One of these made it a duty of physicians attending cases of gonorrhea, syphilis or chancroid to furnish the patient with copies of a circular of instructions issued or approved by the State Commissioner of Health. To meet the demand thus created, a circular was prepared, the text of which follows:

VENEREAL DISEASES

Duties of physicians in relation to venereal diseases

The duties of physicians in relation to venereal diseases are set forth in the following regulation of the Sanitary Code:

Regulation 29-a Chancroid, gonorrhoea and syphilis.

Chancroid, gonor

rhoea and syphilis are hereby declared to be infectious diseases highly dangerous to the public health.

It shall be the duty of every physician, when first attending a person affected with chancroid, gonorrhoea or syphilis to furnish said person with a circular of information issued or approved by the State Commissioner of Health and to instruct such person as to the precautions to be taken in order to prevent the communication of the disease to others.

In the event of failure of persons suffering from venereal diseases to observe the necessary precautions, health officers are now provided with ample power to take such action as will safeguard the community.

Venereal diseases in relation to marriage

Under an amendment to the Domestic Relations Law, in effect May 16, 1917, no marriage license may be issued until the applicant shall have subscribed to the following statement:

"I have not to my knowledge been infected with any venereal disease, or if I have been so infected within five years I have had a laboratory test within that period which shows that I am now free from infection from any such disease."

The purpose of this law is to prevent the transmission of venereal disease after marriage in cases where the infected person while apparently cured. and although free from all symptoms is not actually free from infection and is capable of communicating the disease. The laboratory examination of the blood as now provided by law is absolutely necessary to determine this question.

Instructions to those having gonorrhea

Gonorrhea is a serious infectious disease which, however, may be cured by proper treatment. Time and patience are required to permanently cure it. The infective agent may remain in the body for years after the discharge has disappeared. During this period it will be possible for you to give the disease to others. Therefore you must not marry or have any sexual relations until a reputable physician after a laboratory test has pronounced you cured. It is a very grave disease in women. It is often responsible for childless homes, invalidism and mutilating operations. If a mother has it, a baby may become blind or contract the disease.

For your protection and the protection of others, observe the following rules:

1 Wash your hands thoroughly after handling anything that may be soiled with the discharge. The pus contains millions of germs. A small drop carried to the eyes on your fingers may cause blindness in a few days. 2 Be clean. Do not let the discharge soil the toilet, wash basin, bath tub, etc.

3 Sleep alone.

4 Have no sexual intercourse. Avoid sexual excitement. It will aggravate your disease.

5 Allow no one else to use your toilet articles, particularly towels and wash cloths.

6 Burn all soiled cloths, cotton and gauze after use.

7 Never lend to anyone anything used in your treatment. Destroy such things when you are through with them.

8 Do not be discouraged. Continue treatment until a laboratory test shows that you are cured. This is absolutely required to determine this question.

9 If you can not afford to continue treatment, tell your physician, and he will refer you to a good clinic, or suggest some other provisions for treatment.

10 Never allow anyone except a reputable physician to prescribe for you. Follow his directions implicitly. Never use patent medicines or patronize advertising "specialists."

The laboratory examinations necessary for the diagnosis, supervision and determination of the freedom from infection are made without charge by the State Department of Health.

Instructions to those having syphilis

Syphilis is a germ disease which not only affects the skin, but if neglected, may attack any part of the body and destroy vital organs. If it attacks the brain and spinal cord, paralysis and insanity may follow. Sudden death may result from damage done to the heart and blood vessels.

But it can be cured if you are willing to continue the proper treatment long enough and will follow your physician's directions.

The mere fact that your present symptoms disappear and you feel well does not mean that you are cured. The disease germs may be present in the blood without producing any outward signs or symptoms. If uncured, it may strike you down suddenly after twenty years or more of apparently good health. Your physician will, after making the necessary laboratory tests, tell you when you may safely stop treatment. You should report to him for treatment and for laboratory tests for several years.

The disease is highly communicable and, without extreme care, you may give it to others. To protect yourself and others, including future generations, observe the following rules:

1 Be clean.

2 Sleep alone.

3 Have no sexual intercourse.

4 Have separate towels, brushes, soap, razors, etc., and never let anyone else use them.

5 Never permit anyone to use anything which may have been in your mouth, such as pipes, pencils and eating utensils.

6 If you go to a dentist, tell him about your disease before he examines your teeth.

7 Do not kiss anyone.

8 Always burn dressings that have been on sores.

9 Do not marry until you have been for a long time free from any symptoms but also are free from any blood infection as shown by a laboratory test. This is called the Wassermann test.

10 Avoid alcoholic drinks. Never use drinking utensils in public places. 11 Whenever in the future you consult a physician for any other complaint, tell him you have had syphilis.

12 Do not be discouraged. Stick to treatment until are cured.

13 If you can not afford to continue treatment, tell your physician and he will refer you to a good clinic or to the Department of Health.

14 Never allow anyone except a reputable physician to prescribe for you. Follow his directions explicitly. Shun patent medicines and advertising "specialists."

Chancroid

Chancroid, or "soft chancre," is a germ disease characterized by ulcerating sores on the affected parts, usually the genital organs. It is at times difficult to determine, without laboratory tests, whether a sore is a chancroid or the chancre of syphilis. A person having this condition should therefore continue under the observation of a reputable physician and submit to laboratory tests when necessary. The disease is infectious and may readily be given to others, at times with very serious results.

Laboratory aids to diagnosis and treatment

Reference has been made to certain laboratory tests" which are absolutely necessary for an accurate diagnosis of your condition and to determine definitely when you are cured. These are:

1 An examination of the discharge to determine the presence of " gonococci," the germs of gonorrhea.

2 A blood test, called the complement fixation" test, to determine whether gonorrheal infection is present in the blood.

3 Examination of material from a sore or chancre to determine the presence of the germ of syphilis. The "sore" is the point where the germs of syphilis first enter the body.

4 A blood test, called the Wassermann test, to determine the presence of syphilitic infection in the blood. Without this test, it is impossible to determine when the blood is free from infection and syphilis is cured.

While not abolutely necessary in all cases for the cure of syphilis, the use of salvarsan or its substitutes greatly expedites the recovery and for the complete and permanent cure of many cases it is indispensable.

Upon request from your physician, and without charge, he will be supplied with the outfits necessary for taking specimens, and tests will be made

at the State Laboratory at Albany or the branch laboratory at 338 East 26th street, New York City. When the tests have been made, he will immediately be informed as to the results.

In this connection the Legislature at its 1916-17 session amended the penal code by adding section 1142-a which follows:

§ 1142-a. Advertisements relating to certain diseases prohibited. Whoever publishes, delivers or distributes or causes to be published, delivered or distributed in any manner whatsoever an advertisement concerning a venereal disease, lost manhood, lost vitality, impotency, sexual weakness, seminal emissions, varicocele, self-abuse or excessive sexual indulgence and calling attention to a medicine, article or preparation that may be used therefor or to a person or persons from whom or an office or place at which information, treatment or advice relating to such disease, infirmity, habit or condition may be obtained, is guilty of a misdemeanor and upon conviction thereof shall be punished by imprisonment for not more than six months, or by a fine of not less than fifty dollars nor more than five hundred dollars, or by both such fine and imprisonment.

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The establishment during the year of a number of military cantonments in the State created new problems, one of which was that of the relation of local health officers and district sanitary supervisors to officers in charge of such cantonments, in so far as the control of communicable diseases was concerned. Health officers and supervisors were urged to cooperate in every way, and particularly to bring to the attention of the commanding officers any special prevalence of communicable disease in districts adjacent to camps. For the information of health officers the Department Bulletin for December 15 published the following:

Communicable disease reports from military encampments The attention of health officers in whose districts military posts or encampments are located is called to Regulation 203, in the Manual of the Medical Department of the United States Army, which is as follows:

"203. The senior medical officer of a military post will promptly notify the local board of health, if there is one, of all cases of infectious disease occurring at the post of which such board would take cognizance were the same to occur in the community subject to its supervision."

It was suggested that health officers affected by the regulation cited, confer with the senior medical officers of such posts or