs of syphilis? Suggested Pamphlets for Further Reading 
Jerry Learns a Lesson—Keep Away from Quacks - American Social 
Hygiene Association. 
The Doctor Says - U. S. Public Health Service. 
Questions and Answers about Syphilis and Gonorrhea - American 
Social Hygiene Association. 
With These Weapons 
A one-reel, 16 mm. motion picture with sound; running time 
approximately 12 minutes; suitable for mixed groups of high school age. 
This production was supervised by a special committee of the American Social 
Hygiene Association. 
The search for knowledge about syphilis, the greatest plague of 
modern times, is shown in the laboratories of Schaudinn, Bordet and Tfessor- 
raann, and Ehrlich. The prevalence of this disease is graphically given. 
The narrator then outlines some of the effects of syphilis such as heart- 
disease, insanity, broken homes. Costs are compared with wars, fires and 
floods. 
The weapons at hand aro shown as part of the fight to spread 
knowledge and to overcome ignorance, the greatest ally of syphilis. The 
means of diagnosis that a doctor uses — the clinical history, the thorough 
physical examination with the darkfiold microscopic examination, and the 
blood test — are shown clearly. The need of cooperation between the 
infected person and the doctor is explained. Then the modern treatment with 
its greatest success of cure oarly in the course of the disease is given. 
The need of regular treatment and the length of its course is stressed. 
The spread of syphilis is shown by diagrams. In maps of the United States, 
the states with prenatal and premarital laws are shown. 
The picture closes with the ways that yet face us in our fight 
against syphilis with the need for knowledge of the facts about this 
serious disease. 
Discussion Leads 
These questions are suggested as a means of encouraging classroom 
discussion following the showing of the film* 
1* What part did these men play in the fight against syphilis — 
(a) Scbaudinn 
(b) Bordet and Wassermann 
(c) Ehrlich 65 
2* How widespread is this disease? 
3. What may be some of the effects of syphilis if it is not treated? 
4. What means does a doctor use to find out if a person has the disease? 
5* What is the treatment of syphilis? 
5. Discuss the various weapons we have to fight and control this disease. 
Suggested Pamphlets for Further Reading 
Syphilis—Its Cause, I+s Cure, Its Spread - U. S. Public Health 
Service- 
Facts About Syphilis - Metropolitan Life Insurance Co* 
Let’s Black Out Syphilis - Metropolitan Life Insurance Co. 
It Can Happen to You - U. S. Public Health Service. 6o 
Pertinent Poster Facts 
Posters can be used as an effective part of visual education. 
However, some thought needs to be given to their use so that students 
may receive the message intended by the poster. 
Frequent change of posters on a bulletin board, use of few 
posters at a time rather than many, and attention drawn by the teacher to 
the key points of the posters make them more meaningful. Even in the 
posters that seem self-evident, we need to make certain that students do 
not read false messages in thorn. 
As a result of teacher requests for these poster facts, a few: 
items are prepared as a suggestive help with the classroom use of posters 
on venereal disease which have been sent to the secondary schools. 
Venereal Disease Institute, .-teloiffh, N« C. 
VD Graphic 4 -"America Needs Strong Mon and Womenrt 
Syphilis and gonorrhea constitute the number one wartime 
health problem of America. These diseases are a throat to us 
in wartime as they cripple the striking power of our armed 
forces and cut down the production of our industries through 
the loss of time of those infected with those diseases. 
The patriotic colors of red, white and blue bear out this 
need for attention to these saboteurs of national defense* 
VD Graphic 6 - "Gonorrhea can be Cured Quickly, Painlessly, 
Cheaply” 
The former long, painful treatment has now boon replaced 
by the sulfa drugs, as sulfathiazole, which cure 60% of the 
cases during the first month. However, these drugs are not 
safe for self-treatment and should bo taken only under doctor's 
orders as they may do serious damage to the body. 
VD Graphic 8 - "Both of These Mon Had Syphilis” 
Continuous treatment of weekly injections under doctor's 
care is the generally recommended treatment for syphilis at this 
time* If a person completes his treatment, he usually cannot 
infect his wife and thus their children when born will be free 
from syphilis. 
The opposite is true. If a person with syphilis doesn't 
take his shots (injections of drugs), the germs are not killed 
and he may later have effects such as blindness and crippling 
shoi/m in the poster. 67 
VD Graphic 24 - "If You Have Syphilis, Your Future Depends 
on Regular Trea urgent" 
The same is true of this poster as of the preceding one. 
Blindness and crippling may result from syphilis inadequately 
treated. 
VD Graphic_ 31 - "Gonorrhea can be Cured Quickly, Cheaply, 
Fainlesoly with a Hsw Dmigft 
The old scene, as shown crossed out, of a person crippled 
from gonorrhea is now no longer true. With the new sulfa 
drugs, as sulfathiazole, the disease can be cured in 80$ of 
the cases usually in a month. 
U. S. Public Health Service, Washington. D. C. 
#12 - "Syphilis—Untreated and Treated Mothers" 
This shows why prenatal laws aro passed. If a mother with 
syphilis is untreated, she has only 2 chances in 10 of a live, 
healthy baby. If she is treated adequately, she has 9 out of 
10 chances of a live, healthy baby free from syphilis. 
#13 - "Know for Sure—Get a Blood Test for Syphilis” 
Representing a blood test by means of a rubber tourniquet 
on the arm, this poster shows the importance of it as a means 
. of telling whether a person has syphilis* However, the blood 
test is not the only means of knowing whether a person has 
syphilis* 'The doctor will also use other methods. 
If 14 - "Make our Men as Fit as our Machines” 
As syphilis can often be detected by a blood test, that 
is one of the things represented in this poster by the tourni- 
quet on the arm and the syringe. With late syphilis, damage 
to the heart is often the result. Here the check-up of the 
heart is shown. 
There are also other after-effects so a complete physical 
check-up should be given. 
ff 15 - "No Home Remedy Ever Cured Gonorrhea" 
Only by doctor1 s orders can gonorrhea be treated. .Self- 
treatment is dangerous. Drugstore remedies may be dangerous 
or else useless. Warning against quackery is given here. 68 
#17 - tTKhow for Sure—Get Blood Tests Bo fore Marriage" 
This shows the need for premarital laws. The bridegroom 
carrying his bride across the threshold of her new homo, accord- 
ing to the age-old custom, is shorn. If both persons are Mood 
tested to show freedom from syphilis, then their children will 
be born free from syphilis. If the man is infected, his wife 
will have a good chance of getting the disease. A great many 
wives have been so infected. 
American Social Hygiene Association, 1790 'Broadway, Hew York, K* Y* 
Set I ~ Fosters Included In Teacher1s Kit 
#1 - !TIealth is a Patriotic Duty—Keep Fit*" Venereal 
disease is an important saboteur of the war effort both in 
the armed forces and in industry. 
jL2 •• tfA Blood Test and Examination Protects Your Health 
and Family« M 
§Z - Can be Cured." If treatment is started 
early in the course of the disease, the chances of cure are 
better* 
//4 - "Two Men who had Syphilis.” This contrasts the 
effect of adequate treatment with cure, and no or poor treatment 
with such disastrous after-effects as crippling. 
jr6 - "We are Helping to Stamp Out Syphilis.” The doctor 
and the nurse are among those participating in the program to 
control tho venereal diseases. The doctor, who diagnoses and 
treats the disease, and the nurse, especially the public health 
nurse who often checks on follow-up and contacts, are important 
parts of the community program to control the venereal diseases. 
Sot II - Posters Not Included in Teacher’s Kit 
The following set of posters is more self-evident than 
tho one mentioned above. 
yl - "Syphilis and Gonorrhea.” This shows the effects of 
venereal diseases on people — syphilis kills, both cripple and 
disable, both destroy homes through infected mates and children 
born with the diseases, and both waste manpower in industry 
through loss of time clue to illness. 
#2 -"From Time Immemorial." Tho effect of venereal diseases 
during wars is graphically shown. As usual, during wartime the 
venereal disease rates rise. The present World War II is no 
exception* CV 
$3 - "Still at the Top of the Sick List." This shows 
the loss of time in the Army and Navy due to illness because 
of venereal diseases* It also shows the encouraging fact U at 
the venereal disease rate for World War II is lower than in 
World War I. 
#4 - “Costs to the Public*" The costs as blindness, 
insanity and illness are given* The staggering costs of 
■■300,000,000 per year to the nation are given* 
$5 - "Diseases of Youth." Venereal diseases are most 
often acquired by the young adult. The effect upon our war 
manpower is shown by VD figures found, in examinations of the 
first two million selectees. 
#6 - "The Plan of Action.” It would be interesting to 
check this poster with the U. S. Public Health Service 
pamphlet, "Syphilis and Ywur Town.” This poster shows the 
need of a well-balanced community program to meet the various 
aspects of the venereal disease problem.. 
Rad io Transcript ions 
The following pages present a description of the radio trans- 
criptions available to those schools in No Territory having pro lie 
address systems equipped vTith turntable* :,hat Quorate at the re '.,e of 
55 revolutions nor nJ nuta. Those arc 16-inch records and tie running 
time is 15 minuoos to a side- Those transcriptions are prebably more 
effective if used in classrooms or in small groups* They may bo secured 
from tho Office of Public Health Education, Board of Health, Honolulu, 
T. H., (telephone 54921, local 257). There is no charge for the use of 
those transcriptions. They should be reserved in advance* 
Available transcriptions include: ’’Ought to bo a Law,” 
"Our Town is Your Town," "Some cf Your Business," "Story of a Young 
Man," "Story of Your Town," "This is my Son," "Shadow over the House," 
and "Tho Long Search." 
Some of the statistics mentioned in these transcriptions wore 
accurate for tho time the records were male. Since that time, marked 
progress has been made, notedly in redi ct len of tho number of babies bom, 
yearly with congenital syphilis (from 60.000 to 36,000), and in tho in- 
crease in the number of states having premarital laws (which now number 
30). 
Caution: These records cannot be played on an ordinary 
phonograph turntable which operates at 78 revolutions per minute. 70 
Ought to be a Law — U. S* Office of Education with the U* S. Public 
Health Service, Program No. 3 
The character, Dr. Service, outlines some of the killers in 
America and the fighters against them* The battle for health, part of 
which is legislation against syphilis, is presented. The need for such 
laws is shown by the figures and facts about syphilis as to prevalence 
and effects. The 5-day treatment is mentioned in the discussion* Hie 
question of whether syphilis is hereditary or congenital is discussed. 
The types of laws needed as premarital, prenatal, and laws 
providing funds for syphilis control as the Federal Venereal Disease 
Control Act of 1938, are expanded with their needs, values and advantages 
pointed out* 
A careful, thoughtful presentation is made to show the need for 
legislation as a means for control of syphilis. 
Our Town is Your Town -- U* S. Office of Education with the U* S. Public 
Health Service, Program No* 4 
The character, Dr. Service, gives some figures from Our Town, 
U* S. A*, on syphilis: 
Population of town 100,000 
No. of syphilitics 5,000 
No* who dio from heart disease 
due to syphilis 36 
No* youngsters bom blind or 
crippled 50 
Dr. R. A. Vonderlehr, Assistant Surgeon General of the U. S. 
Public Health Service, speaks on the general plan of syphilis control —. 
finding cases, treating them, and educating the public. He describes the 
mobile clinics of the South, the so-called "Bad Blood Wagon." 
He outlines the points of a good community educational program, 
state or town, as: 
—trained public health staff in venereal diseases. 
—full-time venereal disease offices. 
—required reporting and follow-up on cases. 
—privacy and uniform methods of reporting. 
—patients assured of good treatment, free if necessary, 
—proper diagnosis with proper physical examination and 
blood tests. 
—distribution of free anti-syphilitic drugs to clinics 
and doctors. 
—blood tests for every expectant mother. 
—blood tests before marriage. 
—public education with adequate information. 
The thome of education against syphilis as the business of 
every town is carefully presented in a straightforward way. VI 
Some of Your Business — U. S. Office of Education with the TJ. 3. Public 
Health Service, Program No. 5 
The dollar and cents picture of the venereal disease situation 
in the United States is presented. 
In a dialogue, the characters, Dr. Service and Dr. Thomas, 
bring out the cost in lives and effects of syphilis as example, paresis. 
The costs to the pocketbook, as money spent by the American people on 
quacks with an expose of their methods and treatments, money spent on 
relief cases caused by syphilis, and also the actual cost per person on 
syphilis control, are given. 
A dramatic insert of a person who went to a quack for 15 years 
for useless medicines and finally in despair killed the quack is presented. 
The need for qualified medical advice, good diagnosis, educa- 
tion, and laws are given in a summary of a good syphilis program. Con- 
trasted with these are ignorance and superstition. 
Thus affecting us all in dollars and cents, the problem of 
syphilis becomes "some of your business." 
Note: The three records, Programs 3, 4 and 5, start out the same way 
but each then develops different thomes. 
Story of a Young Man — U. S. Public Health Service 
This presentation opens with a darkfield microscopic descrip- 
tion of the syphilis organism. The dramatic story of Eddie, a young man 
with syphilis, is then given. Eddie, ashamed, first goes to a quack who 
true to form diagnoses it on sight, promises disappearance of symptoms, 
and gives some worthless medicine. 
later Eddie goes to a real doctor who carefully explains symp- 
toms with their later disappearance and the need for adequate medical 
advico and treatment. The need for a blood test is given. The doctor 
answers these questions about syphilis for Eddie: Can ho be cured? 
Can he marry and have children? Can he hold his job? 
Later, on completion of his treatment, Eddie is shorn as about 
to be married. 
The danger of ignorance and quackery with the need of adequate 
knowledge and early treatment about syphilis is brought out. 72 
Story of Your Town — U* S* Public Health Service 
The character, Dr. MacKenzie, speaks of the people in the toxvn 
and the need for open discussion about syphilis and gonorrhea. He shows 
the effect of these diseases on the efficiency and production of a defense 
boom-town. The dramatic story of Jack, the railroad engineer, who because 
of the effects of syphilis almost causes a train wreck is given* 
Figures from World War I on the effect of syphilis on the army 
are given. The need and importance of a venereal disease campaign related 
to the army, navy, and public health, with attention to the problem of 
prostitution and the need for widespread education for the public are 
outlined. The need for a hone front fight against syphilis for national 
defense is the keynote of this transcription. 
This is my Son (Congenital Syphilis) — U. S. Public Health Service, 
Health for America Series No. 2 
This dramatic story told by Sally Green is about her child. As 
an expectant mother who is told by her doctor after blood tests that she 
is syphilitic, Sally is informed by her doctor about the effect of good 
early treatment on the unborn baby and the dangers of untreated syphilis* 
In dramatic inserts, she visualizes her child born with the disease* 
She conscientiously takes treatment. However, these treatments 
must later bo free as she is unable to pay for them.. The doctor explains 
the value of treatment after diagnosis. Sally is rewarded by a healthy 
baby boy and is prepared to have him checked upon at intervals to insure 
his freedom from syphilis. 
Shadow Over the House (Community Syphilis) — II. S. Public Health Service 
Health for America Series No. 3 
This rather dramatic presentation opens with a meeting of the 
neighbors of a community* The pastor is to present the story of Sam and 
his son in an effort to show the need for community attention to the 
problem it raises. 
Sam’s son had left home suddenly and was later discovered in 
prison. He refuses a chance of parole to his father and gives his story# 
Previously he had gone to a trailer on the outskirts of the town and as 
a result contracted syphilis. As there was no clinic in town and he was 
without money, he leaves ashamed to seek treatment elsewhere. Later he is 
sent to prison* although innocent. The reason ho didn’t want to go home 
was that in prison he was receiving treatment which he realized to he 
necessary. 
The need for community action to fight syphilis with open eyes 
and the determination to face the problem openly and boldly is brought 
out. 7: 
The Long Search (Gonorrhea) — U* S. Public Health Service, Health for 
America Series No* 6 
The historical search for a safe cure for gonorrhea is presorted. 
It starts with the decree of James IV of Scotland sending people with 
the disease out of Edinburgh. In turn, the following milestones of 
progress in the fight against the disease are given: 
1835 - Syphilis and gonorrhea are shown to be two separate 
diseases* 
1869 - Tiie description of the gonococcus organism is given* 
1885 - Experiments prove that the gonococcus organism causes 
gonorrhea* 
1935 - The effect of a certain dye is shown on staphococcic 
poisoning. The active part, sulfanilamide, proves 
a cure for pneumonia, spinal meningitis, and child- 
bed fever* In an American clinic, the experiment 
with this drug on 47 cases of gonorrhea is given* 
The effects of sulfapyridine and sulfathiazole with 
the fever treatment are shown, with the latter 
combination given as the cure of gonorrhea thus 
culminating the long search. 
Recording * 
Pertinent data on the venereal disease problem in Hawaii is 
presented in this 12-inch record, to be played at 78 revolutions per 
minute. A complete script of the contents of tho record follows* 
Facing Facts 
Tho venereal diseases are America’s Number One communicable 
disease problem* They are a serious drain upon the nation’s manpower 
in that they reduce the number of men available for the armed services 
and cut down the efficiency of those already in the forces. Out of tho 
first txvo million selectees tested, 90,000 were found to have syphilis* 
In World War I approximately 7,000,000 man days wore lost to the U* S* 
Army because of venereal disease. Some 300,000 troops or the equivalent 
of twenty-three divisions developed syphilis or gonorrhea. Although the 
rate for World War II is much lower than that of World War I, syphilis 
and gonorrhea are still among tho chief causes of lost time to tho army 
and navy. Besides lessoning the efficiency of our fighting forces, venereal 
disease hampers war production. It is a cause of absenteeism from work, 
both because of the diseases and because of their effect on other condi- 
tions. Venereal disease imposes a terrific social cost on tho community 
and nation in terms of death, blindness, insanity, paralysis and sterility. 
* Samuel D. Allison, M. D*, Venereal Disease Control Officer, 
Territory of Hawaii. 74 
Since the national program devoted to the control of these 
diseases began in 1936, much evidence has been accumulated, all of which 
showrs the great extent and seriousness of the problem caused by syphilis 
and gonorrhea. A few years ago Dr. Parran, Surgeon General of the U. S« 
Public He'alth Service, stated that one out of every ten individuals in 
America could at some time in his or her life expect to acquire syphilis. 
This is probably not an overstatement. It is generally accepted that 
there are at least a half million new cases of syphilis and over a million 
new cases of gonorrhea every year in the United States. 
Studies made of representative groups on the mainland indicate 
that of students, 0.4% had syphilis; of nearly a million premarital tests 
made, 1*4$ were positive; of over 200,000 industrial employees and food 
handlers, a little over 5% had the disease. All available figures for 
Hawaii indicate that the problem is as serious here as it is in most 
mainland areas. 
In certain surveys made in Hawaii, syphilis was found in 3.6% 
to 9.2$ of plantation employees. Approximately 2% of all selectees had 
the disease. A study of a small group of male food handlers in Honolulu 
found 10% of them to be syphilitic. Of the pregnant women examined 
during the first three months* operation of the new prenatal blood test 
law, 2,233 tests we re made, of which 44 or approximately 2%> were found 
to bo positive. Board of Health disease reports of the last seven years 
in the Territory place gonorrhea and syphilis numbers 5 and 7 respective- 
ly in the list of all communicable diseases. To be exact, there were 
6,873 cases of gonorrhea and 6,054 cases of syphilis. These diseases 
were only outranked in numbers by influenza, measles, whooping cough, 
mumps and chicken pox. Of all the common contagious diseases, syphilis 
and gonorrhea arc far more serious than any other except pulmonary 
tuberculosis. 
The seriousness of these diseases in Hawaii can be seen from 
the fact that 10% of all admissions to the Territorial Hospital at 
Kaneohe are duo directly to syphilitic damage of the brain. Approximately 
one out of every seven blind persons in the Territory is blind because of 
a venereal disease. 
The unfortunate thing about the venereal disease situation at 
the present time is that we have known for many years exactly how to 
attack the problem. We have known the cause of syphilis since 
Drs. Schaudinn and Hoffman observed the spirochete in 1905. We have been 
able to diagnose the disease by the blood test Dr. Wassermann discovered 
in 1907, and since Dr. Ehrlich developed the drug salvarsan in 1910, we 
have had a drug which would quickly render syphilis noncontagious and 
would cure most of the cases. Since 1879, we have known the cause of 
gonorrhea. For the past six years we have had an effective drug for the 
treatment of gonorrhea. We have had the solution for the venereal disease 
problem but have never made the efforts necessary to effect those proce- 
dures which would solve it. 75 
There has been some interest in the venereal disease problem 
in Hawaii for many years. 'Hie Palaraa Clinic has been in operation for 
the past twenty-two years but from 1929, there had been no appropriation 
by the Territorial Legislature for the control of the venereal diseases 
until the 1943 session. Fortunately, the City and County of Honolulu 
has carried the expense of the Palatna venereal disease clinic from 1929 
to the present time. Since 1937, Federal appropriations have aided 
materially in the fight against these diseases in Hawaii. 
While it is true that venereal diseases are very seldom acquired 
by school students, the- greatest number of cases of these diseases are 
acquired between school and marriage. To prepare youth effectively for 
this period, we must do it while they are still in school. 
The late Marshall Foch reputedly stated that "battles are won 
the day before." So in the battle against the venereal diseases, it is 
necessary to teach our young people, and the most effective place for 
that instruction is in tho schools. 
The solution to the venereal disease problem is clear. We have 
all tho weapons at hand to wipe out syphilis and gonorrhea — knowledge 
of how they are spread; adequate diagnostic procedures; effective drugs 
for their treatment; and methods of preventing them. With effective use 
made of existing weapons through education, these diseases can soon be 
reduced to minor significance. While we are now piling up tremendous 
debts for future generations, one debt wo can free them from is tho social 
and economic debt of venereal disease. 76 
Venereal Disease Control * 
Syphilis and gonorrhea are among the major disease problems 
in Hawaii at the present time. Recently, you have read about the fall 
in venereal disease rates here. Nevertheless, gonorrhea remains one of 
the most common of all contagious diseases reported to the health 
department, and of the serious contagious diseases, syphilis is out- 
ranked only by tuberculosis in its cost to the community. Last year 
there were 1,106 cases of syphilis and 1,344 cases of gonorrhea reported 
to tho health department. 277 of the cases of syphilis were in the 
early acute stages of tho disease. During tho past iivo years, gonorrhea 
ranked third and syphilis fifth on tho list of all communicable diseases 
in tho Hawaiian Islands. Gonorrhea was oxebodod in number only by 
influenza and whooping cough. There; are a few other venereal diseases 
besides those two, but their incidence is low. 
Tho venereal disease control program in Hawaii is not new* 
For over twenty years there has been a venereal disease clinic in 
continuous operation. This clinic was at first financed by the 
Territorial Legislature; later by tho City and County government. 
Recently, in addition to city and county funds, federal aid has been 
granted to the clinic. Tho clinic has been at the Palana Settlement 
ever since it began. 
Since 1937, Board of Health venereal disease rules and regu- 
lations have been in effect, and efforts have been made to trace sources 
of infection and to be assured that adequate treatment is given to all 
patients. Plantation physicians have been interested in the problem 
and in certain areas, such as the Island of Lanai, most of the patients 
with syphilis have been found and have been adequately treated. 
Daring the past year and a half, considerably more emphasis 
has boon directed against the venereal diseases than was true in the 
past. Since February, 1942, there has been a division in the Board of 
Health devoted entirely to the control of these diseases, which has 
worked closely with medical officers of tho armed forces, private 
physicians and local agencies in tho promotion and carrying out of 
activities designed to wipe out syphilis and gonorrhea. Early in 1942, 
a military order was issued which extended tho previously existing 
regulations concerning these diseases and made a much more effective 
program possible. When this order was rescinded, along with certain 
other military orders in March, .1943, it was replaced by a similar 
order by Governor Stainback. 
* Dr* Charles L. Wilbur, Jr., President, Board of Health, 
Territory of Hawaii. One of a series of Board of Health broadcasts 
given over Station KOU, October 3, 1943. 77 
Since that time, there have been two major types of activities 
carried out by the Health Department, the first of which is related to 
the diagnosis and treatment of early and contagious venereal diseases. 
The second phase of the program has been devoted to finding the people 
in the community who have had syphilis for many years and seeing to it 
that they wore provided with the proper type of treatment either through 
private physicians or, if they were unable to afford private medical 
care, through free or part-pay clinics. 
The first phase of this program is in line with the national 
effort which includes (1) repression of prostitution; (2) education as 
to the dangers of syphilis and gonorrhea and the need for continence, 
or provision of specific information as to how to prevent them through 
prophylaxis; (3) establishment of prophylaxis facilities in order to 
disinfect individuals already exposed to possible sources of the 
diseases; (4) discovery and treatment of early cases of venereal dis- 
ease; (5) investigation of all early cases in order to locate sources 
of infection; and (6) adequate treatment of those persons found infected. 
In the Territory of Hawaii, all of the above methods are being carried 
out except repression of prostitution, and on Maui that important step 
has been taken. 
The following activities are carried out. Thousands of 
pamphlets have been distributed to civilians, soldiers and sailors, 
warning of the dangers of these diseases and giving explicit advice as 
to how to keep from acquiring them. Many of these pamphlets were 
purchased from the Federal Printing Office, but recently pamphlets have 
been designed and printed locally in order to meet our own particular 
needs. 
In addition to the pamphlets, thousands of placards have been 
produced and distributed where they will be seen largely by male indus- 
trial employees or members of the aimed forces. Several educational 
films have beon brought to the Territory and shown to many thousands of 
war workers, as well as having been loaned to the armed forces for wide- 
spread presentation. A series of radio transcriptions were obtained 
from the United States Pablic Health Service and presented over all of 
the local radio stations. 
The armed forces have provided prophylaxis facilities through- 
out the islands. Early in 1943, permission was granted by the navy for 
the health department to publicize these facilities and to make them 
available to civilians. Later, similar permission was granted by the 
army. Through widespread use of placards and other educational proce- 
dures, a tremendous increase has resulted in the number of people taking 
prophylaxes. 
The keystone of the venereal disease control program is in- 
vestigating suspected sources of syphilis and gonorrhea — searching 
out individuals exposed to disease — then examining them for the 
presence of the germs of syphilis and gonorrhea. If these people are 
found to be infected they .are promptly placed under adequate treatment, 
thus preventing them from further spreading these diseases* 78 
The following story illustrates how this investigative program 
works toward the prevention of the spread of these contagious diseases: 
Recently, a man went into a private physicianfs office with a 
sore on his lip. The sore was unsightly and failed to heal. After a 
thorough examination for the germs of syphilis under a darkfield micro- 
scope and a blood test, the doctor diagnose)! the sore as due to syphilis. 
The health department was asked to aid in finding out where the man con- 
tracted his disease. The public health nurse assigned to the case 
located the girl who was named as the source of the infection. This 
girl was found to have syphilis in its highly contagious secondary stage. 
This girl named three men with whom she had had contact. Two of those 
contacts wore not available for investigation. The third was a known 
case of early syphilis under treatment by a private physician. He had, 
however, lapsed from taking his treatment so the public health nurse 
returned him to his own physician and also inquired as to where he might 
have obtained his infection. This man named a girl who upon investiga- 
tion was found to have syphilis in its first or primary stage. This 
latter girl named as men to whom she had been exposed the man who had 
named her and in addition, a man in one of the armed services. That 
particular branch of the service was requested to examine the boy, who 
developed syphilis during his period of examination. 
It is a health department responsibility to locate and examine 
all such sources of infection reported either by civilian physicians or 
by the aimed services. During the past year many hundreds of such cases 
have been investigated, and those individuals found infected have been 
placed under effective treatment. This typo of case investigation has 
uncovered a number of small epidemics of gonorrhea and syphilis and, by 
placing the infected individuals under medical care, has quickly brought 
the epidemics to an end. 
Tho socond phase of the venereal disease control program is 
that of seeing to it that people who have had the disease for many years 
receive adequate and prolonged treatment* This aids in preventing the in- 
sanity, blindness, heart disease and other late serious results of 
syphilis* Individuals found to have positive blood tests through selective 
service examinations, through school surveys, through the examination of 
potential blood donors and through examination of certain groups of 
employees are referred to the Board of Health for investigation* Here 
they are interviewed and referred for proper treatment* Many hundreds 
of such people have been directed to physicians and clinics for medical 
caro. This treatment has prevented (and will continue to prevent) much 
blindness, insanity and heart disease. 
So that all patients in Honolulu may get adequate treatment, 
the Board of Health cooperates with Palarnn Settlement in operating a 
clinic whore patients unable to pay for private medical care may receive 
treatment. Similar clinics are in operation at Vfailuku, Maui, and 
Hilo, Hawaii, and in addition largo numbers of patients are being treated 
by government physicians. One particularly effective service rendered 
by the health department in the territory is that of the investigation of 79 
cases of private physicians ■when those patients stop taking treatment 
before they arc cured. Several hundred syphilitic patients under treat- 
ment by over a hundred different physicians are being followed by the 
Board of Health to better ascertain that these patients take regular 
treatment. This service is provided upon the request of the individual 
physician and is a great aid in encouraging the regular treatment of all 
patients. 
Hawaii is cooperating in the national venereal disease control 
program. The cost of the enterprise is being shared by the national and 
territorial governments. Nearly all phases of the joint agreement of the 
War and Navy Departments, the Federal Security Agency, and the State and 
Territorial Health Officers are being carried out. Hawaii is in line with 
the mainland prenatal blood test laws which largely prevent the birth of 
children with syphilis. 
Venereal disease rates in the Territory of Hawaii are declining. 
Regardless of the decline in rates, the number of cases that continue to 
occur keeps gonorrhea and syphilis among the most serious menaces to 
community health. Hawaii is making progross but more progress can be made. 
With full public support, continued major strides can bo made against the 
venereal diseases. 
Social Hygiene * 
Observance of Social Hygiene Day on February 2, 1944, is being 
planned by the Social Protection Committee of the Honolulu Council of 
Social Agencies. Governor Stainback, in proclaiming Hawaii's observance 
of the day, stated: 
"The health and welfare of all citizens during a time of war 
are subject to many hazards* Throughout the nation the results of wartime 
tensions are revealed in a rising trend in juvenile delinquency, more 
family breakdowns, increase in venereal disease, and individual maladjust- 
ments. Social hygiene represents a strong force in combatting these 
problems, for it seeks to conserve the family and to help the individual 
in meeting the health and emotional problems which characterize the war 
period* 
’’National Social Hygiene Day on February 2, is intended to call 
attention to the need for community action in meeting those problems and 
to stimulate an awareness of our responsibilities, as citizens, in meeting 
such problems. 
"On February 2, the organized forces of medicine, education, 
scionco, social service, religion, and other community organizations will 
join in considering social hygiene in relation to other community and so- 
cial problems including juvenile delinquency, family breakdown, public 
health in relation to the control of venereal diseases and law enforcement." 
* Dr. Charles L. Wilber, Jr., President, Board of Health, 
Territory of Hawaii, January 30, 1944. 80 
The Governor has stated the broad implications of social hygiene* 
Tlie Board of Health is particularly interested in the observance 
of Social Hygiene Day, as it calls attention throughout the nation to the 
venereal disease problem* The health department is glad to cooperate with 
the Council of Social Agencies in the observance of this day, not only 
because of its concern with venereal diseases but also because the social 
implications of juvenile delinquency, family breakdowns and emotional 
maladjustments are closely related problems* 
When the national program devoted to the control of the venereal 
diseases began in 1936, the advisory committee on this subject to the 
United States Public Health Service made the statement that "the in- 
formative and educational program against the venereal diseases is, in 
many respects, its most important phase." 
In Hawaii, a broad educational program has been started. This 
has been directed both toward professional people and toward the general 
public* During the past two years, the Board of Health has sponsored 
lectures to all the county medical societies in the Territory and has 
provided a series of films for use by those societies* In addition, the 
Honolulu County Medical Society has presented a series of lectures in 
order to acquaint the physicians of the community with the newer aspects 
of the diagnosis and treatment of the venereal disease. Venereal disease 
material has been presented to the staff nurses of local hospitals* 
Public health nurses throughout the Territory have participated in staff 
conferences related to those diseases. 
The adult education program has used practically all available 
methods of getting information to the public. Papers written by health 
department personnel have been reprinted in local newspapers and magazines. 
The press has boon most cooperative in aiding the Board of Health to in- 
form the general public about the venereal diseases. The barriers against 
the use of the words syphilis and gonorrhea have been broken down so that 
now these words can be openly used. All of the radio stations in the 
Territory have cooperated with the Board of Health in the presentation of 
a number of broadcasts on venereal diseases. The time for these programs 
was generously donated by the radio stations in the interest of community 
health. The Board of Health has also sponsored the showing of films, 
the presentation of lectures and the distribution of pamphlets. These 
films, lectures and pamphlets have reached many thousands of workers 
engaged in war projects. 
It is probable that a reasonably good job of adult education 
has been done in this area. There have been two major difficulties in 
the process, however. 
When Henry Kaiser built a Liberty ship, he recognized the need 
for a firm foundation, something stable to tie to, a base on which to 
assemble the hull and support the superstructure of his ship. In building 
a ship, it is necessary first to lay the keel. In educating people about 
the venereal diseases, wo must also lay a stable keel—a firm foundation 81 
on which to build* Much of our effort toward adult education has been 
dissipated. We have built on the shifting sands of Inadequate knowledge, 
lack of information regarding basic biologic principles and vocabulary 
deficiencies. To reap full benefit from our adult educational program it 
is necessary to lay a keel of basic knowledge, to allay the fears aroused 
by old wivesf tales and to instruct people at an early age when prejudices 
are not too firmly fixed. As yet, this has not been done effectively. 
The second deficiency of the adult education program is that 
the venereal diseases are generally diseases of young adults, contracted 
usually between high school and marriage. Most of the methods used for 
adult education reach the adult at a period too late in his life to pro- 
tect him from the venereal diseases. It is apparent that we must reach 
the young adult. To educate youth, we naturally turn to those most pro- 
ficient in the education field — the school teachers in the Territory. 
Social Hygiene Day, observed on February 2 of this year, 
stresses the fact that health is a powerful weapon against the aggressors, 
a weapon indispensable to victory. The fight to preserve health is an 
essential part of our war effort. 
Some Common Questions About 
the Venereal Diseases * 
ANNOUNCER: Is tho venereal disease problem in Hawaii big enough to 
be considered serious? 
DR. ALLISON: The venereal disease problem here is a serious one. In 
tho first place there are a large number of cases of these 
diseases and in the second place, they can be extremely 
serious. During tho past seven years in the Territory of 
Hawaii, only two diseases have outranked the combined 
venereal diseases in number — influenza and measles. In 
actual rank of all communicable diseases, gonorrhea is fifth 
on the list and syphilis, seventh. From the standpoint of 
numbers alone tho venereal diseases must be considered among 
tho most important of health problems. 
ANITOUNCFiR: Just how serious are those diseases? 
DR. ALLISON: In addition to occurring in large numbers, both syphilis 
and gonorrhea can be extremely serious. Gonorrhea may cause 
arthritis, blindness, and result in childless marriage. 
Syphilis is extremely serious. Many of its victims die of 
syphilitic heart disease, others go blind, and still others 
go insane. As a matter of fact, 10 per cent of all admissions 
to tho Territorial Hospital at Kaneohe are due directly to 
syphilis. One out of every seven blind persons in the Terri- 
tory is blind because of either syphilis or gonorrhea. 
* Samuel D. Allison, M.D., Venereal Disease Control Officer, 
Board of Health, Territory of Hawaii, April 16, 1944. 82 
ANNOUNCER: We hear a great many stories about the relationship of 
venereal diseases to other diseases and the ease with which 
they can be acquired. Can the venereal disease be transmitted 
by any other means than sex contact? 
DR. ALLISON; Yes, sometimes they can. Gonorrhea in adults is in 
nearly 100 per cent of the cases a sexually acquired disease. 
On the other hand, the gonorrhea germs can get into the eyes 
of newborn infants and cause blindness. That is the reason 
the law requires that silver nitrate drops be put into the 
eyes of all newborn babies. Thanks to the use of silver 
nitrate, blindness in the newborn duo to gonorrhea rarely 
occurs at the present time. Syphilis, however, can be trans- 
mitted through other means than sexual contact. There are 
probably at least 35,000 babies born in the United States 
every year with syphilis. About one out of every twenty 
persons with syphilis acquires his disease through close 
nonsexual contact, such as kissing. Cases are recorded of 
dentists who have acquired the disease from working in the 
mouths of patients with infectious syphilis. There is a 
recorded instance of seventeen youngsters having acquired 
syphilis through playing a kissing game. 
One of the best examples of how syphilis may be trans- 
mitted is the story of the elderly professor who went to a 
doctor1s office for a skin rash. The doctor recognized the 
rash as that of syphilis but couldn’t see how the elderly 
professor acquired the disease. The doctor gave the professor 
a blood test and it came back positive. The professor was 
then asked to bring his wife in for an examination and the 
wife, an elderly woman, was also found to have the disease* 
Where could this elderly couple have acquired syphilis? To 
make a long story short, it was found that a few weeks before 
they developed the rash, they had visited the home of their 
daughter and son-in-law. On further investigation it was 
found that the daughter, the son-in-law and a grandchild all 
had syphilis. The son-in-law had acquired his syphilis 
shortly before marriage, had taken a few injections and thought 
ho was cured. Following this he married the professor’s 
daughter and she acquired syphilis through marriage. She 
became pregnant and gave birth to a child with syphilis. The 
grandparents acquired their disease from kissing the child. 
This story illustrates nearly all of the common ways of 
getting syphilis. In the first instance the son-in-law 
acquired his disease through premarital sex relations. Ho 
in turn infected his innocent wife. She then transmitted her 
disease to her baby, and the grandparents acquired their 
infection through kissing the baby. 33 
ANNOUNCER: Where do most people acquire their venereal diseases? 
DR. ALLISON: Most commonly from illicit sexual relations* In Hawaii, 
most men acquire their infections from prostitutes. 
ANNOUNCER: Could you tell us something about a blood test? Just 
what is a blood test, anyway? 
DR. ATLISON: There arc a great many typos of blood tests. In addi- 
tion to the blood tost for syphilis, other tests are for the 
purpose of finding out the typo of blood, such as is done at 
the blood bank; to determine how much iron there is in the 
blood or whether certain infections exist. The blood or 
serologic test for syphilis, commonly known as the Wassermann 
test, is for one purpose only — that of detecting syphilis. 
Such a test can be obtained from your family physician* 
ANNOUNCER: A few weeks ago I had a blood test for syphilis. How 
long will I be assured that I will be free of the disease? 
DR. ALLISON: If a person's blood test is negative and he is not en- 
gaging in illicit intercourse, he can be assured usually that 
he will continue free from syphilis. If on the other hand he 
is engaged in illicit intercourse, there can be no certainty 
that the disease cannot be acquired at any time. 
There are certain times when blood tests should be taken* 
All adults should have one test to be sure that they have not 
acquired the disease earlier in life. All applicants for 
marriage should have a test so that if one or the other 
applicant is infected, treatment can bo given and the other 
not infected. An extremely important time to have a blood 
test is during pregnancy. Women who have syphilis and who 
take treatment for syphilis during pregnancy can be assured, 
in nearly all instances, of having a baby born free from the 
disease. On the other hand, if treatment is not taken the 
mother stands a seven out of eight chances of having a baby 
bom dead or syphilitic. 
ANNOUNCER: If blood tests are so good, why should not every one 
have one? 
DR. ALLISON: It is our hope that some day everybody will have the 
necessary blood test to discover .syphilis. During tho past 
two years wo have soon what one hundred per cent health 
measures can do for the community — Hawaii has no smallpox 
because everyone is vaccinated. Typhoid fever has been 
nearly eliminated from the community because of total immuni- 
zation. The island of Lanai has practically wiped out syphilis 
through testing most of the population and treating those 
found infected. I don't know of any place in the United 
States where syphilis can bo more effectively attacked than 
hero in Hawaii* One state, Alabama, already has a law demand- 
ing that all people between the ages of 14 and 50 have a blood 
test. By such a procedure there is no reason why syphilis 
could not bo aLmost completely eradicated from this area* 84 
ANNOUNCER: Is there such a. thing as a one-day cure for syphilis? 
DR. ALLISON: At the present time syphilis can be cured in one day, 
five days, six months or a year and a half. The only trouble 
with one-day and five-day treatments is that they are 
dangerous. With the present six-month type of treatment, 
syphilis can be cured fairly quickly and of more importance, 
safely. While the very rapid types of treatment undoubtedly 
will cure most cases, they are too dangerous for ordinary use* 
ANNOUNCER: Is penicillin accepted as a cure for the venereal diseases? 
DR. ALLISON: Present info mat ion indicates that penicillin is a one 
hundred per cent cure for gonorrhea. So far not enough cases 
have been treated with it to know what is going to happen over 
a long period of time. Whon the sulfa drugs came out they 
cured most cases of gonorrhea but with the passage of time, 
many cases of gonorrhea resisted them. The same may happen 
with penicillin. We hope not but it is too early to say. 
Penicillin has been used experimentally in the treatment 
of a few cases of syphilis. The results so far are encourag- 
ing but as yet we don’t know whether the drug will be as 
good as the present treatment. 
ANNOUNCER: Is it possible to exterminate the venereal diseases? 
DR. ALLISON: I feel that the venereal diseases can be wiped out. This 
will be a difficult job but the elimination of other com- 
municable diseases has also been difficult. The island of 
Lanai has practically wiped out the venereal diseases. Only 
through the admission of infected people from the outside 
can the disease be spread in that area. During the last 
year there were several months when no contagious venereal 
diseases were reported for Maui County. Selectees in New 
Hampshire have one-one hundredth of the amount of syphilis 
that occurs among negro selectees in Florida. Prior to the 
war Sweden had only about one-hundredth of the amount of 
syphilis which existed in a comparable population in Now York. 
The venereal diseases can be exterminated, or if not 
exterminated can be reduced to diseases of minor significance. 
I know of no better place in the world where this can be done 
than in the Territory of Hawaii. 85 
Penicillin, A Cure for Gonorrhea * 
ANNOUNCER: Newspapers recently came out with the news that penicillin 
is to be used in the fight against gonorrhea in Hawaii. A 
leader in the fight against venereal diseases in Hawaii is 
Dr. Samuel D. Allison, Venereal Disease Control Officer of 
the territorial Board of Health. 
MR. W. TATE 
ROBINSON: In writing about penicillin recently, TIME magazine had 
this to say: "Under the aspect of eternity, the medical news 
might even be more important than the military.” It must be 
a fabulous drug indeed to merit such praise. Whose "brain- 
child" is this new drug? 
DR. ALLISON: The drug was discovered by an Englishman* Dr. Alexander 
Fleming. He was growing some very common germs in his 
laboratory one day and noticed that a mold had spoiled one 
of his cultures. The peculiar thing about this mold was 
that where it grew none of the germs grew. Eventually it 
was found that this mold, Penicillium notatum, could be used 
to produce a material which would kill many kinds of germs* 
MR. ROBINSON: Just what germs does penicillin attack? 
DR. ALLISON: So far penicillin has been found effective in the treat- 
ment of skin infections, hemolytic streptococcic infections, 
such as septic sore throat, pneumonia, all gonococcic infec- 
tions that sulfa drugs will not cure, and many other 
infections. It may be of some value in the treatment of 
syphilis and bacterial endocarditis. However, there needs 
to be much more experimentation before its value in the 
treatment of syphilis will be clear. 
MR. ROBINSON: I noticed, Dr. Allison, that you called the drug 
penicillin. Just what is the correct pronunciation of the 
word? ITve heard it called peni’cillin. 
DR. ALLISON: I don’t know the correct pronunciation of the word. 
As far as I know the pronunciation has not been standardized. 
Some people like the expression "peni’cillin" to avoid con- 
fusing the word with the name of the common mold penicillium. 
As penicillin is made from the mold Penicillium notatum, 
many people feel that the refined product should be called 
"penicillin." It does not matter what we call it, it vrorks 
effectively and that is what we are interested in. 
* Samuel D. Allison, M.D., Venereal Disease Control Officer, 
Board of Health, Territory of Hawaii, June 18, 1944. 86 
MR. ROBINSON; I understand that the Board of Health has acquired 
penicillin for the treatment of all cases of gonorrhea in the 
Territory. How did the Territory happen to get the drug for 
this purpose? 
DR. ALLISON: It was the feeling of the health department that there 
was no better place in the country than right here in Hawaii 
to see whether penicillin could quickly reduce the number of 
cases of gonorrhea. We have a reasonably good venereal 
disease control system in operation; there is a very close 
relationship between the Army and the Navy and civilian 
venereal disease control programs; and we already have a low 
gonorrhea rate. It seemed that Hawaii was the best place in 
the country to try out penicillin in this manner. 
MR. ROBINSON: Just how much gonorrhea is there in the Territory? Is 
it as serious a problem as some people would have us believe? 
DR. ALLISON: There are about 100 new cases of gonorrhea reported in 
the Territory each month. These are the ones we know about. 
There are undoubtedly far more cases than this, but many of 
them are never known to the health department. Occasionally 
the symptoms of gonorrhea are so mild that the person will 
ignore the disease. This is particularly true among women. 
Frequently people suffering from the disease will go to the 
drug store and get patent medicines and treat the disease 
themselves. Occasionally they will get hold of a sulfa drug 
for this self-treatment. Some patients will go to the 
various quacks and an occasional case is seen by a regular 
private physician that is not reported. We don’t know the 
exact number of cases in the Territory each month but we know 
that there are more than 100 cases which, incidentally, puts 
gonorrhea among the loading communicable diseases. During 
the year 1943, there were more cases of gonorrhea reported 
in the Territory than any other contagious disease except 
influenza, whooping cough, chicken pox and mumps. 
MR. ROBINSON: Well, how long does it take to cure gonorrhea, 
Dr. Allison? 
DR. ALLISON: The cure of gonorrhea depends on the type of treatment. 
The sulfa drugs cure a fairly large proportion of the cases 
within about a week’s time. Unfortunately the sulfa drugs do 
not cure all cases and sometimes they are dangerous to the 
person being treated. Sometimes these drugs appear to cure 
the disease, but all of the germs are not wiped out. The 
disease may then return to the person or may be the source of 
infection to other people. That is why sulfa drugs should be 
used only under direction of a physician. Before we had the 
sulfa drugs, gonorrhea could often be cured quickly by the 
use of fever. The only trouble with fever was that the body 
temperature had to be raised to a fairly dangerous level and 87 
it had to be kept there for a long time. The treatment was 
very uncomfortable and somewhat dangerous. With penicillin, 
most cases of gonorrhea can be cured within one day and 
penicillin is safe. 
MR. ROBINSON; Where do most people acquire their gonorrhea in Honolulu? 
DR. ALLISON; About two-thirds of the men wTho get gonorrhea in 
Honolulu attribute their infections to professional prosti- 
tutes; about one-third name clandestine prostitutes; a very 
small fraction of cases are attributed to other women. It 
might be of interest to our audience that last year 120 pro- 
fessional prostitutes were hospitalized 166 times for 
contagious venereal diseases. I don’t think we have to look 
much further for our major source of infection. 
MR. ROBINSON: You mentioned that many cases of gonorrhea could be cured 
fairly quickly with sulfa drugs. What are the relative ad- 
vantages and disadvantages of penicillin as compared with the 
sulfa drugs? 
DR. ALLISON: At the present time the penicillin cures practically all 
cases of gonorrhea and does it safely. As this drug must be 
injected it can be given only by physicians. As a conse- 
quence, enough of the drug is usually given to completely 
cure the case. The sulfa drugs, on the other hand, can often 
be obtained from others than physicians. If the drug is used 
in too small dosages, the germs become what we call "sulfa- 
fast"; in other words, the germs grow in the sulfa drug. 
And on the other hand, if the patient takes too much of the 
sulfa drug he may be seriously injured. At the present 
time so many of the strains of gonorrhea are becoming sulfa- 
fast that we must use other treatment to cure them. So far 
as we know there are no penicillin-fast strains in the com- 
munity yet. 
MR. ROBINSON: How do you plan to administer the distribution of 
penicillin in the Territory, Dr. Allison? 
DR. ALLISON: The Board of Health is now providing penicillin for the 
treatment of all cases of gonorrhea. As this drug must be 
injected at about 3-hour intervals, all patients must be put 
in a hospital. The usual total time of the treatment takes 
less than one day in this manner. The very powerful drug is 
dissolved in a salt solution and about a half teaspoonful of 
the solution is injected into a muscle every three hours. 
Penicillin is being distributed for other serious conditions 
by other agencies other than the Board of Health. 88 
MR. ROBINSON: Why can’t penicillin bo given by mouth? 
DR. ALLISON; The penicillin now available is destroyed by the juices 
in the stomach, making it necessary for the drug to be injected 
directly into the body* 
MR. ROBINSON; Do you think that penicillin is going to aid you in the 
fight against syphilis? 
DR. ALLISON; There are many indications that penicillin will be an 
effective drug for the treatment of syphilis. This has not 
been proved conclusively as yet but a number of well done 
experiments point that my. In the past, many people acquired 
syphilis and gonorrhea at the same time* As gonorrhea causes 
more symptoms at first, syphilis is often overlooked* Perhaps 
with the penicillin treatment of gonorrhea, we will be able to 
nip a number of syphilitic infections in the bud. 
MR. ROBINSON; This drug is still fairly expensive, I understand* How 
does the Health Department justify giving this drug to all 
physicians for the treatment of their patients? 
DR. ALLISON: So far penicillin cannot be bought on the open market* 
The only my physicians can get it for the treatment of 
gonorrhea is from the Board of Health. ■ Vfe felt that by pro- 
viding the drag, physicians could treat the patients for much 
less money than if they had to purchase the drug. A medical 
society committee has recommended that physicians charge 
their regular office and hospital prices for the administration 
of this drug. This will encourage many patients xvho formerly 
took treatment from quacks, the local druggists or from • 
friends to go to their doctor. By providing the drag it also 
enables the Health Department to be assured that all people 
exposed to the disease will be investigated. We are not 
going to require that patients be reported by name, but before 
the drug is given we must be assured that all people whom we 
call contacts have been investigated* Those found infected 
will also be placed under treatment. This examination of 
people exposed to the disease is extremely important for if 
we can locate all the cases of gonorrhea in the community and 
their contacts and treat them quickly by the use of penicillin, 
gonorrhea can be quickly reduced to a minimum. If we lower 
the number of civilian cases there also will be a sharp drop 
in the number of cases acquired by servicemen, as nearly all 
servicemen acquire the disease from civilians* 89 
MR. ROBINS®!: How does this new type of treatment tie in with the 
other phases of the venereal disease control program? 
DR. ALLISON: Penicillin is the answer to a venereal disease control 
officers dream. In 1937 when the control program began, we 
had an effective weapon against syphilis but no such weapon 
against gonorrhea. The venereal disease control program was 
developed around education and case-finding. Probably the 
keystone of the whole activity is that of finding tho early 
cases of tho disease and making them noncontagious. With 
syphilis this could bo done quickly. One injection of an 
arsenical would generally make the person free of surface 
germs; a few injections would make him temporarily nonconta- 
gious. His disease would not then be spread to other people 
and one chain in tho course of infection would thus be broken. 
Unfortunately, this was not possible in the case of gonorrhea. 
We could find the cases and get them under treatment but 
there was no way to make them noncontagious quickly. Shortly 
after the venereal disease control program began, the sulfa 
drug came into use. With them it was possible to cure a 
number of cases quickly, but not all cases responded to these 
drugs. From present indications it appears that penicillin 
will cure gonorrhea quickly. Thus, every case found and 
treated breaks one more link in tho chain of infection. We 
must continue our education, continue to tell people how to 
avoid venereal diseases, encourage laws which will help re- 
duce the infections and continue our case-finding methods. 
But in addition to all this, we can now cure the cases of 
gonorrhea reported to us. Wo sincerely hope that through tho 
use of penicillin, gonorrhea is now finally on the way to 
being controlled.