Prophylaxis in the venereal diseases.

With the world -wide rise in both gonorrhea a nd syphilis in the face of the existence of s pecific curative m eas ures a nd of demonstra ted hi ghly successful public h ealth progra ms , a nd in spite of experi ence with and success in the u se of proph ylaxis , paI'ticula rly under conditions of social stress in two world wars, it see ms appropria te to a ssess again the ro le of prophylaxis as one of the elements of venereal disease control measures that mu st be considered in planning for future programs to deal with the proble m. The concept of prophylaxis da tes bac k to the s ixteenth century w he n Fa llopio; wrote of the use of the sheath (condom) to protect mecha nically again st syphHis. He reported that he invented it to protec t again st sy philis and tried it on 11 00 m en. Further history of the use of the condom as a proph ylactic agent in addition to its contraceptive use is not easily docum ented. Today the valu e of the cond6m as a prophylac tic is still being debated. However , the condom has been an important ele ment in highly successful milita ry health progra ms in both the First and Second World Wars. It a ppears toda y tha t the public·s perception of the purpose of the condom is c ha ngin g. In the United States , for ins tan ce, it has inc reasingly been considered primarily as a contraceptive agent rather tha n a pTophyJactic. This has been documented by Utidjian a nd Hin gson. g • 20 Studies of its manufacture and disuibution throughout the world as reported by Sollins and Be lsky suggest tha t th ere is littl e present prospect for increased production of th e condom throu ghout th e world,, /J As a con sequ ence, Htt le more l'eHa nce can be placed upon it under present circumstances as a contribu tor to proph ylactic e fforts . In 1882, Crede reported on the vaJ ue of si lver nitra te solution ins tilled into the eyes of th e n ewborn as a prophylactic measure again st gonorrheal ophtha lmia n eonatorum, then the leading cause of blindness . The ex perience is reviewed in the recent me morial article by Velhagen.:w Silver pre para tions of vaIious kinds, both organic and inorganic, were then in ves ti gated and a number of differe nt compounds were found valuable not only for this purpose but also for both the prevention and treatme nt of genital gonorrheal infections.