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Under the National Health Service Act of 1946, diagnosis and
treatment of venereal diseases became a responsibility of the Regional
Hospital Boards and the functions of the local health authorities
were limited to those of prevention. In practical terms, this means
the tracing of contacts, a difficult and often unrewarding part of the
preventive service.
Syphilis affects the circulatory system and the elastic tissue of
the aorta may be damaged giving rise to an aneurysm which, at best,
may impair the functioning of the aortic valves or precipitate heart
failure and, at worst, by its rupture lead to sudden death. When the
treponema damages the nervous system (tabes dorsalis) there follows
a history of progressive destruction of nerve fibres in the spine and
periphery and, in cases where the brain cells are affected, there
arises a condition known as 'general paralysis of the insane'. In
tabes, there may also be crippling joint destruction while involvement
of the eyes could result in blindness. Unborn children of syphilitic
women can be infected via the mother's blood and, moreover, the
earlier pregnancies of an affected woman often end in abortion and
later ones in stillbirth. Many children who survived these hazards
suffered from congenital syphilis which gave rise to mental deficiency,
blindness and deafness.
Although it can be the source of serious complications gonorrhoea,
a disease more localised than syphilis, is seldom lethal but is
one of the causes of sterility in men and women. Before effective
prophylaxis was introduced, ophthalmia neonatorum, previously the
most common cause of blindness, was often acquired by children at
birth as a result of the mother's infection.
Venereal disease can have catastrophic effects on health,
happiness and family life. Indeed, the Matrimonial Causes Act of
1950 gives undisclosed communicable venereal disease at time of
marriage as grounds for rendering such a marriage invalid.
In the sphere of venereal disease, promiscuity and an 'infector'
pool are the two factors determining the size of the problem. Promiscuity
is a reflector of personal behaviour and morals and, naturally,
the higher these standards the less prevalent are the venereal diseases.
Pools of infection are increased and enlarged by promiscuity and
reduced after the contagious period is over or a person is cured.
No reliable means exist of estimating the extent of promiscuity
in a community although the number of persons attending the
special clinics may provide a pointer to the numbers exposing