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100
1913
as the Medical Officer of the Local Government Board states, is greatly
reducing the risk of neglect of treatment of this serious condition. It is to
be regretted that the public are not fully aware of the serious extent to which
syphilis in particular affects the national health; for if they were, it is only
reasonable to suppose that they would take a deeper interest in the question
of its cure and prevention than they do.
Syphilis is supposed to have been introduced into Europe by the
adventurers who accompanied Christopher Columbus on his voyage of
discovery on their return in 1493 from America; but whether this statement
be correct or not, the disease does not appear to have been known until the
close of the 15th century. At all events, it is certain that in 1494 syphilis
ravaged Spain, and extended to France and Germany in 1495; to Holland
and Greeoe in 1496; to England and Scotland in 1497, and to Russia and
Hungary in 1499, since which time it has been endemic in Europe.
It is difficult to state with exactitude the number of deaths from this
disease that occur annually in this country, because as a writer (Dr. R. W.
Johnstone) on the subject puts it in a report to the Local Government Board :
" few medical men are so callous as not to try to spare the memory of the dead
and the feelings of the relatives by attributing the death to some of the contributary
causes which always exist. In consequence, syphilis is rarely
certified as the cause of death."
The Registrar-General, in his Annual Report for 1912, dwells at more
length on this subject, and he states that: " The deaths tabulated
from the registers as due to syphilis clearly afford no measure of the absolute
amount of mortality properly ascribable to the disease. This is inevitable
under the present system by which the causes of death are certified, an open
certificate being handed by the certifying practitioner to the relatives of the
deceased, and subsequently included in a register open to inspection by any
member of the public on payment of a small fee. The practitioner is
obviously strongly tempted, in fact almost obliged, in many cases under this
system to avoid mention on the certificate of the syphilitic nature of the
disease he is returning as the cause of death. Indeed, the fact that such
concealment is commonly practised is frequently illustrated both by the
correspondence with medical men who have issued purposely indefinite certificates,
and by efforts made in certain cases to embody in the wording of the
certificate a hint as to the true cause of death not likely to be understood by