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January 1980


Arch Intern Med. 1980;140(1):133. doi:10.1001/archinte.1980.00330130135034

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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

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