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

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Greenwich 1967

[Report of the Medical Officer of Health for Greenwich Borough]

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66
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. In bygone days many children
who survived these hazards suffered from congenital syphilis which
gave rise to mental deficiency, blindness and deafness but, with
modern preventive methods, this problem is minimal in England
today.
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.
Previously, because of the element of "guilt and shame" in
venereal infections, there has always been a reluctance to seek
advice and treatment although this was partially offset by the introduction
of penicillin. Unfortunately, the very success of this
anti-biotic has tended to minimise the seriousness of these diseases
especially among the young persons where there is a measure of
sexual freedom undreamt of a decade ago.
Speed of modern travel makes local control of infectious diseases
difficult if not well nigh impossible on occasions, a fact which serves
to emphasise the urgent need for a more vigorously and


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