More than one deadly touch of Venus

Press, 9 April 1977, Page 17

More than one deadly touch of Venus

The V.D. Epidemic. How it started: where it's going; what to do about it. By Louis Lasagna. University of Queensland Press. 156 pp. Illustrated. (Reviewed by Ralf Unger) Dr Lasagna is a clinical pharmacologist who considered that although there were numerous books on the market about venereal disease none of them fitted his purpose of public education and enlightenment. Therefore he has gathered in this small book a great deal of information about the history of the disease, its dangers, in spite of modern treatments, and how the ordinary person can identify infection and seek treatment. Although it is possible that syphilis was present in Western man previously it is not referred to in the literature until around 1500 A.D. The hypothesis advanced was that the natives of America repaid their ravaging European conquerors by exposing them for the first time to a disease that had long existed in the New World, but had not had the same dire effects on the infected.

Both syphilis and gonorrhea were soon attributed only to sexual relations. Any other description of infection was thought to be a coy evasion of the truth. Interestingly enough, however, in 1973 a Swedish physician showed that the traditonal toilet seat could spread gonorrhea even 24 hours after the patient with a lesion had sat on it. Nevertheless, in the majority of cases the correlation between sexual relations and venereal infection is undoubted.

A newer form of venereal infection has occurred in recent years because of the increasing boredom of younger people particularly with traditional sexual practices. As a result we have gonoccal infections of the pharynx and rectum. Women who practice fellatio contract the former, and male homosexuals contract oral and rectal gonorrhea. Treatment with “heavy metals” such as mercury pastes became the vogue in the sixteenth century, and proved highly profitable to the barbersurgeons and the charlatans. Indeed, it has been said that syphilis finally allowed the alchemists to turn mercury into gold. The effects of the mercury poisoning plus the sweating in tubs played havoc with the physical and mental health of the patients probably to as great an extent as the actual infection. Mercury treatments did not actually disappear form medical use as an antisyphilitic until the advent of penicillin in the 19405. It has been described as “the most colossal hoax ever perpetrated in the history of a profession which has never been free of hoaxes.” Primary and secondary lesions of syphilis cleared up while the patient was being treated with mercury. But often this was a spontaneous disappearance, and the major tertiary stage appeared several years later. Paul Ehrlich, who continued with the metals used in the treatment of syphilis, developed “06” or salvarsan in 1909. This was a compound of arsenic which was indeed effective, but also fatal in one case in every 2000, and with severe side effects such

as hepatitis and gangrene in 36 to 40 per cent of the treated individuals. It was not until 1943 that a quiet report on the efforts of penicillin showed that an effective cure for syphilis had finally been found. The story of a means of ridding the world of venereal diseases, is exciting, but Dr Lasagna shows clearly how both nature and the nature of man combat such successes. New strains of infection are developed which are resistant to previously effective antibiotics, such as the diseases Vietnam veterans brought back to the United States, and the over-all smug confidence and apathy of the ordinary person preclude him from seeking treatment at an early stage. A case study in the book shows only too well how quickly the disease can then spread through a permissive sexual culture.

China, by its emphasis on the good of the whole rather than the individual, plus the highly organised health protection campaigns, and concentration on “at risk” groups, has managed virtually to eliminate venereal diseases in a society where it was once rampant. Although this cannot be done in the same way in a different political system such as ours, the need for a more realistic and open approach is emphasised in this useful book. Dr Lasagna argues that if the massive resurgence of an apparently once-controlled infection is to be blocked, education programmes for the teen-agers who comprise at least onethird of afflicted venereal disease carriers, should spell out that sex and V.D. are both personal and social.