But many clinicians think this applies to homosexuality as well as syphilis. If public health officers would really like to get rid of VD as much as the homosexual would, they will have to approach the problem with more understanding. In preliminary interview. details of the story should be noted with courteous but casual interest. Any tendency to reticence about sexual activities is understandable and should be respected. The importance of the patient's being made aware of the likelihood of his own infection, and his being asked to attend for examination, should be pointed out. On the other hand, if a homosexual patient is unwilling to disclose many particulars it would be well if the clinician remembers that it is not for him to play detective, and that his immediate duty is to the patient before him. At this point the attitude of the doctor is important because the diagnosis of some of the more unusual aspects of homosexually transmitted veneral disease is clinically fascinating.

As a result of fellatio, patients have acquired Neisseria gonorrhoeae from a partner with acute gonorrhea of the uretha or penile infection. Sodomy has precipitated anal "onorrhea and rectal chancres, etc. Some of the more exotic diagnoses have posed a considerable challenge to diagnostic acumen. The most compelling argument in favor of law changes that would allow the homosexual to speak freely to his doctor is that before the doctor can diagnose veneral disease resulting from homosexual transmission, he must not only be aware that it exists, but he must actively look for the usual as well as the less usual lesions. Associated with appropriate clinical history such seemingly innocuous complaints as minor anal fissure, ulcerated hemorrhoids, discomfort on defecation and anal discharge can assume considerable

clinical significance if there is a possible homosexual contact. Unfortunately for all concerned, these minor signs and symptoms may constitute the only manifestation of an active syphilitic or gonorrheal infection. If their true implications are unrecognized, these lesions bode unfortunate consequences not only for the infected person but his hapless sexual partners as well.

Homosexuals are delightfully imaginative in their sexual behavior. As a result the varied lesions of venereal disease may be found anywhere on our bodies. A rectal chancre will readily infect a sexual partner's penis, etc., and this according to health authorities is the most common method of syphilitic transmission encountered among homosexuals. Thus the fact that a patient exhibits a penile chancre in no way indicates that he obtained it through heterosexual contact, because such lesions may just as readily be acquired through tas oral or rectal contact which are homosexually as well as heterosexually possible. To insure his health, we feel the male homosexual who is participating at all should have routine examinations for veneral disease. He needs checkups based on sexual activity, not merely on symptomology (which may never develop). But these should be made by his private physician, and he should be morally free to lie concerning the contact until he is able to tell the truth with the same impunity as the heterosexual.

Unfortunately, most homosexuals de not recognize the importance of checkups. And even when symptoms develop, the misinformed homosexual may tend to discount their significance. This attitude complicates the physician's task. But when the homosexual becomes aware that he has acquired a veneral infection, he is faced with a dilemma which does not

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