NA TURE 



169 



THURSDAY, OCTOBER 6, 1921. 



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Editorial communications to the Editor. 



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The Prevention of Venereal Disease. 



THE interest of many readers of Xatlre has 

 no doubt been aroused by recent corre- 

 spondence in the Times upon the subject of pre- 

 vention of venereal disease, together with the 

 trenchant article by its medical correspondent 

 directing attention to the refusal by the Ministry 

 of Health to accede "to the application of some 

 of the greatest medical authorities in the world 

 for leave under Section 2 of the V.D. Act of 1917 

 for " :— 



"The preparation and sale by chemists under 

 the supervision and control of the Society for the 

 Prevention of Venereal Disease of the materials 

 for immediate self-disinfection recommended by 

 them," 



And for : — 



■'The framing and issue by the Society for 

 the Prevention of Venereal Disease of the neces- 

 sary instruction for the efficient application of 

 those disinfectants, as it is obvious that the pro- 

 vision of disinfectants without instructions as to 

 their application would greatly diminish the effi- 

 cacy of this method of prevention of venereal 

 disease." 



Owing to the very serious immediate and re- 

 mote results upon the health of the nation of this 

 widespread preventable disease, which has in- 

 creased in prevalence as a result of the war, it is 

 desirable to consider the facts concerning the 

 measures which the Ministry of Health have 

 adopted or prepared, and compare the same with 

 those in operation in the Commonwealth of Penn- 

 sylvania. 



NO. 2710, VOL. I08I 



The Ministry of Health has established igi free 

 treatment centres, which cost last year half a 

 million pounds. The taxpayer will naturally ask 

 whether people who incur the risk should not be 

 required to pay for treatment, and it is not sur- 

 prising, therefore, to find indications of a change 

 of policy of the Ministry, for on page 119 of the 

 recently .issued Report of the Chief Medical Officer 

 it is stated : — 



" It is extremely desirable that fuller arrange- 

 ments should be made by the authorities for bring- 

 ing the general practitioner within their schemes 

 of treatment or education. It cannot be too clearly 

 understood that the best way of dealing with most 

 cases of these diseases is through the skilful 

 private practitioner. For a substantial portion of 

 this problem, the public clinic should be looked 

 upon as a temporary organisation pending the 

 time when the practitioner is ready, available, 

 competent and properly equipped to undertake 

 effective treatment. Certain patients require hos- 

 pital treatment, but the authority should not need- 

 lessly establish institutions, if and when the 

 ordinary channels of medical practice are avail- 

 able and reliable or can be made so." 



This pious medical opinion should be compared 

 with the following practical measures which have 

 been adopted and carried out by the Health Com- 

 missioner of the Commonwealth of Penneylvania. 



"The Department of Health of the State of 

 Pennsylvania maintains thirty public clinics for 

 the treatment of venereal disease, over which it 

 has entire supervision and for which it assumes 

 all financial responsibility. In these clinics free 

 treatment is given to those patients whose 

 economic condition will not permit treatment 

 either by private physicians, or by clinics charging 

 a fee. Upon entrance to clinics, patients are ques- 

 tioned as to their ability to pay for services. 

 Those able to pay a private physician are referred 

 to outside doctors who are registered with the 

 clinics. If in a position to pay only a small sum 

 thev are referred to hospital clinics which charge 

 a nominal fee. Indigent patients are treated 

 in the State Clinics." 



It will be observed that discrimination is shown 

 in respect to free treatment. The practitioner 

 registered with the clinic, it may be assumed, is 

 ready and capable of carrying out treatment effi- 

 cientlv, for which he is paid by the infected person. 



In our svstem there are no measures taken to 

 prevent discontinuance of treatment, consequently 

 a large percentage remain infective and are left 

 to spread the disease broadcast. This is mani- 

 fested by the table of statistics in the Report, 

 which shows that of 176,415 who attended the 

 183 treatment centres in the year 1919-20, 59,328 

 did not complete the course of treatment, 15,831 



