London's Pulse: Medical Officer of Health reports 1848-1972

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City of London 1919

Report of the Medical Officer of Health of the City of London for the year 1919

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If a Medical Officer of Health is satisfied that any person who needs anti-rabic
treatment cannot afford to stay at the Centre at his own expense for the two or
three weeks necessary for the completion of the course, financial assistance may
be rendered by the District Council.
In this connection the Corporation authorised the Chairman of the Sanitary
Committee to make whatever monetary grants might prove necessary.
The Centre for the treatment of venereal diseases, which was established by
the Corporation at the City Shelter in Golden Lane, and which was administered
and worked by the authorities and staff of St. Bartholomew's Hospital, is still
doing an excellent and an increasing amount of work. The details of the scheme
have already been submitted to the Sanitary Committee, but at the present
moment, owing to the demands on the existing accommodation, its very success
is liable to prove prejudicial as it becomes increasingly difficult to secure the
necessary privacy. Proposals are now being worked out to effect some amount of
re-organisation so as to provide additional facilities.
During the year the original contribution to the Hospital Authorities of
£1,800 a year was increased to £2,100. This amount will probably be required
to be doubled within the near future.
At the beginning of the year 273 males and 123 females were registered on
the books as receiving treatment; of these 135 males and 63 females were under
treatment for syphilis, and 127 males and 57 females for gonorrhoea. New patients
admitted during the year totalled 861, as under :—
Syphilis. Gonorrhoea. Soft Chancre.
Male. Female. Male. Female. Male. Female.
232 82 399 111 3
The chief difficulty which is observed in the case of treatment of syphilis is
that patients do not continue sufficiently long under treatment to ensure that the
disease is satisfactorily cured. This is an important difficulty and is receiving the
attention of the Ministry of Health. 43 men and 22 women discharged themselves
before completing the course of treatment, and 10 men and 19 women ceased to
attend after completion of the course of treatment, but before final tests as to cure
were applied. In the case of gonorrhoea 216 men and 47 women completed the
course. The total attendances of persons at the clinic numbered 15,269 ; this total
is made up as follows :—
Syphilis. Soft Chancre. Gonorrhoea. Non-venereal conditions. Total Attendances.
Male. Female. Male. Female. Male. Female. Male. Female. Male. Female.
3,896 2,356 3 6,978 2,002 26 8 10,903 4,366
A few beds are provided at the Institution for in-patient treatment and the
number of days of such treatment totalled 558.
In the laboratory attached to the Institution 2,485 specimens were examined.
Of these 643 referred to patients under treatment in the Centre and 1,216 to
patients under the treatment of general practitioners and in the hospital. 33
examinations for spirochete were made and 487 for gonococci.
As regards the places of residence of patients coming under treatment, it is
reported that patients resided in the following counties :—London, Essex, Hertfordshire,
Middlesex, Surrey, Kent, Bedfordshire, Buckinghamshire, Sussex,
Hampshire, Dorsetshire, and Gloucestershire.
The salvarsan substitutes which were used are Nov-Arseno-Billon and Galyl.
Six doses of salvarsan substitutes are given in a full course and salvarsan substitutes
are used in all cases in the treatment of syphilis. The tests which were
applied to decide as to the discharge of patients are, in the case of syphilis,
Wasserman re-action every three months and supervision monthly for one year
after the last course ; in the case of gonorrhoea, three tests are applied at intervals
by means of culture and examination of slides of material expressed by urethroprostatic
massage. The urethroscope is also used.

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