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West London Hospital — Martha & Luke Clinic Report, 1966
I am most grateful to the Director of the Special Clinic, Dr. J.L. Fluker, for his report
which appears below:—
During the year 1966 the total number of new cases rose from 6312 in 1965 to 6824.
There was a slight decline in the total number of cases of syphilis seen, from 196 to 162, but
this may have been more apparent than real, as more cases of latent yaws were diagnosed and it
is often impossible to be absolutely certain with which disease one is dealing, as the blood
reactions for both are the same. There was no significant difference in the number of cases of
early syphilis which, of course, is the most important from the point of view of the public health.
Of these, there were 127 cases in 1966. There is reason to believe that there is a good deal of
undetected early syphilis in this area, a large amount of it among homosexuals, and it is hoped
that now the Bill before Parliament has been passed on homosexuality it may be easier to persuade
some of these people to attend, and with this in view we have obtained the co-operation of
the Albany Trust. Although the numbers in proportion to the total are still low, there is no cause
for complacency.
There was a sharp increase in the amount of gonorrhoea, which rose from 1391 to 1626.
The incidence in male West Indians fell from 20.8% of the total to 19.6%, although their actual
numbers increased. This is a phenomenon which is happening throughout the whole country and
is due to a faster-rising incidence of the disease amongst U.K. born subjects. Approximately one
quarter of the female cases of gonorrhoea were in girls under the age of 20. There were 11 patients
under the age of 16. See Table 16, Page 121.
The great bulk of our patients, 5005 last year, were due to other non-venereal conditions,
of which there are a large number — many of them, but not all of them of course, sexually
transmitted. In males, the commonest of such conditions is non-gonococcal urethritis, of which
there were over 1192 cases. In females Trichomoniasis and Candidiasis were very prominent; but
there were all sorts of other conditions, including skins, gynaecological conditions, psychiatric
troubles, disorders of sex and sexual function, and of course many people who thought that they
had taken a risk, and who came up for test, but had nothing wrong with them. We also get quite a
number of patients, particularly young males, who wish to have an explanation of the facts of
life. Again, there are many who come for contraceptive advice, so that really we are now offering
an advisory service, not only upon sexual infections, but on all disorders of sex. It is, we feel,
very important that the term "Venereal" be used as little as possible, because, although it is
entirely illogical, many people feel unclean, if they have a venereal disease such as gonorrhoea;
but if it is only an infection — like urethritis, then it is quite respectable. Apparently the mode
of acquisition of the complaint is immaterial! We are anxious to make the service widely available,
and as broad as possible; and, therefore, anything which may discourage patients from
coming is to be deprecated.
During the year 1967, there has been a further large increase, the main feature of which
has been a sharp rise in the incidence of gonorrhoea, with an increasing proportion of resistant
cases. The outlook is not at all encouraging, and every effort should be made, particularly in
schools, to provide the public with some facts about this group of infections, which they so
sadly lack. If this is not done, despite its immediate success, the large campaign mounted in
Hammersmith, at the end of 1966, will have to be judged an ultimate failure.
J.L. FLUKER,
DIRECTOR.
SPECIAL CLINIC.
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