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36
from 2,537 in 1931 to 1,424 in 1936, and congenital syphilis during the same period
from 543 to 265 cases. The mortality rate of children under one year per 1,000
live births, from syphilis for London only, has declined from 2.46 in 1917 to 0.36
in 1935.

These figures are strictly comparable year by year and are not governed by
the note to table 38.
Cases of congenital syphilis dealt with at the clinics during the same period
are shown below:—

It cannot, I think, be denied that the figures quoted represent a genuine decrease
in the incidence of new syphilitic infections. In support of this contention it may
be pointed out that for several years, and more especially during the last decade,
the school medical service, the maternity and child welfare centres, the practising
midwife and the various departments of the voluntary hospitals have been on the
alert to detect signs and symptoms of this disease and to refer suspects to the
approved treatment centres.
For the past twenty years, local authorities have provided free facilities for
diagnosis and treatment of venereal disease, and have endeavoured by lectures,
demonstrations, public meetings, etc., to draw the attention of the public to the
serious effects of venereal disease and to the paramount duty of sufferers to
seek early and skilled treatment not only for their own physical well-being but also
for that of their potential offspring. All this has occasioned expenditure but the
results show that such expenditure has been justified.
Gonorrhœa.
Unfortunately the same satisfactory story cannot be told with regard to
gonorrhoea where, owing to the nature of the disease, the uncertainty of treatment
and length of time required for complete cure, patients remain in an infective
condition for much longer than is the case where syphilis receives proper treatment
by modern methods. The position regarding gonorrhoea is briefly summarised in
the following paragraphs.
As regards England and Wales, the greatest number of cases attending the
centres in any one year since the facilities for diagnosis and treatment were provided
in 1917, was 45,001, which occurred in the year 1930. For the year 1935, the
number was 41,332. This latter figure is, however, greater than that for any year
prior to 1928.