Outlining his interest and work in the prevention of VD, especially gonorrhea and syphilis, the author addresses the questions of prophylaxis and contraceptives, together with their technological advances, and ties these two concepts into the complex fabric of human behavior, history of available therapy in both world wars as well as the economic, social, moral and national concepts of what constitutes proper emphasis: prevention or cure. Thus, the absence of therapeutic modalities spurred the United States Armed Services to utilize Credé's solution for urethral irrigation and locally applied calomel ointment for prophylactic purposes in World War I but abandoned this mode when cheap penicillin therapy became available after World War II. Similarly, the utilization of combined prophylactic and contraceptive methods for women has to await the overcoming of societal and parental resistance. Particularly where teenagers are concerned the importance of combined modalities is stressed.
PIP: During World Wars 1 and 2, the leading single cause of absence from duty in the armed services was VD (venereal diseases). The discovery of penicillin however, made it possible to cure VD in a short time, and many in the medical community believed that it was much cheaper to treat the disease than to prevent it. There was little interest then in the prevention of VD, including prophylaxis, even though the effectiveness of prophylaxis in managing VD was demonstrated during the 2 world wars when major reductions in risk of VD infections through the use of prophylaxis were achieved. As rates of penicillin-resistant gonorrhea, and other problems such as infection and infertility increase, however, the medical community will certainly be concerned with promoting types of self-protection behavior, such as the use of condom and vaginal contraceptives, and changed patterns of sexual behavior. Various clinical trials show that vaginal contraceptives have varying degrees of spermicidal and bactericidal effectiveness against the spectrum of organisms causing STD (sexually transmissible diseases). VD control programs experience various problems with respect to contraception, prophylaxis, and other elements of behavior required to maintain health. Patient motivation is critical because without it, effective methods are essentially worthless. Motivating youths to have responsible self-protective prophylactic behavior such as use of condom/vaginal contraceptives would reduce risk of unplanned pregnancy and STD transmission. The use of the contraceptive-prophylactic approach in a VD control and family planning program appears to offer great potential for the patient.