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The Prevention of Venereal Disease
22
PUBLIC HEALTH, November, 1945
2. Research should be directed (if the remedy is not known) to the alleged wearing or corrosion of zinc sheeting by water dripping on to it from tiled roofs. There seems to be some chemical or physical action of tiles on zinc: it is a pest in this district. 3. Roof gutters and their supports should be made strong enough to stand up to .the weight of snow accumulating on roofs and drifting to the gutter edge. Colossal damage results in this district from this cause. 4. All drains, pipes, telephone and electric wires laid below ground should be charted and named on the plans of houses, and copies thereof supplied to those buying leasehold or'~freehold property or otherwise being liable for house maintenance. I have recently been put to much trouble and expense tracing a downpipe drain that ran under a return-building to a rubble-hole in the next garden. Even the agent for the ground rent had no plans of these drains. 5. The posts for wooden fences bounding house property should be made of concrete with suitable slots for the wooden horizontals. Even 30 years ago concrete fence posts were the standard thing in ~tqew Zealand; why not here ? Wooden posts are continually rotting away from fungus action at ground teveI and have to be replaced every few years. These points relate mainly to better-class housing, but for all that deserve attention, as I think you will agree. Houses should be built primarily from the standpoint of living in them and maintaining them.--I am, etc., I I, Vesey Road, E . H . WILKINS. Wvlde Green, Birmingham. BOOK REVIEWS B y R. Y. Kmms a n d B. G . RIGDEN. E. & S. L i v i n g s t o n e , L t d . Pp. 273. Price
Pulmonary Tuberculosis.
Edinburgh: 17s. 6d. T h i s is a s o u n d book w h i c h p r e s e n t s a w e l l . b a l a n c e d acc o u n t of p u l m o n a r y t u b e r c u l o s i s as b o t h a clinical a n d social malady. T h e e m p h a s i s is o n t h e clinical aspect, w h i c h is adequately covered w i t h o u t too m u c h t e c h n i c a l detail of n o p a r t i c u l a r interest to ' t h e general practitioner. T h e book can also b e r e c o m m e n d e d to t h o s e b e g i n n i n g to specialise in the subject a n d w h o desire some f o u n d a t i o n f r o m w h i c h to start. T h e a u t h o r s are wise to stress t h e p o i n t t h a t history, x - r a y examination, a n d bacteriology are m o r e i m p o r t a n t t h a n physical signs in t h e early diagnosis of t h e disease. T h e a c c o u n t of t r e a t m e n t follows m o d e m views, e x c e p t for advocacy of t h e u s e of gold p r e p a r a t i o n s , e v e n if o n a limited scale. T o do m o r e t h a n m e n t i o n t h e n o n - p u l m o n a r y m a n i f e s t a t i o n s seems u n n e c e s s a r y , a n d we w o n d e r w h y t h e a u t h o r s t h o u g h t it desirable to include an a c c o u n t of u r i n a r y a n d m a l e genital tuberculosis. T h e t e x t is illustrated w i t h n u m e r o u s r e p r o d u c t i o n s of x - r a y films, b u t u n f o r t u n a t e l y t h e stafidard o f t h e r e p r o d u c t i o n s is n o t always good. T h e r e are also illustrations of pathological specimens. I t is a pity t h a t t h e e m i n e n t w r i t e r of t h e f o r e w o r d h a s seen fit to express views a b o u t local a u t h o r i t i e s a n d S t a t e c o n t r o l w h i c h are irrelevant to t h e subject m a t t e r of t h e book.
The Prevention of Venereal Disease.
By L. ~/IARTINDALE,
C.B.E., M.D., B.S., F.R.C.O.G. L o n d o n : R e s e a r c h Books ( W m . H e i n e m a n n ) , L t d . 1945. P p . 74. P r i c e 2s. 6d. T h e prevailing policy of a d v e r t i s e m e n t a n d p u b l i c i t y relating to t h e v e n e r e a l diseases a n d t h e i r p r e v e n t i o n gives scope for a n i n f o r m a t i v e booklet o n this subject for t h e intelligent a n d e n q u i r i n g layman. T o p r o v i d e t h i s i n f o r m a t i o n in t h e r i g h t language, w i t h t h e r i g h t r e s t r a i n t a n d w i t h e m p h a s i s in t h e r i g h t p l a c e s , is a difficult task. D r . M a r t i n d a l e ' s p r e s e n t a t i o n of t h e s u b j e c t suffers in t h a t its u n d e n i a b l y good qualities are often o b s c u r e d , a n d it is to b e feared t h a t in m a n y m i n d s t h e u l t i m a t e effect m a y b e c o n f u s i o n of t h o u g h t r a t h e r t h a n clarification of ideas. T h e first p a r t o f t h e booklet is d e v o t e d to a d e s c r i p t i o n of t h e t h r e e m a i n venereal diseases, t h e i r causes, s y m p t o m s a n d signs, a n d t r e a t m e n t , a n d it is h e r e t h a t t h e r e is m o s t m a t t e r for criticism. T h e language u s e d varies f r o m t h e c o n u n e n d a b l y simple to t h e h i g h l y technical, a n d t h e f r e q u e n t c h a n g e s f r o m o n e to t h e o t h e r m u s t b e as c o n f u s i n g to t h e l a y m a n as they are irritating to t h e m e d i c a l reader. S o m e of t h e m e t h o d s of t r e a t m e n t r e c o m m e n d e d are controversial a n d others are q u i t e o u t of date, b u t for t h e m o s t p a r t t h e y are
p u t forward so dogmatically t h a t t h e r e a d e r u n d e r t r e a t m e n t w h o h a s great f a i t h in t h e w r i t t e n w o r d m i g h t b e f o r g i v e n f o r losing confidence in his m e d i c a l a t t e n d a n t . T h e a u t h o r ' s h a b i t o f giving initial capital letters to t h e diseases a n d t h e i r causative o r g a n i s m s is u n n e c e s s a r y , a n d is a p t to give t h e i m p r e s s i o n of a r a t h e r d i s t u r b i n g series o f headlines. S u c c e e d i n g p a r t s of t h e booklet deal w i t h p a s t a n d p r e s e n t m e t h o d s u s e d to control t h e v e n e r e a l diseases b y legislation, a n d b y o t h e r m e a n s , a n d t h e policy a d o p t e d in t h i s c o u n t r y is c o n trasted w i t h t h a t w h i c h o b t a i n s in o t h e r p a r t s of t h e world. T h e r e is m u c h useful i n f o r m a t i o n in these pages, b u t it is clear t h a t D r . M a r t i n d a l e h a s s t r o n g views o n these m a t t e r s a n d h e r p r e s e n t a t i o n of certain v e x e d q u e s t i o n s s u c h as, for instance, t h e m a t t e r of notification, is a p t to b e one-sided. S h e does less t h a n j u s t i c e to t h e value of R e g u l a t i o n 33B, especially w h e n unofficial action is t a k e n o n a single notification, as it n o w so often is. The measures which the author r e c o m m e n d s for t h e s o l u t i o n of t h e p r o b l e m o f v e n e r e a l diseases are t h r e e in n u m b e r : full e m p l o y m e n t for w o m e n o n a basis of equality w i t h m e a s u r e s to reclaim a n d a d e q u a t e l y to t r a i n t h e p r o s t i t u t e , repressive m e a s u r e s against c o m m e r cialised p r o s t i t u t i o n , a n d a w i d e s p r e a d appeal for t h e i m p r o v e m e n t of m o r a l s t a n d a r d s . T h e p r e s e n t facilities for diagnosis a n d t r e a t m e n t are r e g a r d e d as a d e q u a t e in association w i t h a c o n t i n u e d p r o g r a m m e of careful publicity. A p p e n d i c e s i n c l u d e t h e R e p o r t of t h e C o m m i t t e e of I n q u i r y o n V e n e r e a l Disease of 1922 a n d a list of t h e v e n e r e a l diseases clinics in G r e a t B r i t a i n . The Industrial Health Research Board of the Medical Research Council has issued a pamphlet on " T h e Problem of Sickness Among Women in Industry " (Pamphlet 3, London, H.M.S.O., price 4d.) The first part of the pamphlet is based on the investigations carried out by the Industrial Health Research Board during the last six months of 1942 ("A Study of Certified Sickness Absence Among Women in Industry," H.M.S.O., price 10d. post free). During these six months, 45% of the women were not absent at all, and many of the others had only short illnesses, with the result that two-thirds of the total amount of time lost through illness was caused by 16% of the women. Thus, special care of a comparatively small number of women might lead to a big reduction in the time lost. Among the most common causes of absence were respiratory diseases, nervous diseases and fatigue, and digestive disorders. At the end of the pamphlet the women's own comments on shift work are quoted and discussed. Week-end work was so unpopular that, as one woman said, " I t would be worth losing wages to have the Sunday night shift off." Only about one-third of the women disliked the night shift, but those who did dislike it found it very tiring and boring, often causing unhappiness, worry, and irritation because of disturbance of family life. Sick absence was found frequently to be connected with some personal worry outside factory life; for instance, housekeeping difficulties, husbands and sweethearts overseas, or worry about the health of a member of the family. A t the end of the pamphlet it is suggested that careful medical examination might reveal the need for special medical treatment in certain cases, tlgat the kind of jobs done by these women should be studied, and the hours of work adapted or reduced. It is also suggested that young married women have a high rate of sickness absence and that, therefore, it may be an unwise policy to engage them on full-time work.
OBITUARY ERNEST WARD, M.D., F.R~C.S.
We much regret to announce the death, on September 21st, of Dr. Ernest Ward, a former President of the Society of Medical Officers of Health and for many years tuberculosis officer for South Devon, For the past decade and more his friends and colleagues had watched in him the slow march of the physically encasing affliction known as Parkinsonism. Although his movements became more and more restricted and disabling his intellect remained clear and his courage undaunted. He seemed to have schooled himself to view his prolonged disorder with detachment of mind, and with stoic cheerfulness to carry on his many activities so long as he felt he had a contribution to make. Born in 1877, Ernest Ward was the son of Sir John Ward, an active force in the municipal life of Leeds and twice mayor of that city. Ernest Ward went to Cambridge,as a scholar of Clare, a college with a mathematical tradition. He took firstclass honours in both parts of the Natural Science Tripes and continued his medical studies at the London Hospital, with which he maintained an association all his life. After qualifying in
PUBLIC HEALTH, November, 1945
2. Research should be directed (if the remedy is not known) to the alleged wearing or corrosion of zinc sheeting by water dripping on to it from tiled roofs. There seems to be some chemical or physical action of tiles on zinc: it is a pest in this district. 3. Roof gutters and their supports should be made strong enough to stand up to .the weight of snow accumulating on roofs and drifting to the gutter edge. Colossal damage results in this district from this cause. 4. All drains, pipes, telephone and electric wires laid below ground should be charted and named on the plans of houses, and copies thereof supplied to those buying leasehold or'~freehold property or otherwise being liable for house maintenance. I have recently been put to much trouble and expense tracing a downpipe drain that ran under a return-building to a rubble-hole in the next garden. Even the agent for the ground rent had no plans of these drains. 5. The posts for wooden fences bounding house property should be made of concrete with suitable slots for the wooden horizontals. Even 30 years ago concrete fence posts were the standard thing in ~tqew Zealand; why not here ? Wooden posts are continually rotting away from fungus action at ground teveI and have to be replaced every few years. These points relate mainly to better-class housing, but for all that deserve attention, as I think you will agree. Houses should be built primarily from the standpoint of living in them and maintaining them.--I am, etc., I I, Vesey Road, E . H . WILKINS. Wvlde Green, Birmingham. BOOK REVIEWS B y R. Y. Kmms a n d B. G . RIGDEN. E. & S. L i v i n g s t o n e , L t d . Pp. 273. Price
Pulmonary Tuberculosis.
Edinburgh: 17s. 6d. T h i s is a s o u n d book w h i c h p r e s e n t s a w e l l . b a l a n c e d acc o u n t of p u l m o n a r y t u b e r c u l o s i s as b o t h a clinical a n d social malady. T h e e m p h a s i s is o n t h e clinical aspect, w h i c h is adequately covered w i t h o u t too m u c h t e c h n i c a l detail of n o p a r t i c u l a r interest to ' t h e general practitioner. T h e book can also b e r e c o m m e n d e d to t h o s e b e g i n n i n g to specialise in the subject a n d w h o desire some f o u n d a t i o n f r o m w h i c h to start. T h e a u t h o r s are wise to stress t h e p o i n t t h a t history, x - r a y examination, a n d bacteriology are m o r e i m p o r t a n t t h a n physical signs in t h e early diagnosis of t h e disease. T h e a c c o u n t of t r e a t m e n t follows m o d e m views, e x c e p t for advocacy of t h e u s e of gold p r e p a r a t i o n s , e v e n if o n a limited scale. T o do m o r e t h a n m e n t i o n t h e n o n - p u l m o n a r y m a n i f e s t a t i o n s seems u n n e c e s s a r y , a n d we w o n d e r w h y t h e a u t h o r s t h o u g h t it desirable to include an a c c o u n t of u r i n a r y a n d m a l e genital tuberculosis. T h e t e x t is illustrated w i t h n u m e r o u s r e p r o d u c t i o n s of x - r a y films, b u t u n f o r t u n a t e l y t h e stafidard o f t h e r e p r o d u c t i o n s is n o t always good. T h e r e are also illustrations of pathological specimens. I t is a pity t h a t t h e e m i n e n t w r i t e r of t h e f o r e w o r d h a s seen fit to express views a b o u t local a u t h o r i t i e s a n d S t a t e c o n t r o l w h i c h are irrelevant to t h e subject m a t t e r of t h e book.
The Prevention of Venereal Disease.
By L. ~/IARTINDALE,
C.B.E., M.D., B.S., F.R.C.O.G. L o n d o n : R e s e a r c h Books ( W m . H e i n e m a n n ) , L t d . 1945. P p . 74. P r i c e 2s. 6d. T h e prevailing policy of a d v e r t i s e m e n t a n d p u b l i c i t y relating to t h e v e n e r e a l diseases a n d t h e i r p r e v e n t i o n gives scope for a n i n f o r m a t i v e booklet o n this subject for t h e intelligent a n d e n q u i r i n g layman. T o p r o v i d e t h i s i n f o r m a t i o n in t h e r i g h t language, w i t h t h e r i g h t r e s t r a i n t a n d w i t h e m p h a s i s in t h e r i g h t p l a c e s , is a difficult task. D r . M a r t i n d a l e ' s p r e s e n t a t i o n of t h e s u b j e c t suffers in t h a t its u n d e n i a b l y good qualities are often o b s c u r e d , a n d it is to b e feared t h a t in m a n y m i n d s t h e u l t i m a t e effect m a y b e c o n f u s i o n of t h o u g h t r a t h e r t h a n clarification of ideas. T h e first p a r t o f t h e booklet is d e v o t e d to a d e s c r i p t i o n of t h e t h r e e m a i n venereal diseases, t h e i r causes, s y m p t o m s a n d signs, a n d t r e a t m e n t , a n d it is h e r e t h a t t h e r e is m o s t m a t t e r for criticism. T h e language u s e d varies f r o m t h e c o n u n e n d a b l y simple to t h e h i g h l y technical, a n d t h e f r e q u e n t c h a n g e s f r o m o n e to t h e o t h e r m u s t b e as c o n f u s i n g to t h e l a y m a n as they are irritating to t h e m e d i c a l reader. S o m e of t h e m e t h o d s of t r e a t m e n t r e c o m m e n d e d are controversial a n d others are q u i t e o u t of date, b u t for t h e m o s t p a r t t h e y are
p u t forward so dogmatically t h a t t h e r e a d e r u n d e r t r e a t m e n t w h o h a s great f a i t h in t h e w r i t t e n w o r d m i g h t b e f o r g i v e n f o r losing confidence in his m e d i c a l a t t e n d a n t . T h e a u t h o r ' s h a b i t o f giving initial capital letters to t h e diseases a n d t h e i r causative o r g a n i s m s is u n n e c e s s a r y , a n d is a p t to give t h e i m p r e s s i o n of a r a t h e r d i s t u r b i n g series o f headlines. S u c c e e d i n g p a r t s of t h e booklet deal w i t h p a s t a n d p r e s e n t m e t h o d s u s e d to control t h e v e n e r e a l diseases b y legislation, a n d b y o t h e r m e a n s , a n d t h e policy a d o p t e d in t h i s c o u n t r y is c o n trasted w i t h t h a t w h i c h o b t a i n s in o t h e r p a r t s of t h e world. T h e r e is m u c h useful i n f o r m a t i o n in these pages, b u t it is clear t h a t D r . M a r t i n d a l e h a s s t r o n g views o n these m a t t e r s a n d h e r p r e s e n t a t i o n of certain v e x e d q u e s t i o n s s u c h as, for instance, t h e m a t t e r of notification, is a p t to b e one-sided. S h e does less t h a n j u s t i c e to t h e value of R e g u l a t i o n 33B, especially w h e n unofficial action is t a k e n o n a single notification, as it n o w so often is. The measures which the author r e c o m m e n d s for t h e s o l u t i o n of t h e p r o b l e m o f v e n e r e a l diseases are t h r e e in n u m b e r : full e m p l o y m e n t for w o m e n o n a basis of equality w i t h m e a s u r e s to reclaim a n d a d e q u a t e l y to t r a i n t h e p r o s t i t u t e , repressive m e a s u r e s against c o m m e r cialised p r o s t i t u t i o n , a n d a w i d e s p r e a d appeal for t h e i m p r o v e m e n t of m o r a l s t a n d a r d s . T h e p r e s e n t facilities for diagnosis a n d t r e a t m e n t are r e g a r d e d as a d e q u a t e in association w i t h a c o n t i n u e d p r o g r a m m e of careful publicity. A p p e n d i c e s i n c l u d e t h e R e p o r t of t h e C o m m i t t e e of I n q u i r y o n V e n e r e a l Disease of 1922 a n d a list of t h e v e n e r e a l diseases clinics in G r e a t B r i t a i n . The Industrial Health Research Board of the Medical Research Council has issued a pamphlet on " T h e Problem of Sickness Among Women in Industry " (Pamphlet 3, London, H.M.S.O., price 4d.) The first part of the pamphlet is based on the investigations carried out by the Industrial Health Research Board during the last six months of 1942 ("A Study of Certified Sickness Absence Among Women in Industry," H.M.S.O., price 10d. post free). During these six months, 45% of the women were not absent at all, and many of the others had only short illnesses, with the result that two-thirds of the total amount of time lost through illness was caused by 16% of the women. Thus, special care of a comparatively small number of women might lead to a big reduction in the time lost. Among the most common causes of absence were respiratory diseases, nervous diseases and fatigue, and digestive disorders. At the end of the pamphlet the women's own comments on shift work are quoted and discussed. Week-end work was so unpopular that, as one woman said, " I t would be worth losing wages to have the Sunday night shift off." Only about one-third of the women disliked the night shift, but those who did dislike it found it very tiring and boring, often causing unhappiness, worry, and irritation because of disturbance of family life. Sick absence was found frequently to be connected with some personal worry outside factory life; for instance, housekeeping difficulties, husbands and sweethearts overseas, or worry about the health of a member of the family. A t the end of the pamphlet it is suggested that careful medical examination might reveal the need for special medical treatment in certain cases, tlgat the kind of jobs done by these women should be studied, and the hours of work adapted or reduced. It is also suggested that young married women have a high rate of sickness absence and that, therefore, it may be an unwise policy to engage them on full-time work.
OBITUARY ERNEST WARD, M.D., F.R~C.S.
We much regret to announce the death, on September 21st, of Dr. Ernest Ward, a former President of the Society of Medical Officers of Health and for many years tuberculosis officer for South Devon, For the past decade and more his friends and colleagues had watched in him the slow march of the physically encasing affliction known as Parkinsonism. Although his movements became more and more restricted and disabling his intellect remained clear and his courage undaunted. He seemed to have schooled himself to view his prolonged disorder with detachment of mind, and with stoic cheerfulness to carry on his many activities so long as he felt he had a contribution to make. Born in 1877, Ernest Ward was the son of Sir John Ward, an active force in the municipal life of Leeds and twice mayor of that city. Ernest Ward went to Cambridge,as a scholar of Clare, a college with a mathematical tradition. He took firstclass honours in both parts of the Natural Science Tripes and continued his medical studies at the London Hospital, with which he maintained an association all his life. After qualifying in