General Preventive Measures

GENERAL PREVENTIVE MEASURES The period since 1910 has been marked by the commencement of a campaign which has developed into a world-war against venereal diseases. In this work Great Britain has taken a prom inent part.

In 1913 a royal commission was set up to inquire into "the prevalence of venereal diseases in the United Kingdom, their effects on the health of the community, and the means by which those effects can be alleviated or prevented." The royal commis sion reported in 1916, and their recommendations were imme diately acted upon by the Local Government Board of England and Wales (now the Ministry of Health), and the public meas ures for combating venereal diseases in England and Wales are now as mentioned below, while in Scotland and Ireland the cam paign is being conducted on the same principles.

Legislative Action.

i. By an Act of Parliament passed in 1917 the treatment of patients for venereal disease by others than registered medical practitioners and the sale without the pre scription of a registered medical practitioner or the advertisement to the lay public of remedies for the treatment or prevention of venereal diseases are forbidden.

2. There are 193 centres chiefly in voluntary hospitals for the treatment, free of charge, of persons suffering from venereal disease.

3. Fourteen hostels exist for the care and treatment of females who are infected, and would, unless helped by shelter, become professional prostitutes.

4. Seven institutions are specially for the care of pregnant f e males who are infected.

5. Treatment of venereal disease is also provided in poor law institutions.

6. Arsenobenzol (salvarsan) compounds are given free of charge to medical practitioners qualified to administer these remedies.

7. Specimens from persons suspected to be suffering from venereal disease can be examined free of charge in 73 laboratories which have been approved for the purpose.

8. The work of educating the public in the dangers of venereal diseases and the importance of early and continued treatment is carried out by the British Social Hygiene Council (formerly the National Council for Combating Venereal Diseases), which re ceives from the Government a grant in aid of its expenses. Propa

gandist work is also undertaken by the county councils and county borough councils, either directly or in conjunction with the British Social Hygiene Council.

The arrangements for establishment of free treatment facilities for distribution of arsenobenzol compounds and for laboratory examinations are under the control of county councils and county borough councils, which receive from the Government 75% of their approved expenditure on this account.

Results Obtained.

Some idea of the results obtained may be gathered by comparing the returns of cases seen for the first time in 192o, when the numbers were highest, with those seen for the first time in 1924, as presented hereunder :— The table discloses a substantial reduction in the number of cases of syphilis, and the figures indicate that the incidence of syphilis in the community has declined considerably. Similar results have been reported by other countries which have set up venereal-disease schemes on the principle of treating the infected. The attendance at the centres in 192o was 1,488,514 and in had increased to 1,645,415.

Gonorrhoea.

No outstanding remedy has been discovered analogous to that of arsenobenzol in syphilis, but, particularly since 1914, improvements in detail have made the diagnosis and cure of gonorrhoea more certain. In diagnosis, improvements in methods of cultivating the gonococcus on artificial media have placed the surgeon on firmer ground when determining the ques tion of cure. In treatment the practice of administering vaccines to raise the patient's resistance has become much more common. In complications of gonorrhoea, such as gonorrhoeal rheumatism and iritis, what is known as protein-shock therapy has proved useful.