Trends in the prevalence of venereal diseases in England and Wales.

Abstract

The venereal diseases are and have been of particular interest to the epidemiologist throughout recorded history. We learn from Leviticus xv, that, in Biblical times, doubtless in response to the best epidemiological advice of the day, sufferers from gonorrhoea were excluded from the tabernacle; not only was the patient himself considered unclean but also his bed, garments, and anything he might have sat upon-including his saddle, and also his eating and drinking vessels. The infected patient remained an outcast from the camp for 7 days after the cessation of the discharge, and could then make atonement by disinfection and by the offering in the tabernacle of two turtle doves or two young pigeons. Whether syphilis existed in those times is more controversial, but the drastic preventive medicine ordered by Moses, entailing the slaughter of all the Midianite women hath known man by lying with him (Numbers xxxi) was founded upon an epidemiological study of the plague of Moab which some believe to have been an example of this serious disease (Willcox, 1949). In modern times the venereal diseases still offer an opportunity for epidemiological studies, as most countries can supply at least crude statistics of the numbers of cases treated in hospitals and clinics. Only when a national health service has reached the stage of being adequate for the potential demand, do such statistics become of value in assessing trends of prevalence. The present paper is concerned with trends in the prevalence of the venereal diseases in the clinics of England and Wales (which are officially considered separately from Scotland) during the past 35 years. The statistics from these clinics, published annually in the Report of the Chief Medical Officer to the Ministry of Health, are available for each year since 1925; greater detail has been supplied since 1931 and again since 1951. The author has drawn freely on these figures, and also on those published by the British Cooperative Clinical Group (1956, 1960a, b, 1962). It must, however, be emphasized that these take no account of patients treated by private practitioners; surveys have shown that these may not be as numerous as is sometimes thought (British Cooperative Clinical Group, 1959).