Venereal Diseases


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Venereal Diseases

 

a group of infectious diseases (syphilis, gonorrhea, chancroid or soft chancre, and lymphogranuloma inguinale) that are transmitted principally by sexual intercourse. The term “venereal disease” was proposed in 1527 by the French scientist J. de Béthencourt.

Venereal diseases have been known since early antiquity (2500 B.C.); however, they were regarded as one single disease. The individual venereal diseases were distinguished as independent diseases after the discovery of their causative agents.

The spread of venereal diseases is fostered by casual sexual contacts. The social significance of venereal diseases is defined by their wide distribution, their serious consequences for the health of the patients themselves, and their danger to society. If they are improperly treated, venereal diseases take a prolonged course and cause long-term loss of ability to work, and sometimes even invalidism. Gonorrhea may be the cause of many gynecological diseases and of male and female infertility; untreated or insufficiently treated syphilis is transmitted to offspring, causing congenital defects, blindness, and deafness. Without treatment, or with treatment that is begun too late or is performed carelessly or incompletely, syphilis may be complicated by serious affections of the internal organs and the nervous system. In colonial and underdeveloped countries, where elementary sanitary and hygienic habits are absent among the population, and also as a consequence of certain religious customs that promote transmission of disease, syphilis (spreading, as a rule, through everyday activities rather than sexually) may be if it is not treated one of the causes of extinction of a population.

The social and economic conditions of capitalist countries—crises that cause mass unemployment; colonial wars and racial discrimination, which push women toward prostitution; alcoholism (infection often occurs in a drunken state); late marriage owing to material insecurity; the satiation with life of the more secure circles of capitalist society; and the corrupting influence of erotic literature, art, and cinema—generate and maintain a high level of morbidity from venereal diseases. Some bourgeois theoreticians deny the social roots of the widespread distribution of venereal diseases in capitalist society and endeavor to explain the growth of venereal diseases by people’s lack of concern for their health, personality defects, loss of the feeling of responsibility before god, the absence of an international struggle against venereal diseases, and other secondary causes.

Venereal diseases became widespread in Europe at the end of the 15th century, a condition fostered by colonial wars, the race for new markets, the development of cities, and the growth of prostitution in the cities.

The incidence of venereal diseases in present-day capitalist countries cannot be accurately calculated. Obligatory recording of venereal diseases does not exist in all capitalist countries; it was introduced in Denmark in 1854, in Norway in 1874, in Finland in 1894, in Australia in 1917, in the USA in 1918, and in Sweden in 1919. However, patients’ attempts to hide their illness and treatment by private physicians make it impossible to compile a complete representation of the scope of morbidity from venereal diseases. According to official data of the World Health Organization, from 1956 through 1967 the number of patients in the USA with new types of syphilis increased from 4.1 to 10.8 per 100,000, and in France from 1960 to 1965 the number of persons afflicted with syphilis increased from 5.5 to 9.3 per 100,000; in Norway it increased by a factor of 2.7, in Sweden 5.1, and in Denmark 9.4.

In capitalist countries control of venereal diseases is limited to half-measures—the regulation of prostitution, the registration of venereal-disease patients, and so on. But since the bulk of patients in these countries are treated by private physicians, all these laws, as a rule, do not achieve their goal. In the USA in 1918-19, according to information provided by 22 percent of the physicians, there were 100,466 syphilis patients and 131,193 gonorrhea patients; 42,805 new cases of syphilis were recorded in Great Britain (1920), and in France 10 percent of the population was affected by syphilis (1922).

In Russia in 1915 there were 96 syphilis patients per 100,000. Of the total number of patients recorded children constituted 24.9-30 percent. The greatest incidence of venereal diseases occurred in Penza, Simbirsk, and Tambov provinces, Buriat-Mongolia, Bashkiria, Turkmenia, and Kara-Kalpakia; in these areas, syphilis was also spread by everyday activities. In tsarist Russia, progressive physicians (S. A. Venechanskii, A. G. Bakherakht, P. P. Zablotskii-Desiatovskii, N. P. Mansurov, M. I. Stukovenkov, V. M. Tarnovskii, A. I. Pospelov, A. G. Polotebnov, T. P. Pavlov, and others) did a great deal of work in the struggle against venereal diseases. The Russian Society of Syphilologists (organized in 1885; the first in Europe), the Pirogov congresses, and the All-Russian Conference on the Discussion of Measures Against Syphilis (convoked in 1897; the first in the world) played an important role in this connection. However, in spite of all the efforts of the medical community, because of poverty, cultural backwardness, and the absence of medical help in many rural localities, syphilis continued to cripple the inhabitants of entire villages, some of which (for example, the village of Starozhivotinnoe, Voronezh Province) became completely extinct.

After the October Revolution, with the establishment of a socialist system of public health, the struggle against venereal diseases became possible on a governmental scale. In 1918 the Central Medical Commission on the War Against Venereal Diseases was formed; subsequently a special section in the People’s Committee of Public Health of the RSFSR for the struggle against social diseases was formed. In 1921 the Government Venereological Institute, which became the organizational and scientific-methodical center in the war against venereal diseases, was opened in Moscow. Subsequently, similar institutes were created in almost all union republics and in some large oblasts.

The development of a powerful network of antivenereal institutions was of great significance: whereas in tsarist Russia there were only 12 dermatological-venereological outpatient clinics, in the USSR as early as 1924 there were 60 dermatological-venereological dispensaries, by 1940 there were 3,063 venereological institutions, in 1950 there were 5,466, and in 1965, 6,123. The number of beds in these institutions also increased significantly (7,100 in 1926, 15,400 in 1940, and 36,000 in 1965). In 1940 there were 4,807 dermatologist-venereologists, and by 1965 there were 10,268. The growth of specialized institutions, in connection with a sharp decrease in the number of patients, permitted the organization of timely medical help in cases of venereal diseases and the adoption of prophylactic measures.

In the USSR, unified forms and methods of combating venereal diseases have been developed. The principal procedures consist in the obligatory counting of venereal-disease patients, discovery of the sources of infection and examination of persons having contact with the patient. Prophylactic examinations of workers in food enterprises, public baths, barbershops, and children’s institutions are conducted periodically; pregnant women are examined for the purpose of prophylaxis against congenital syphilis; and compulsory free treatment of venereal diseases, clinical care of patients, and sanitary education are provided. Soviet law (RSFSR Criminal Code, article 115), establishes criminal responsibility for the infection of another person with a venereal disease by a person who knows of the presence of this disease in himself (punishable by deprivation of freedom for a term up to three years or by corrective labor for a period up to one year). Medical secrecy protects the interests of venereal-disease patients who apply for treatment or prophylactic help in medical institutions. Information about patients is given only upon demand of judicial-investigative bodies, and also in cases where the patient threatens the health of people around him by his behavior.

Present-day drugs and methods make it possible to cure venereal diseases completely if application for medical help is made in time and if careful treatment is provided. In the USSR, chancroid and lymphogranuloma inguinale have been eliminated, and morbidity from syphilis and gonorrhea has been substantially reduced. In the new socioeconomic conditions, and thanks to organizational methods in the USSR and in other socialist countries, all the conditions for complete elimination of venereal diseases have been created.

REFERENCE

Mnogotomnoe rukovodstvo po dermato-venerologii, vol. 1. Moscow, 1959.

I. IA. SHAKHTMEISTER

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