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allotted, with internal arrangements specially adapted for the purposes of a venereal disease clinic.
It may not be out of place in this report to describe this clinic and the principles on which it was designed.
The St. Thomas's Hospital venereal disease clinic consists of two separate sections, male and
female. The former is located in a hut, and the latter in the basement of block 8, adjoining the male
clinic. In the same block are 20 beds for venereal disease in-patients.
The hut devoted to the male clinic is 90 ft. by 40 ft., and at the end furthest from the entrance
are two annexes, one for the laboratory, the other for W.C.s and lavatory. The main portion of the hut
is arranged as shown on the plan, page 13, which may be explained by giving an account of the manner
in which it is worked.
On arrival each patient reports at the enquiry window of the clerk's office. He may be:—
(a) A new patient.
(b) An old patient attending for anti-syphilitic treatment.
(c) An old patient suffering from gonorrhœa, and attending for examination by a medical
officer.
(d) A gonorrhœal case attending for irrigation.
In the case of (a), the particulars are entered in the confidential register, the patient receives a ticket
showing his identification number, a treatment card is made out for him, and he is directed to one of
the examination cubicles shown on the left of the plan. The clerk knows to which cubicle to direct
the patient, as there is an electric light indicator behind him which is operated by the bolts on the cubicle
doors, and shows a number when a cubicle is occupied. The examination cubicle is reached by the
patient via the corridor on the left of the plan, and no patient is permitted within the central space
between the two rows of cubicles. On reaching the cubicle, the patient undresses sufficiently for a
complete examination to be made, and is then examined by a medical officer. Each examination
cubicle is closed by 7 ft. high partitions on three sides, and is open on the fourth side. On this side, as
shown on the plan, is a counter 2 ft. 8 in. high and 1 ft. 4 in. broad, which is upholstered so as to serve
as an examination couch if required. Access by the medical officer to the cubicle is obtained by lifting
a flap in the counter. The fourth side can be closed by a curtain if desired. The furniture of each
cubicle consists of—
(i.) A small writing table on which are all stationery requirements.
(ii.) An instrument table on which are all the instruments for taking specimens and for
making an ordinary examination.
(iii.) A double basin, portable wash hand stand with perchloride lotion above, in which to
sterilise hands, and carbolic or lysol below for used instruments.
(iv.) A rack holding four urine glasses.
The cubicle equipment is supplemented by that for special examinations, and treatment, which is carried
on trolleys standing in the central space of the clinic. This supplementary equipment is grouped
according to its purpose. Thus there are:—
(i.) A minor operation and dressings trolley, holding all the instruments, etc., required
for dealing with a case of, e.g., bubo.
(ii.) A gonorrhœa trolley containing all the instruments required for special examination
of a case of gonorrhœa, including urethroscope and rheostat, the latter working from an electric
wall-socket in a partition of each cubicle.
(iii.) Mercurial injection, arsenobenzol and urine-testing trolleys.
If a medical officer requires special instruments other than those which form the normal equipment
of an examination cubicle, he calls up the appropriate trolley, which stands whilst in use outside the
cubicle alongside the counter or examination couch.
The result of these arrangements is that neither patient nor medical officer need leave the cubicle
from beginning to end of the examination, except when the medical officer wishes to examine a microscopical
specimen. This is done at the bench running down the centre of the clinic. Incidentally, it
may be mentioned here that a partition, the top of which is 7 ft. above the floor, divides this work bench
longitudinally and serves both to carry shelves and cupboards and as a screen preventing patients from
seeing others in opposite cubicles.
(b) In the case of patients attending for anti-syphilitic treatment, the routine is as follows:—
(i.) Anti-syphilitic injections are given at set hours, though new cases are injected at once, (ii.) Each
patient is first interviewed and examined in the doctor's room and receives a slip on which is written
the dose to be injected. He is then sent to one of the examination cubicles, these being filled at the
rate of five to each cubicle, (iii.) Each patient passes his urine. (iv.) All urines are tested by an
orderly passing from cubicle to cubicle with a trolley carrying urine-testing apparatus. (v.) A medical
officer follows with a trolley holding the arsenobenzol injection syringes and gives the injections. For
this purpose the patient sits in a chair within the cubicle and lays his arm out over the counter conveniently
for the medical officer standing outside the cubicle. (vi.) Another medical officer follows
with the mercurial trolley. (vii.) The cubicles empty in turn as the trolleys proceed along the line of
cubicles, so that by the time the last cubicle is finished the first has filled with a fresh batch of patients,
and so on until all have been treated.
(c) Patients attending for treatment for gonorrhœa by the medical officer may require only a
minor examination, in which case they are sent into the room behind the doctor's room; or a more
detailed examination, which is carried out in the room behind the office.
(d) Patients attending for irrigation receive a pink ticket on which are written the details of the
irrigation required. The patient takes his pink ticket to one of the irrigation cubicles shown on the