Facts about ‘unmentionable’ diseases

Press, 26 July 1980, Page 17

Facts about ‘unmentionable’ diseases

Sexually Transmitted Diseases: The Facts. By David Barlow. Oxford University Press, 1980, 138 pp. Index. $15.25. (Reviewed by W. M. Platts) It is a sign of the times that a book on sexually transmitted diseases (S.T.D) is being reviewed on- the literary page of a respected; daily newspaper, indicating that these once unmentionable and “self inflicted” infections have become so much part of our society, that knowledge about them is essential. They total more than 10 in number, the commonest being ' gonorrhoea, which, is more common, even than measles. Between two and three million nfew . cases occurred in the United States last year.) Their survival and probable increase, is 'ensured by the promiscuity inherent in the permissive society. - This slim and readable book by a senior .venereologist ' at one of London’s best known clinics (now called S.T.D. clinics) is of interest to doctor and layman alike. The style is lively, the facts are accurate, up to date, and; full enough for use by medical students and nurses, yet the volume is highly suitable for schools, social workers and lay people. Medical terms are defined, as far as possible, and the text is enlivened by a number of interesting personal case histories, as well as several clever cartoons by Dickinson, of “Punch” fame. There is also a chapter on sexual anatomy. Before descriptions of the different

diseases, there are short chapters on their part in history, the . present depressing world-wide picture, and the enlightened attitude of the Nordic countries to S.T.D.; also bn the development of the excellent V.D. sendee in Britain, unequalled in the world today. In 1916 the V.D. regulations in Britain became law, instructing all local health authorities to provide free V.D. clinics for diagnosis and treatment, actually antedating, an effective cure for gonorrhoea by 20 years. New Zealand passed a. similar ordinance a year later — the Social Hygiene Act, of 1917, with the same provisions as its British counterpart, but adding a quaint clause which provided for “health patrols” to patrol the streets “to protect the health and morality of young persons”. In neither country, in contradistinction to nearly all others, was V.D. made a notifiable disease. These measures enabled Britain to establish the specialty of venereology, and were the forerunner of today's 200 clinics, attended by about 50 per cent of all S.T.D. cases. The efficiency of this approach is highlighted by the gonorrhoea incidence in the United States where, in contrast, the great majority of cases are seen by private doctors, being nearly 10 times that in Britain. New Zealand has tagged along slowly following the English system, figures being fess than double those in Britain. However more clinics are needed. Each of the afflictions is clearly

described in this book with some illustrations, special emphasis being given to difficult conditions such as non-specific urethritis (N.S.U.), vaginal discharge, and the . increasingly common and sinister genital herpes infections, often recurrent, and for which there is no cure. A timely warning is given of the little known dangers of oral sex if the slightest trace of a cold sore is present, the viruses - being virtually identical. Hepatitis is another viral disease transmitted sexually. A further seldom mentioned viral infection, genital warts, is described. These are extremely common, being the “despair” of doctors facing the numerous patients who return week after week for further treatment of their new crops of warts. The place of the clinic in the control of S.T.D. is almost the theme of the book and so a chapter on the personal side of a visit to a clinic is pertinent and sympathetic, and is fully applicable in New Zealand. The sad point is made that patients with S.T.D. are still burdened with the stigma and shame of half a century ago. Unfortunately this attitude is shared by many high placed medical colleagues and administrative colleagues who should know better. The net result is the almost world-wide relegation of venereology to lowest priority in terms of finance and recognition for staffing, amenities and research. (Dr Platts is a venereologist in Christchurch.)