John H. Stokes

VENEREAL DISEASE CONTROL: PROBLEMS AND METHODS

THE STATUS OF THE VENEREAL DISEASE CONTROL MOVEMENT In the United States, the movement for the control of syphilis and gonorrhea lies today somewhat up-grade from the bottom of a declivity, down which it gently subsided from the epochal peak of effectiveness reached during the World War. In this somewhat fungoid rise and cataclysmic fall, it has been true to the emotionalism of American reformatory and constructive tradition. In marked contrast, the slower progress of our more phlegmatic overseas brethren, the British, whose national program scarcely assumed distinct form during the war, has in the end brought them apparently, or at least measurably, farther than our own. Today the English vital statistics are measuring, in what appear to be fairly trustworthy terms, a decline of nearly 50 per cent in the incidence of syphilis and gonorrhea in the British Isles. Belgium, Germany and France are reporting comparative and in some

LOCAL ANESTHESIA IN INTRAVENOUS INJECTIONS

At the risk of seeming to offer a trivial suggestion, I wish to call attention to the advantages of inducing local anesthesia as a preliminary to intravenous injections, in which the larger bored needles, such as the 17 and 18 gage, can be used to advantage. The method as introduced by me into the dermatologic clinic of the University Hospital, Ann Arbor, Mich., in the administration of old salvarsan, consists in the injection of 1 or 2 minims of a 2 per cent. cocain solution with a very fine needle, immediately beside the distended vein at the point at which the large needle is to be entered. The injection should not raise a wheal, but should be given more into the subcutis than intradermally. Within a few seconds, anesthesia is sufficiently complete for the operator to make a careful and deliberate entry rather than a haphazard one, without a gesture