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

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City of London 1920

Report of the Medical Officer of Health of the City of London for the year 1920

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Statement showing the services rendered at the Treatment Centre during the year,
classified according to the areas in which the patients resided.
*Name of County or County Borough (or
Country in the case of persons residing
elsewhere than in England and Wales)
to be inserted in these headings.
London.
Essex.
Herts.
Middlesex.
Surrey.
Kent.
Bucks.
Hants.
Total.
A. § Number of persons from each area dealt
with during the year at or in connection
with the out-patient Clinic for the first
time and found to be suffering from:—
†Syphilis
398
10
5
5
4
2
l
2
427
†Soft chancre
...
...
...
...
...
...
...
...
...
†Gonorrhœa
550
12
7
6
7
2
2
2
588
Conditions other than venereal
31
3
...
1
2
1
...
...
38
Total
979
25
14
12
11
5
3
4
1,053
B. § Total number of attendances at the outpatient
Clinic of all patients residing in
each area
21,428
100
37
32
49
20
10
13
21,689
C. § Aggregate number of "In patient days "
of all patients residing in each area
371
20
19
5
1
...
...
...
416
D. Number of doses of
Salvarsan substitutes
given in the:—
1. Out-patient Clinic
3,408
90
42
66
33
18
6
11
3,674
2. In-patient Dept.
16
...
...
...
...
...
...
...
16
to patients residing in each area.
E. Give the names of Salvarsan substitutes
used in the treatment of syphilis and the
usual initial and final doses
Billon.
Silver 606.
Intra-muscular Galyl.
F. State the number of doses of Salvarsan
substitutes usually given in a full course
of treatment
6 in each course.
G. State in what proportion of cases, approximately,
Salvarsan substitutes are used in
the treatment of syphilis
97%.
H. State the nature of tests applied in deciding
as to discharge of patients referred to in
Item 5 on previous page
(See notes on back and Memo. V21.)
E. W.R. every 3 months.
After completion of a course for 2 years.
Supervision monthly for 1 year after last course.
Gonorrhœa. M.T.— i.e. 3 tests at intervals, cultures and
slides from urethra and prostate after massage. C.F.T.
urethroscope examination.
Females— 3 tests, cultures and slides from urethra, cervix
and Bartholin's glands after menstrual period.
25
February llth, 1921. KENNETH M. WALKER,
Medical Officer of the Treatment Centre.
* A list of the Administrative Counties and County Boroughs In England and Wales is given on the back of this Form.
† If a persou has been treated for both syphilis and gonorrhoea, he should be included under both diseases, and similarly for other combinations of
venereal diseases.
§ The totals in Item A should agree with the corresponding totals in Item 2 on the previous page, and the totals in Items B and C should agree
with the respective totals in Items 7 and 8 on the previous page.
NOTES.
Item 1. The number to be inserted here is the number of persons who in the period preceding the year under report were dealt with at or in
connection with the out-patient Clinic and who, at the end of that year, had not been discharged after completion of treatment and observation
or had not been marked off as having ceased to attend under circumstances described in Items 3 (a), 3 (6) or 4.
Item 3 (a)or(b). Patients should not be marked off as having ceased to attend until after efforts have been made by letter or otherwise to induce
them to continue attendance. Patients who do not return to the Clinic within two months of the last of such efforts may be regarded as having
ceased attendance.
Item 4. In this Item will be included patients removing to other districts, to whom Form V15 or Form V15A should have been given.
Item 5. Attention is drawn to the accompanying Memorandum (V21) which was prepared by the Ministry of Health for the guidance of the Medical
Officers of V.D. Treatment Centres in December, 1919. The Memorandum is based on suggestions which have been made to the Ministry by certain
Medical Officers of V.D. Treatment Centres as to the tests which in their opinion should be applied, before discharging a person who has suffered
from syphilis or gonorrhoea, as having completed the course of treatment and observation. Medical Officers are asked to give careful consideration
to the Memorandum, but it is not intended to suggest the invariable adoption of the methods indicated.
As regards Syphilis, the following circumstances would justify discharge on completion of treatment and observation incases coming under
treatment in the secondary stage, or in the late primary stage with positive Wassermann reaction:—
Two years' freedom from all signs of the disease either clinical or serological, after suspension of all medical treatment, and notwithstanding
"provocative" injections of arsenobenzol compounds, a Wassermann test being taken not less frequently than every three months.
In cases of primary infection, with negative Wassermanu reaction, a period of two years' observation from commencement of treatment
would suffice.
As regards Gonorrhoea, it will be noted that in the Memorandum certain te ts are regarded as essential, while others {e.g.. culture tests and
complement fixation test) are regarded rather as supplementary..
Medical Officers are requested to indicate in paragraph H of this Return the tests which have been applied on discharge of patients from
treatment.


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