Notes, Short Comments, and Answers to Correspondents

1918 The Lancet  
of the Royal College of Surgeons of England, who presided, introduced the lecturer by stating. that the present war might be followed by a huge increase in venereal disease throughout the country, and unless it was combated the result to the nation would be disastrous. Twoclasses of women, amateur and professional, said Lieutenant-Colonel Harrison, infected our soldiers, and, generally speaking, two-thirds of the cases of venereal disease dealt with among soldiers was due to infection by the
more » ... teurs. After the war the burden of combating the disease would falt chiefly on the civilian community. More had been done in the matter of education in this connexion by a few devoted workers in the four years of the war than during thepast 400 years, but ignorance was still appalling, and it was . necessary that the public should know how to protect itself against the disease. Syphilis comprised only about onequarter of venereal disease, and although we had admirableremedies against it the long periods of treatment under which the patient must be under observation made treatment. costly. The successful management of gonorrhoem was immensely more difficult than that of syphilis, though, unfortunately, a large number of doctors still looked upon it as a light matter. It was one of the most difficult tasks in medicine to clear the genital passage from the gonococcus. From a medical point of view the prevention of venereal disease was as easy as cure was difficult. With regard to soldiers, experiences at Aldershot had' shown that the admission-rate for venereal diseases could be materially lowered by providing healthy distractions. In 1885 the ratio per 1000 per annum of admissions for venereal disease was very high, but it gradually decreased until the period of the South African War, when there was a relapse. From then onward to 1913 a decrease was again shown. This the lecturer considered to be due to the fact that Aldershot had been made a model home for the soldier, who need not leave barracks in order to find amusements and recreation of congenial kinds. From this heargued that something more might be done in providing. healthy distractions for civilian working men. If workmen's clubs were made something better than pot-houses, and places provided where men could be really comfortable in their leisure hours, it would not only tend to reduce the spread of venereal disease, but increase efficiency, and in terms of pounds, shillings, and pence would be profitable. With regard to segregation of women, the proper inspection of women on a large scale was impracticable. The best plan for dealing with prostitutes was to act on the assumption that all were diseased and teach them how to avoid infecting the men. But if we could make the prostitute safe, there remained still the perfectly hopeless class of amateurs to deal with. The greatest hope lay in breaking the chain at the male end by prophylactic treatment, but disinfection must be carried out soon after connexion. He advocated the appointment of subsidiary centres for treatment after instruction at the central clinics, but whatever arrangements were made for the treatment of venereal diseaees it was necessary to have the cooperation of the public, and it was the duty of the medical profession to secure that cooperation by education. Colonel Walker testified to the excellent results of prophy-lactic treatment on the American soldier in France. Sir Thomas Barlow said that the moral side and medical side ofthe question were not incompatible, and so long as wecould use prophylactic measures, not as an encouragement to men to expose themselves, but as a means of helping them after they had gone astray, it was the imperative duty of themedical profession to do so. Sir George Makina contended that the question of continence was no more than abstention from alcohol or anything else, and we ought not to make it easier for people tu be incontinent. The lecturer, in reply to questions, did not consider that prophylactic treatment encouraged sexuality. We were dealing with an implacable foe, and it was no more unchristian to use the methods indicated than to fight on, Sunday or use a gas against another implacable foe. Colonel Harrison also said that teetotalers formed a large proportion of venereal patients, and in one hospital 34 per cent. of venereal cases up to date proved to betotal abstainers. He could not explain the circumstance, but thought it might be due to the fact that the abstainers.
doi:10.1016/s0140-6736(01)02963-4 fatcat:f4y7tv3q7bhtrcbwnxnazyh6pm