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To the Editor.
—First, as an old dermatologist and venereal disease officer in World War II, I learned early that in the context of time, practically no urethritis in men or women, vaginitis in women, or salpingo-oophoritis of alleged nonspecific nature arises without a specific gonorrheal origin in the past. Almost all gonorrheas arrive at a so-called nonspecific stage where the Gram-negative diplococcus is no longer demonstrable on smear or culture. Nevertheless, on careful search into history, there was always a preceding episode of gonorrheal infection by husband or wife. The guilt overlay makes accurate detection difficult if not impossible in most situations.When a physician found she had vaginitis, it was the key to fear, guilt feelings, and the need for self-punishment. The sense of loyalty kept her from admitting even to herself that her spouse had had to cheat on her to bring home the cause of the
Clateman A. Guilt. Arch Intern Med. 1980;140(1):133. doi:10.1001/archinte.1980.00330130135034