Experimental chancroid in man; relative effectiveness of various drugs tested by three methods.

Introduction During I949, at the invitation of the Government of Southern Rhodesia, the author spent six months in that country undertaking a venereal diseases survey, specifically .to determine how new methods of treatment could, consistent with cost and local conditions, be extended to the African native. The project was financed by means of a grant from the Rhodesian State Lottery Trustees. It was found possible, however, to exceed these terms of reference and make a venereal diseases survey of the country as a whole. On arrival in that country it was evident that, although penicillin was in use in some places for gonorrhoea, this was not the case in the treatment of early syphilis-for which disease a course of four to six weeks, varying upon the clinic, of neoarsphenamine with or without bismuth was being given. Of necessity, also, facilities for dark field examinations, and sometimes serum tests in addition, were often lacking and every case of penile sore, including chancroid which was sometimes unsuspect, was given such treatment without attempts to arrive at a more precise diagnosis. As it appeared probable that the introduction of penicillin for routine use for early syphilis in the African native would be a more costly method of treatment than the one already in use, it was felt necessary to show that the current method was unsatisfactory. That it was not a thoroughly sound treatment for the syphilitic patient was obvious, although it could be argued that it was not unsatisfactory as a treatment of the masses (the so-called ' public health cure ' aimed purely at the eradication of infectious lesions). Moreover, many local doctors were satisfied with the treatment, claiming that the penile sores ultimately healed during the not inconsiderable period that the patients spent in hospital.