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sexually, such as non-gonococcal urethritis and trichomonal
infection have recently been taking progressively more of the
venereologist's time but, fortunately, although in some instances
these can produce serious complications, in the main they do not
present the difficulties associated with syphilis and gonorrhoea.
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, and the establishment of efficient
publicity and health education machinery.
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
antibiotic has tended to minimise the seriousness of these diseases
especially among young persons where there is a measure of sexual
freedom undreamt of a decade ago). In the modern permissive
society and to the detriment of venereal disease rates generally,
this attitude to sexual morality is rapidly changing. As an example,
in a recent television programme, teenage girls claimed that they
would feel no shame if it were discovered that they were suffering
from venereal disease. Such a radical change in outlook may be
a shock to many sections of the public but it seems to have one
advantage—there is less reluctance on the part of would-be patients
to seek medical advice and treatment on account of the "shame"
element.
It is more than probable that the oral contraceptive pill is making
its contribution to the increased incidence of venereal disease. Its
use is promoting greater promiscuity and, in one survey carried
out in this country recently, the infectivity rate in women taking
the pill was twice that of the general population. Furthermore,
there is evidence to the effect that since the pill causes a lowering
of the pH value of vaginal mucosa there is an increase in the susceptibility
of the female genitalia to certain infections.
Homosexuality, possibly aided and abetted by recent liberalising
legislation, is also adding its quota to the rising totals.