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Gonorrhoea
There was a sharp increase from 2,388 in 1968 to 2,998 in 1969, The
ratio of males to females was 2,076/920 which is well over 2 to 1 but
there were 566 male cases that were homosexually acquired, so that a more
realistic ratio would be 15 to 12 to 920, which is approximately 1,6 to 1
and shows a continuing improvement over previous years, though not yet
good enough. The high rate of incidence still continues in the age groups
under 20, with a marked preponderance in females, at this level. School
children are still continuing to attend of their own volition which is,
of course, an excellent thing; but it highlights the necessity for continued
education in schools which, despite the remarkable record of the Borough,
is still woefully deficient in certain quarters.
Other conditions which form the great bulk of our cases have also
risen sharply, rising from 6,496 in the previous year to 8,403 during 1969.
In males, there were 1984 new cases of non-gonococcal urethritis and 13 of
Reiters disease;non-gonococcal urethritis is often a very troublesome condition
medically, may run a prolonged course, and result in precisely the same
complications as gonorrhoea, including urethral stricture. There seems to
be a general lack of awareness of this, both medical and lay, and there
is still too great a readiness to dismiss this complaint as of little
significance whereas, in fact, it can cause a great deal of suffering,
ill health, and mental distress not excluding quite severe depression,
which last may require treatment for its own sake. In all cases it is
advisable to see female contacts too, who may be suffering from a variety
of conditions of which the commonest is non-specific cervicitis,
"Patients requiring no treatment within the centre": these rose from 1,730
to 2008. This is a somewhat misleading heading as it may include patients
who just wish for a routine examination and blood test on the one hand;
and others who may have some quite severe medical or surgical condition
requiring admission to hospital, who are not actually treated within the
clinic. Prominent under this heading are anxiety states of various kinds.
One of the most disturbing developments during the recent year has
been the increase in the number of male patients who come up, or are
often sent up by their infected girl friends, who have no symptoms at all
but who are, in fact, suffering from gonorrhoea. This can only be revealed
by means of urethral scrapes, careful examination of urine, often the
first early morning specimen, always with microscopy; and in some cases,
prostatic massage with microscopic and cultural examination of the prostatic
fluid. There have been one or two cases of infection still present
in a previously-overlooked stricture,
There is no doubt at all that gonorrhoea is tending to get much
milder clinically, while progressively more difficult to treat successfully.
It is my considered opinion that without proper facilities these
infections are almost impossible to diagnose and treat properly outside
a clinic.
The number of homosexuals attending remained at about the same level
as previously, about 15.9% of all new male patients. It is not generally
appreciated that this mode of sexual expression is highly dangerous from
the point of view of infection, but we are very glad that patients are
coming forward so that we can deal with their
Probably the most outstanding feature of the last two years has been
the enormous increase in the number of female patients, rising from 9,362
attendances in 1968 to 16,307 in 1969, and this increase continues steadily.
It is obviously an excellent thing that people are coming forward in
such numbers, and every effort must be made to encourage them to continue
to do so; at the same time our facilities are now over-stretched to such
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