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of a venereal disease clinic. In these circumstanees it was fortunate that the Royal Free Hospital was
able to make some special provision for the treatment of pregnant women suffering from venereal disease
by means of its new Maternity Hospital at 21, Endsleigh-street, and the Hostel at 13, Burton-street, for
which provision a considerable addition was made to the grant in aid to this hospital for the year
1920-21.
The premises at 82 and 84, Stockwell Park-road, which the Federation of Children's Rescue
Committees proposed to adapt and utilise for the treatment of gonorrhoea in children, were ultimately
abandoned owing to difficulties in connection with the lease of the premises, but in this instance it is
a matter for congratulation that much more suitable premises were found at Coldharbour, Waddon,
(near Croydon) Surrey, with accommodation for 25 children, and these are now in occupation. One
of the special features in connection with the treatment of these cases is the immense importance of
the provision of education for the children whilst still under treatment, not only because of the fact
that this is generally prolonged in such cases (often many weeks and even months), but also in order to.
divert the naturally active, precocious minds of such children from dwelling upon " treatment " as the
dominant factor in their lives.
During the year 1919, two more hostels were opened, one at 168, Lambeth-road, and the other
at 24, Gloucester-road, Regent's Park. The former is directly associated with the work of the venereal
-disease clinic at St. Thomas's Hospital, and the latter with the venereal disease clinic at the Royal Free
Hospital, though in both institutions cases may be accepted from any of the venereal disease clinics
in the scheme. At the time of writing this report, it may be noted that arrangements have
recently bean completed for the opening of a hostel at 93", Grove-lane, Camberwell, for pregnant women
suffering from venereal disease, and negotiations are in progress for linking up another hostel in Sinclairroad,
Hammersmith, with the work of the venereal disease clinic at the West London Hospital. It is
also worthy of note that each year's additional experience serves to confirm the value of hostels in
increasing the efficiency of treatment of certain types of patients and in preventing to some extent the
spread of these diseases in the manner indicated in an earlier portion of this report.
Two other matters of considerable practical importance may conveniently be referred to at this
juncture in connection with the development of the London scheme. One is the fact that at St. Thomas's
Hospital during the year 1920 the whole of the venereal disease clinic has undergone a complete reconstruction
in every sense of the word. New premises, especially designed for the needs of a venereal
disease clinic, have been provided, and concurrently with the opening of these premises, there has been
appointed a specially selected medical, nursing, and male orderly staff sufficient to permit of the facilities
for diagnosis and treatment being available from 8 a.m. until 10 p.m. daily. A description of these
arrangements will be found in page 11, but attention is drawn to them here as they constitute the most
important development in the direction of the facilities provided for diagnosis and treatment in the
scheme for the year 1920.
The other matter to which attention should be drawn is the opening of a venereal disease clinic
at the Royal London Ophthalmic Hospital, Moorfields. To some minds it may doubtless appear to be
somewhat difficult to justify such a step, but to those who know the immense amount of blindness,
partial and complete, which is directly traceable to venereal disease and is avoidable by appropriate
treatment at the right moment, there will be no difficulty in appreciating the great possibilities for
good work arising from the establishment of facilities for the treatment of these diseases at the Royal
London Ophthalmic Hospital and their possible extension later to other ophthalmic hospitals.
During the year 1920 the number of sessions at most of the venereal disease clinics throughout
London has been increased in order to cope with the constant and continuous increase of the work.
To meet these demands, the councils participating in the scheme have also made considerable
additions to their grants in aid to the hospitals carrying out the work, as will be seen from Appendix A.
By the end of the year 1920, the scheme will have been in operation for four years, and
in view of the fact that the difficulties of staff, which were so pronounced during the first three years
are now much less marked, the present moment seemed a convenient one for a careful survey of the
work of the venereal diseases clinics, and for a review of the direction in which future developments of
the campaign against venereal disease should aim. Accordingly, as opportunities have offered, special
visits have been made from time to time to each of the venereal disease clinics included in the scheme,
and in addition numerous enquiries have been made and stimulated in many directions as to the various
activities which may reasonably be considered as directly or indirectly concerned with the campaign
against venereal disease. Whilst the immensity and complexity of this task is fully recognised, as well
as the important issues involved and the vast amount of time which would be necessary for a complete
study and appreciation of all the activities concerned, an effort has been made to include in this report
some comments, criticisms and suggestions based upon the results of these enquiries, which it is hoped
may be of service to those who are charged with the responsibility of providing both for the diagnosis
and treatment of these diseases and for their prevention.
II.
General Principles Governing the Organisation of Venereal Disease Clinics.
Before commenting on the conditions which were found to exist in the clinics operating under
the scheme it would be well to set out briefly the general principles which should govern the organisation
and conduct of such clinica.