VENEREAL DISEASE

Greymouth Evening Star, 28 December 1928, Page 2

VENEREAL DISEASE

POSITION REVIEWED

(By the Department of Health.) As a danger to the public health, as a peril to the family, and as a menace to the vitality, health, and physical progress of the race, the venereal diseases are justly regarded as the greatest of modern plagues, and their prophylaxis the most pressing problem of preventive medicine tha£ confronts us at the present day-—M. J. Rosenau, Professor of Preventive Medicine and Hygiene, Harvard. Throughout the world, a very great deal of attention lias been devoted in recent years to the important problem of venereal diseases, and it lias been recognised with increasing force that these diseases constitute one of the most serious scourges of mankind. Syphilis occurs at all ages, and in all classes of society, is the cause of much insanity, and is one of the causes of mental and physically deficient children ; it is an important factor in the production of blindness, deafness, and the diseases of degeneration of the arteries; it is the cause of many abortions and miscarriages. Altogether, it is perhaps the most serious cause of disruption of home and happiness, and causes untold suffering and misery. Gonorrhoea, the other major venerea] disease, is much more prevalent than syphilis. From an economic and public health standpoint it does not fall very far short of syphilis in importance. It is a common cause of sterility, and in. women of many internal internal inflammations and disablement. These perhaps are the most serious of its after-effects.

It will lie remembered that public attention in New Zealand was drawn to the matter in 1917, when the Social Hygiene Act was placed on the Statute Book. Following upon this, public clinics under the charge of fulltime medical specialists were organised in 1919. The next step in the campaign against venereal diseases was the setting up of a committee of the Board of Health in 1922, under the chairmanship of the Hon. AV. IT. Triggs, to report upon the subject of venereal diseases in New Zealand and to recommend what further departmental action should be taken to cope with them- The committee brought down important recommendations, many of which have already been put into force. Amongst other matters, they recommended that legislation be introduced providing for what is known as conditional notification of venereal disease ; that is notification by a doctor of each case of venereal disease by number or symbol only. They further recommended that if any patient refused to continue treatment until cured it should then be the duty of the doctor last in attendance to notify the case to the Department by name. WHAT THE LAW REQUIRES. In 1925 regulations were passed which embody most of the recommendations of the special committee. One point, however, in which the recommendation of the committee has not been completely adopted is that relating to notification. The present law does not require the medical man to notify by number or symbol each case of venereal disease which comes under Iris personal care. It does require him, however, to report to the Department the names of any patients who have failed to attend' for treatment until cured. This provision is regarded as very necessary, and gives a very definite measure- of control over patients who otherwise would be a menace both to themselves and the rest of the community.

At the present time in New Zealand there are reasonably complete provisions for the treatment, of patients suffering from venereal diseases. In many cases, of course, treatment is, and always will be, a matter of private arrangement between the doctor and the patient. The State is not concerned in such cases, except in ensuring that the patient remains under treatment until cured, and observes certain requirements specified by regulation. In the case of patients however, who cannot afford to pay for private treatment, the following provisions have been made: —In the four main centres, clinics have been established at the jntblic hospitals under the charge of part-time specialist medical officers- The clinics are open at fixed hours for male and female cases respectively. The fact that treatment .is available at these clinics has been made widely known by public notices. In all other towns wherever a hospital is located, treatment may be obtained at the hospital. In other parts of New Zealand, where public hospital facilities are not available within reasonable distance, the Department pays medical, practitioners to undertake’the treatment of patients who cannot afford payment lor treatment. It is recognised that the accuiate diagnosis of cases is essential. With this end in view, the Department has arranged for the free examination of specimens from patients sulfering itom venereal diseases at all bacteriological laboratories throughout the Dominion. The mere elaborate and expensive Warsert’inann tests are carried out free in all eases where they are deemed necessary in the interests of public health.

AN OFFICIAL .REPORT. At the recent meeting of the Board of Health, considerable discussion took place on the presentation of a report on the working of tire law relating to venereal diseases in New Zealand. After briefly reviewing the laws governing these diseases and the present provision for their treatment, the report gave some detailed information in. regard to the incidence of the diseases in New Zealand. Returns from public clinics in the four main centres were quoted which show a very substantial )decline in the cases of syphilis under treatment during the period for which figures are available, but a very definite increase in the numbers in the cases of gonorrhoea at public clinics betokens an actual .increase of the disease, or is merely due to the wider knowledge of the existence of the clinics and increased use.of the facilities provided. Whichever explanation is accepted, there is every reason to believe that the decreased attendance off cases of syphilis at the public clinics represent an actual decline in the incidence of tin's disease. This is regarded as one of the most encouraging features of the modern crusade against venereal disease and is due to improved methods of treatment and more particularly to the use of modern arsenica l preparations. Some interesting figures were also supplied which allord an indication of the incidence of venereal disease outside of the lour main centres. In one of the provincial districts the doctors I

have for some time past voluntarily reported to the Medical Officer of Health the number of cases attended by them. The figures show that syphilis is five times and gonorrhoea twice as rife in the main centres as in this particular district, which is regarded as reasonably representative, of the rest of New Zealand. An inquiry was also made as to the extent to which venereal diseases are imported from overseas. The consensus of opinion is that infection from overseas is not a factor of much moment in the spread of venereal diseases within the Dominion. In this connection it should perhaps be added that in 1925 New Zealand signed an international agreement whereunder the subscribing countries guaranteed to establish and maintain at their chief ports clinics at which sailors suffering from venereal diseases could be treated free of cost. At present, then, sailors suffering from venereal diseases have every inducement to report- the fact upon their arrival in New Zealand waters in so far as facilities are available where they may receive treatment entirely free of cost.

Some comment was made upon the efficacy of the existing law- Figures were given showing the number of patients who through carelessness or ignorance had failed to continue treatment until cured and who had been picked up through the provisions of the Social Hygiene Act and Regulations requiring notification of names and addresses of such persons to the Department of .Health. Apart from the actual cases which have been followed up in this way there is good reason to believe that the knowledge that there is power to enforce treatment has been a deciding factor in determining many patients to continue treatment until cured. The opinion was freely expressed by the medical officers consulted that the present legal machinery, although imperfect, had proved of definite value. “The essentials in a campaign against venereal disease,’’ the report went on to say. “are first the provision of adequate facilities for diagnosis and treatment, and second the education of the public as to the need for early and thorough treatment.’’ It is considered that the provisions for diagnosis and treatment in New Zealand arc reasonably adequate, but that there is still hick of appreciation on the part of many patients of the importance of early and thorough treatment. To counter this it is suggested that the Department should make an earnest attempt to enlist the more active interest and co-operation of the medical profession, and should urge all doctors to warn their patients of the importance of continuing treatment until cured, and to report to the Department any patient who ignores this advice and who fails to report for treatment upon the date appointed by his medical attendant. The report concludes by emphasising the dangers of seeking to deal with venereal diseases by means of drastic legislation, and points out that educative rather than repressive measures may be expected to give the best results in dealing with such complex diseases. During the discussion on the report it was recognised that there is need for fuller knowledge oil the part of the public of these particular diseases, and that any information which could be given in regard to the present position could only be of value. Accordingly a resolution was passed suggesting that suitable extracts be published in the newspapers with the view of informing the public as io what actually has been and is being done to assist in combating these dread diseases.