The terrible peril: a historical perspective on the venereal diseases.

Abstract

I have chosen a historical theme for my lecture today to mark the creation of the first chair of genitourinary medicine in the world. The first part is concerned with the events leading to the creation of an organised clinical service for the venereal diseases in the UK and its subsequent growth. In the second part I will examine the history of the Middlesex Hospital in relation to these diseases and the development of the new academic depart ment. During the nineteenth and early twentieth centuries govern ment reports and legislation did not manage to control these diseases, and, if anything, created more controversy than the illnesses themselves. The Contagious Diseases Acts of 1864 and 1866 required the compulsory registration and police super vision of all prostitutes plus regular examinations and even compulsory hospital detention. The Royal Commission on Poor Laws of 1909 also recommended detention orders for patients with these diseases, and the Royal Commission on Divorce of 1912 reported that the passing on of a venereal disease was an act of cruelty second to none as grounds for divorce. Society was happier ignoring the problems of these illnesses and, if forced to face them, developed suitable defence mechanisms. One was to project the blame on to the prostitute, or treat her as a non-person. George Vivian Poore, discussing the rape of prostitutes by Jack the Ripper in his book on medical jurisprudence, maintained that they were not violated because most of them were prostitutes.1 Other mechanisms to contain the realities of the problem were by detaining the patient or classifying the passing on of such disease as cruelty. The medical profession often added to this censorious and moralistic sup pression. Dr Samuel Solly, president of the Royal Medical and Chirurgical Society, giving evidence to a government com mittee, said of syphilis that it was self-inflicted, was avoidable by refraining from sexual activity, and was intended as a punishment for our sins and that we should not interfere in the matter.2 Even though this was said in 1868, attitudes had not greatly changed by the turn of the century, and some doctors still refused to treat venereal diseases. It was reported that one had written to a patient as follows, You have had the disease one year, and I hope it may plague you many more to punish you for your sins and I would not think of treating you.3