I

grants to states to support venereal disease control programmes since 1939 (Anderson, 1965a). For most of these years, syphilis control was the main objective. In 1972, however, this assistance was increased to $22 3 million (more than trebling the annual amounts paid during the previous decade, Fig. 1) and a national gonorrhoea control pro-gramme began. Although partly a symptom of changes in the field of venereal disease, the new federal initiative has itself stimulated change, and this article gives a brief overview of the current situation. Actual appropriation (grant)" Anderson reviewed venereal disease control in the United States between 1912 and 1964 (Anderson, 1965a). He described the initiation of the grant in 1939, the establishment of rapid treatment centres for treating syphilis and gonorrhoea during the early 1940s as an emergency wartime measure, and the postwar dismantling of the control apparatus between 1946 and 1955, and this story does not need to be told again here. However, two events should be singled out for special comment. These are the discovery of penicillin as a cure for syphilis, and the postwar decision to terminate direct federal assistance for treating patients with venereal disease. Penicillin left a paradoxical legacy: it works so well that it obviates the need for routine inpatient care, and the dramatic decrease in the incidence of syphilis in the early 1950s (Fig. 2) which accompanied the widespread use of penicillin convinced many tha