BACKGROUND 
I 
STD TREATMENT OPTIONS 
The modern era for the treatment 
of syphilis began in 1 909 when 
Dr. Paul Ehrlich developed 
salvarsan, an arsenic-based 
compound. Bismuth used in 
combination with either mercury 
or arsenic-based compounds 
became a popular treatment 
for syphilis in the early 1920s, 
though patients found it 
complicated, time consuming, 
and even toxic. Arsenical 
therapy remained the primary 
treatment for syphilis until after 
1943 when the effectiveness of 
penicillin was demonstrated. In 
1938, sulfanilamide became the 
first reliable method of curing 
gonorrhea. Sulfonamides were 
still being used to treat gonorrhea 
when the U.S. involvement in the 
Second World War began in 1941. 
John F. Mahoney 
From the Lasker Foundation 
give us a much more effective method of 
treatment than we now have.” 41 
Dr. Parran also emphasized the need for more 
funds to train the doctors who would man 
the front lines against STDs, which posed a 
major threat to members of the military, as 
well as the general population. Operating 
without such funding “would be like sending 
a battleship to sea with untrained officers and 
crew aboard,” said Dr. Parran. 42 
New developments in STD treatment and 
prophylaxis were overdue. At the begin- 
ning of World War II the same system of 
chemical prophylaxis had been in use in the 
U.S. Army and Navy for about 30 years. 43 
The procedure required men to begin by 
urinating and washing with soap and water. 
They then injected a silver proteinate into 
their penises to prevent gonorrhea and 
rubbed a calomel ointment over their penis 
and pubic region to prevent syphilis. 44 
These methods had been adopted based on 
“poorly controlled and relatively uncon- 
vincing statistical studies carried out in the 
field.” 45 Speaking of the need to re-evaluate 
the regimen of prophylaxis followed by 
the armed services, STD expert Dr. John 
F. Mahoney, then head of PHS/VDRL in 
Staten Island, New York, said, “[t]he preven- 
tion of the primary invasion of the male by 
the syphilis spirochete, as a means of mini- 
mizing the loss of effectiveness which is 
incident to established disease, still consti- 
tutes one of the most pressing problems of 
military medicine.” 46 
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