the blood test. It is important to remember that the blood test may not become positive until a month or longer after the disease is caught. In the secondary stage, germs may similarly be found by using the darkfield microscope. By this time the blood test is nearly always strongly positive. Later stages of syphilis can be determined by spinal tests, by fluoroscopic or X-ray examinations and by a thorough physical examination to detect heart and nervous changes due to the disease.

Gonorrhea of the penis usually is easily determined by a "smear" test because the drop of pus from the penis is thick with germs. But, because the germs may be few and far between and symptoms rare, rectal and vaginal infections may be difficult even for the doctor to diagnose. In these cases, the doctor employs a laboratory "culture" test using specimens from the cervix of a woman or the rectum of the man or woman. The germs from this specimen are grown and studied in the laboratory. Routine tests of this kind on patients who are sexually active is the only certain way to detect presence of the gonorrhea we so frequently encounter without symptoms. Early detection by this means avoids complications in the patient later on and also prevents spread to sex contacts. Blood tests are not used to detect gonorrhea.

Q. What are the methods of treatment?

A. The methods of treatment are simple. For syphilis, penicillin is given so that it remains in the blood stream two weeks for the early stages or for four weeks in the late stages complicated by positive spinal, heart or other findings. For gonorrhea, one injection of a sufficient penicillin dosage frequently cures gonorrhea, though sometimes more injections are required, particuarly when the disease has been undetected in the body for some length of time. For those who

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are allergic to penicillin, certain other antibiotics can be given effectively, though absolute cure is not quite as certain. Important in the cure of any venereal disease are follow-up examinations and tests to determine whether cure has actually been obtained. Such follow-up requires from one to three months for gonorrhea and one year to a life-time for syphilis. Besides determining whether a patient responds to treatment, follow-up tests can also detect re-infection.

Q. How much hope can be offered from treatment?

A. In gonorrhea, the disease is quickly cured in at least 80 per cent of the cases. In the others, it is cured within a month or two. In syphilis, finding the disease early and treating it early results in close to 100 per cent cure. After the disease has remained in the body for a year or more, the chances of cure are reduced. About 2 per cent of treated syphilis patients will develop the serious late symptoms if they are not adequately followed by medical examination for the rest of their lives.

Q. Is it true there is an increase in the spread of venereal disease?

A. There is no question that the actual incidence of venereal disease has dramatically risen throughout the country in almost every state, including California, and in almost every city, including Los Angeles, since 1957. In general, the rates for infectious syphilis have increased by about 400 per cent in the past four years, and continues to rise. In many areas, including Los Angeles, it has been stated that gonorrhea is more common than measles. The reason that the public is not aware of the latter fact is that people with measles readily tell their friends about it, and people with gonorrhea do not.

Q. How does the Public Health Venereal Disease Program function?

A. The main public health functions can be broadly classified as

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