First Report [with Final Report and Appendices] of the Commissioners.

  • Great Britain. Royal Commission on Venereal Diseases.
Date:
1914-1916
Catalogue details

Licence: In copyright

Credit: First Report [with Final Report and Appendices] of the Commissioners. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    A history of S. was obtained in about 60-70 per cent, of these cases, but the actual niimber was raised by the use of the W This pi-obably explained the figures put forward by Welch. Welch was the first investigator to point out the connection between fibroid aortitis and S., but his statements were not believed at the time. He obtained a definite history of S. in 46 per cent, of the cases examined, which numbered 117. This was before the days of the W., and would probably be an under-estimate. The frequency of aortitis in cases of S. was not yet adequately recognised. It was most important that the disease should be recognised early so as to secure ti-eatment. If treatment were applied sufficiently early it would probably lead to the arrest of the disease. Aortic trouble manifested itself at varying periods after the first infection, and might extend from 18 months to 20 years. Moreover the disease of the aorta might be latent for as much as 10 years before giving rise to symptoms. The age for syphilitic aortitis fell between 35 and 50, and |.he duration of the disease in 54 cases examined averaged 22 ■ 9 years. Patients suffering from aortitis should be treated with Sn. Witness did not himself treat these cases, but sent them to other consultants and lost sight of the cases. He believed, however, that the treatment was important, and he had not seen any ill effects from Sn. W. was a reliable method of diagnosis when the reaction was positive. A negative reaction did not exclude S. Many cases of S. showed hardly any outward sign of the disease, and it was frequently contracted without the patient being aware of the illness. The majority of cases of aortic regurgitation are due to S., and the varying percentages given by different writei-s bears the same explanation as in the case of syphilitic aortitis. (Q. 13,500 to 13,507. It appears from the context that witness was referring to cases in middle life only.) The notification of S. would be useful statistically, but was rather a matter for the State than for the doctor. Witness would object very strongly to notifying persons himself. No special instruction as to venereal disease was given to undergraduates, but lectures might be given, say, once a term, and would probably be useful. Alcohol was not a determining factor in the produc- tion of S., but would aggravate the disease when present. Mrs. ROBERT PEEL WETHERED, Hon. Secretary of the Paddington and St. Marylebone Ladies' Association of Rescue and Care of Friendless Girls, and Miss HUGHES, General Superin- tendent of the Queen Victoria Jubilee Institute for Nurses. (Q. 13,662-14,003.) Witnesses attended on behaH of a meeting of ladies which had been convened by Her Royal Highness Princess Christian. The meeting consisted of ladies interested in rescue work; matrons of homes, lady guardians and representatives of various societies for helping women were also present, the total number being about 38. A resolution was passed, 48 additional individual signatures to the resolution being subsequently obtained. The resolution was worded as follows :— That this meeting, consisting of rescue woi'kers, matrons of workhouses and hospitals, district nurses, lady guardians and others, advo- cates a system of confidential notification (by doctors) to a specially appointed sanitary authority as the only means of altering the law of libel, and 80 ensuring proper precautions being taken against danger to the community, and especially to innocent- persons. Venereal disease was spread owing to the present system of secrecy in regard to venereal disease (cases were brought foi-ward to support this statement). If there were more general instiniction upon these matters it was reasonable to suppose that treatment would be more widely sought and persevered in. Venereal disease should be recognised as an infec- tious disease and there should be confidential notification. Increased facilities for treatment were required and should be available for all. It might be necessary to have some degi-ee of com- pulsory treatment. Nurses and midwives should receive instruction in the matter of venereal diseases. At the present time their ignorance upon these mattei-s was a source of danger both to themselves and to their patients, among whom they might be the means unconsciously of spreading the disease. The law of libel should be altered to protect the doctors, who should be given power to deal with these diseases as with other infectious diseases. It would be necessary to go gently at first, but opinion would gradually become educated to this SiE WILLIAM OSLER, Bt., Regius Professor of Medicine at Oxford. (Q. 14,004-14,259.) As a general impression it seemed probable that venereal disease had decreased and was of a less severe type in recent years. This might be due to some degree of general immunisation. The statistias of the Registrar General showing the deaths from S. were totally inadequate, as they did not cover several groups of diseases in which the fundamental cause of death, such as premature births, locomotor ataxia, G.P.I., many cases of hemiplegia and paraplegia. Probably about one-fourth of these cases were deaths due to S. Probably nearly all cases (95 per cent.) of aneurism in persons under 60 were due to S., and a considerable number of other cases of disease of some of the internal organs. S. probably came fourth in the list of killing diseases following tuberculosis, cancer and pneumonia. The 1,649 cases entered as due to S. were those of brief duration and did not include the large number of cases dying 10 to 20 years after the infection. The greater proportion of deaths occurred among congenital cases, and this form was probably more fatal than the acquired disease. The disease was very amenable to energetic treat- ment, which should be undertaken early. There were a considerable number of cases of innocent S. among doctors and othei's which might lead to the same late lesults as in other cases. G. was a very serious disease, being very damaging to health, and the cause of sterility in both men and women. Blindness as a result of ophthalmia neonatorum had greatly decreased, and would do so still fm'ther if it could be dealt with effectively. The treatment by Sn. was very satisfactory, and witness had experienced no ill effects from the treatment. W. was a reliable test in the hands of a good worker. It was very important that students of medicine should receive adequate instruction in venereal disease, not that they should become specialists but that they should be able to recognise the disease. It was a question whether the instniction should be imparted by means of special classes and as a separate division, or whether it could be dealt with as a part of the general curriculum. S. was a disease affecting so many organs that if it were thoroughly known it would imply a thorough knowledge of medicine. It was almost impossible to add to the present medical curri- culum for medical students, and if there were more beds, and if sufficient attention were jjaid to it in the out-patient department, this would probably suffice. Every general hospital thi-oughout the country should have a department for genito-urinary diseases, which should include venereal diseases not connected with the genito-urinary organs. The larger clinics should have their owu labora- tories. In smaller districts it would probably be better to combine. This arrangement would a g 4