The usual reservations concerning the reliability of information received from clinic patients must be made, although we have no evidence of systematic distortion in the data provided, apart from the understatement of previous clinic attendances. Analysis of the 3,045 male registrations included in the survey revealed that: (1)More than half were of patients under 25 years of age. This age group included almost one-third of the cases of syphilis, 56-3% of the cases of gonorrhoea, and 49-7% diagnoses of NGU. (2) Some 30% of registrations were of married men living with their wives. The proportion of registrations in this category increased substantially through the upper age groups. (3) The incidence of gonorrhoea and of syphilis was higher among the separated or divorced than among single, married, or widowed men. (4) The incidence of gonorrhoea was higher among patients in their teens and twenties than in succeeding age groups; NGU was diagnosed most frequently among patients in their forties. (5) The incidence of NGU varied inversely to that of gonorrhoea in relation to social class. Gonorrhoea was diagnosed more frequently among manual than among non-manual workers, while the incidence of NGU was higher among white-collar workers (including students). The highest incidence of gonorrhoea was recorded among registrations in the semi- and unskilled categories where the incidence of NGU was lowest, while the lowest and highest frequencies of gonorrhoea and NGU respectively were recorded among registrations in Social Class III (N)-comprising mainly clerical and sales workers. Some of the above findings may be of mainly local significance, and much additional evidence is required before the influence of such factors as marital status and social class can be adequately interpreted.

A series of 162 patients with uncomplicated genital gonorrhoea was assessed after single-dose treatment with 3 g. amoxycillin. This seems to be an acceptable method of treatment, resulting in clearance rates in both male and female patients of 99 and 95% respectively at the first follow-up. The default rates on follow-up over a 4-week period are also shown.

In a 12-month period, a gonorrhoea screening programme was carried out and 192,983 cultures were collected from various sources in Tennessee; 7% were positive for gonococci. The positivity rate varied from 31-7% in veneral disease clinics to 0-5% in military dependants. The low yield of positive results in certain population groups suggests that selective groups of persons at high risk of infection with gonorrhoea.

The effect of CO2 concentration on the growth and colonial stability of Type 1 Neisseria gonorrhoeae has been investigated. Carbon dioxide at a concentration of 16 per cent in air above flasks incubated in a shaker was effective in supporting growth and 100 per cent colonial stability of Types 1, 1', 2, and 4. Lower CO2 tensions increased the generation time of the strains and were less effective in maintaining the stability of virulent variants. Of several liquid media tested, Enriched Single Phase medium, which consists of Difco GC medium base (devoid of agar and starch) to which Lankford supplement and "Isovitalex" have been added, was the most suitable for use with small inocula.

Both tissue culture cells and human epithelial cells ingest gonococci, and subsequently protect them from the lethal action of various bactericidal agents. Using the convenient chamber produced by the subcutaneous insertion of a polyvinyl ring, the fate of the gonococci in mice was studied in vivo. Both humoral and cellular factors have free access to the organisms, and under normal circumstances these do not survive longer than 3 days. However, when gonococci were protected within tissue culture cells, their survival was prolonged. Only eventual graft rejection caused the death of the tissue culture cells and gonococci contained within them.

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Blood samples for measurement of ethanol concentration were taken on a routine basis from 543 male and 158 female patients attending Special Clinics in Glasgow. Ethanol was detected in 56 (10-3 per cent.) of the men and eight (5-1 per cent.) of the women, and at concentrations in excess of 0-1 g./l. in 37 (6-8 per cent.) and three (1-9 per cent.) respectively. In nine men and one woman, the blood ethanol concentration was over 0-8 g./l. when they attended the clinic. The majority (84 per cent.) of positive findings were obtained in specimens collected after 2 p.m. and one-quarter on Tuesday afternoons, the local half-day. The other peak periods related to attendance at football matches on Wednesday evenings, and to receiving wages on Friday mornings. Male new patients attending a clinic for the first time had the highest incidence, 32 (11-6 per cent.) having detectable amounts of ethanol among whom 26 (9-4 per cent.) had levels in excess of 0-1 g./l., compared with only 4-1 per cent. among those either returning to the clinics with a fresh infection or on surveillance. Only 5 per cent. of female patients attending for the first time and 3 per cent. of those on surveillance had detectable amounts of ethanol in the blood, compared with 9 per cent. of those few returning with fresh infections. Levels in excess of 0-1 g./1. were only found in promiscuous women. Those with concentrations in excess of 0-8 g./1. were unreliable attenders. Only one, a known alcoholic, completed surveillance; one defaulted after his fourth visit, four after the second, and four after the first visit.

Details are given of a double-blind trial involving 400 cases in which tetracycline 500 mg. four times a day for 7 days was compared with tetracycline 250 mg. four times a day for 14 days and also of the findings in 311 cases treated with Deteclo 300 mg. three times a day for 3 weeks. The treatment in the double-blind trial were equally effective and appeared to be as effective as the long-term Deteclo therapy. When the results of these treatments were compared with those obtained previously with tetracycline 250 mg. four times a day for 4 days and allowance was made for the time at which the latter results have been assessed, it was concluded that neither the treatment used in the double-blind trial nor Deteclo 300 mg. three times a day for 3 weeks offered any advantage over the customary treatment with tetracycline 250 mg, four times a day for 4 days.

A double-blind trial of oxytetracycline (Imperacin-I.C.I.) and tetracycline hydrochloride in a sustained-release formulation (Tetrabid-Organon) was carried out on 259 men suffering from non-specific urethritis. Patients who had NSU in the preceeding 3 months were excluded from the trial. The response to treatment assessed at 10 days was favourable in ninety patients out of 129 (35 per cent.) who received oxytetracycline and in 89 patients out of 130 (34 per cent.) who received Tetrabid-Organon. Eight patients in each group required re-treatment and the remainder failed to attend for follow-up. At 4 weeks after treatment one (1-3 per cent.) of 74 patients treated with Tetrabid-Organon and twenty (37-7 per cent.) of patients treated with oxytetracycline required further treatment. A large proportion of patients who were free of signs and symptoms at the first follow-up failed to return at 4 weeks, so that the true rates of cure at 4 weeks are difficult to assess. In a field such as venereology, the twice-daily administration of medication offers distinct advantages over a four-times-daily regime. This study suggests that Tetrabid-Organon, a tetracycline designed specifically for twice-daily dosage, is more effective than standard oxytetracycline, given twice daily, in the treatment of NSU. It was satisfying to find that the traditional advice concerning abstention from sexual activity and alcohol consumption during the treatment of NSU has a sound basis. The study showed a close correlation between recurrence of NSU and failure to follow such advice. It would be interesting to investigate the means by which alcohol consumption may act to delay recovery.

Papanicolaou-stained cervical smears taken from 203 female patients with either gonorrhoea, trichomoniasis, or candidosis were examined for the degree of inflammatory change. The results from these patients were compared with the results of smears taken from women who had no evidence of sexually-acquired infection after full assessment in the clinic. Gonorrhoea and trichomoniasis were associated with inflammatory changes but these were less marked in patients with candidosis. It is concluded that, before cytological inflammatory changes are attributed to non-specific genital infection, it is important to exclude gonorrhoea, trichomoniasis, and, to a lesser extent, candidosis.

The microneutralization test was used to determine the occurrence of antibodies to Herpesvirus hominis Type 1 and Type 2 in sera from patients attending the Special Clinic, Bristol Royal Infirmary, with proven herpes genitalis, and in sera taken from blood donors in Bath, Dursley, and Bristol, as well as from donors in three different prison populations. The findings in patients with herpes genitalis indicate that the test accurately reflects the antibody response expected in relation to the type of herpes virus isolated from the lesions. The incidence of Type 2 antibodies among the blood donors ranged from 5 per cent. for donors from the Bath area up to 60 per cent. among donors from Dartmoor prison. The findings suggested that Type 2 herpes infection could spread among longterm prison populations, and it is postulated that this may be due to both homosexual contact, and also by non-sexual contact, either directly or via fomites.

Two adult male baboons (Papio cynocephalus) were infected by urethral catheter with a Type D strain of Chlamydia trachomatis isolated from a male patient with nongonococcal urethritis. Chlamydial organisms were shed from the urethra for about 90 days and serum antibody developed. Intraurethral re-inoculation of homologous and heterologous (Type I) strains of Chalmydia, 4 and 11 months later, resulted in relatively shorter periods of infection of less than 15 days. The antibody titres and type-specific patterns were not substantially influenced by re-infection.

Among 2,005 women attending a contraceptive clinic 9-3 per cent. were found to have gonorrhoea. When these women were classified according to the method of contraception used at the time of their initial visit to the clinic, the following prevalence of gonorrhoea was observed: oral contraceptives 11-5 per cent., intrauterine contraceptive devices 9-9 per cent., barrier methods (condom-diaphragm-foam) 4-2 per cent. These differences are statistically significant. The authors suggest that the additional protective advantage of barrier methods should be considered when the physician and patient are selecting appropriate methods of contraception.

Nitrogen and oxygen gases were injected into mouse subcutaneous chambers which contained virulent Treponema pallidum. The effect of each gas on the viability and survival of T. pallidum in an in vivo system was determined. In comparison with the effects in nontreated control mice, injection of nitrogen enhanced both motility and survival time, but oxygen exerted a deleterious effect.

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Motility of pathogenic T. pallidum was maintained in aerobic in vitro cultures for several weeks using a special medium. The latter consisted of McCoy's 5a medium supplemented with glutathione, sodium pyruvate, HEPES buffer, gentamycin (garamycin), and fetal calf serum. The virulence of the organisms was lost in 5 to 6 days. No multiplication of the organisms was observed. Four antibiotics (viomycin, kanamycin, gentamycin (garamycin), and neomycin) were tested for their bactericidal action and possible toxicity to T. pallidum. Gentamycin proved to be superior to the other three antibiotics in being non-toxic to the treponemes and showing a possible stimulatory effect on their motility and longevity. Cultivation of T. pallidum in cultured cells in the presence of the enzymes, superoxide dismutase and catalase, in a special medium showed possibilities for future experimentation under monitored, reduced oxygen pressure with a continuous system to dismutate superoxide radicals.