Venereology

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Venereology

 

a branch of medicine concerned with infectious diseases transmitted mainly by sexual intercourse (venereal diseases). References to venereal diseases are found in Egyptian papyruses, Chinese literary sources (2500 B.C.), and religious myths of the American Indians and in the writings of Hippocrates (fifth to fourth centuries B.C.), Celsus (first century B.C. to first century A.D.), Plutarch (first to second centuries), Aretaeus (second century), Galen (second century), and others.

Venereology separated from general medicine and became an independent discipline at the end of the 15th century, when a syphilis pandemic broke out in Europe. As syphilis spread through Europe, it was called either the Italian disease (1494) or the French disease (1496). Syphilis and gonorrhea were long regarded as a single disease because little was known about the causative agents and because of the mistaken notions of the late 18th-century English scientist J. Hunter, who injected himself with pus from a gonorrhea patient who was apparently suffering from syphilis at the same time; a primary syphiloma formed at the injection site.

The French school of venereologists arose in the first half of the 19th century; P. Ricord was its founder. To demonstrate the differences between these diseases, Ricord performed barbaric experiments on human beings (1838), deliberately infecting 600 persons with syphilis and 800 with gonorrhea. In doing so, Ricord made some gross mistakes: he argued that the secondary manifestations of syphilis are not contagious and combined chancroid (soft chancre) and hard chancre into a single disease. In 1879 the founder of the Breslau school of venereologists, A. Neisser, discovered gonococcus, the causative agent of gonorrhea, thereby conclusively demonstrating the independence of this disease. In 1885 the Italian physician P. Ferrari found streptobacilli in the discharge of a chancroid, and in 1887 the Russian scientist O. V. Petersen demonstrated experimentally that Streptobacillus is the causative agent of chancroid—that is, he established the difference between soft and hard chancres. The experiments of the Russian scientist E. Metchnikoff and the French scientist E. Roux in 1903 and of the Russian scientist D. K. Zabolotnyi in 1904 demonstrated the possibility of infecting apes (chimpanzees and baboons) with syphilis and experimentally inducing all periods of syphilitic infection in them. In 1905 the German scientists F. Schaudinn and E. Hoffmann discovered the causative agent of syphilis, Spirochaeta pallida, and in 1906 the German scientist A. von Wassermann proposed the Wassermann test as a means of diagnosing syphilis.

Lymphogranuloma inguinale, which was first described as an independent disease in 1913 by the French physicians J. Durand, J. Nicolas, and M. Favre, is caused by a specific filterable virus. This virus was studied from 1930 to 1934 by the German scientists S. Hellerström and E. Wassen and was described in detail by the Japanese bacteriologist Y. Miyagawa (1935-36).

The Russian scientists S. A. Venechanskii, A. G. Bakherakht, N. I. Pirogov, M. Ia. Mudrov, P. P. Zablotskii-Desiatovskii, and others played a major role in the development of venereology. The first Russian dissertation on venereology was defended by S. A. Ter-Gukasov in Moscow in 1824. In 1829, Mudrov began to lecture medical students on syphilis, and in 1846, F. Koch published the first handbook of venereology in St. Petersburg. Others who lectured on the subject include N. I. Pirogov, G. A. Zakhar’in, S. P. Botkin, and A. I. Pol’. In 1869 the first special sub-department of dermatological and venereal diseases in Russia was established at Moscow University, with D. I. Naidenov as its head. Similar subdepartments were organized in St. Petersburg (directed by V. M. Tarnovskii) in 1870 and in Kazan (directed by A. G. Ge) and Kiev (directed by M. I. Stukovenkov) in 1883. These subdepartments stimulated the development in Russia of venereology as a science. In 1872 the Russian physician A. G. Polotebnov reported the possibility of using green mold (Penicillium glaucum) to heal syphilitic ulcers, and in 1869-70 he wrote the Course on Venereal Diseases. P. F. Bogdanov, G. D. Voskresenskii, V. E. Dembskaia, M. I. Molchanov, and others did important research on the mechanism of development and treatment of gonorrhea. The Russian Journal of Dermatological and Venereal Diseases was founded in Kharkov in 1901 under the editorship of I. F. Zelenev.

After the Soviet regime came to power, institutes of dermatology and venereology were organized in Moscow, the national republics, and the large oblasts, and the number of medical schools and independent departments of dermatological and venereal diseases increased greatly. Scientific societies also played a major part in the development of venereology. Russia’s first society of venereologists was organized in 1885 in St. Petersburg (with V. M. Tarnovskii as president), and in 1891 a scientific society of dermatologists and venereologists was organized in Moscow. The All-Union Scientific Society of Dermatologists and Venereologists was founded in 1937. Scientific societies were organized in the republics, with branches in oblasts and cities. Associations of dermatologists and venereologists in the United States, Great Britain, France, and Italy and dermatological societies in the German Democratic Republic, the Federal Republic of Germany, Poland, Bulgaria, Czechoslovakia, and other countries are also working on scientific problems and exchanging knowledge in the field of venereology. The USSR has been a member of the International Union Against the Venereal Diseases and the Tre-ponematoses since 1924.

The First International Venereological Congress was held in Paris in 1889. Subsequent congresses were held in Brussels, Paris, Berlin, New York, Budapest, Rome, and other cities. An all-Russian congress met in 1897 to discuss ways of combating syphilis. Aspects of the clinical picture, treatment, and control of venereal diseases were discussed at the Pirogov congresses, which convened periodically. All-union congresses of venereologists and dermatologists (the first was held in 1923), as well as congresses and conferences of the union republics and oblasts, are held in the USSR.

Important contributions to the experimental study of syphilis (on animals) have been made by the Soviet scientists P. S. Grigor’ev (1932), L. A. Shteinlukht (1949), and P. G. Oganesian (1959), the American scientists C. D. Post and G. C. Coony (1933) and H. J. Magnuson (1951), and the French scientist L. M. Pautrier (1936).

The biology of the causative agents of venereal diseases was studied by the Russian scientist A. Ia. Vilenchuk (1947), the American scientists H. E. Morton and T. F. Anderson (1942) and R. A. Nelson (1948), the French scientist F. Jahnel (1949), the English scientist A. Wilson (1953), and others. The Soviet scientist N. M. Ovchinnikov and his coworkers (1967), using an electron microscope, discovered several developmental and structural characteristics of Spirochaeta pallida, leptospira, and borrelias. G. I. Meshcherskii (1924), S. T. Pavlov (1934), and S. E. Gorbovitskii (1944), the German scientist W. Kolle (1935), and others did research on immunity to venereal diseases.

In addition to reinfection and superinfection, the question of nonspecific immunity, which was treated by Ovchinnikov, V. A. Rakhmanov (and his coworkers), and others, is of considerable interest. The diagnosis and treatment of syphilitic lesions of the viscera and nervous system were studied. The serodiagnosis of venereal diseases was investigated by the Soviet scientist N. M. Ovchinnikov (1935-62), the American scientists R. A. Nelson and M. Mayer (1949), and others. New, highly sensitive specific reactions to diagnose syphilis (the immunofluorescence reaction and the immobilization reaction of treponemas) have been developed and put into practice. The symptoms and treatment of syphilis were extensively researched by the Soviet scientists O. N. Podvysotskaia (1956), V. Ia. Arutiunov and N. S. Smelov (1959), M. A. Rozentul (1967), and others. V. A. Rakhmanov and his coworkers (1968) discovered new characteristics of the course of syphilis. The advantage of long-term intermittent treatment of syphilis and the high therapeutic efficacy of penicillin preparations (Bicillin-1, -3, -4, and -6) were demonstrated. Various aspects relating to the prevention and treatment of congenital syphilis were developed in detail by the Russian scientists B. M. Pashkov (1955), Zh. Ome (1956), M. M. Raits (1959), and others. The Soviet scientists V. E. Dembskaia (1956), I. M. Porudominskii (1967), E. N. Turanova (1968), and others studied in detail certain aspects of the etiology and pathogenesis of gonorrhea and developed plans for the treatment of the disease with Bicillin. Considerable attention is devoted to the study of organizational forms of controlling venereal diseases, especially in the socialist countries—in the USSR, for example, by E. D. Ashurkov (1954), M. P. Batunin (1962), N. M. Turanov (1965), and N. V. Nikitina (1968). Institutes of dermatology and venereology are undertaking a great deal of research in this field.

New and urgent questions of scientific and practical venereology are discussed in the pages of such specialized journals of dermatology and venereology as Archives of Dermatology (New York, since 1960), British Journal of Venereal Diseases (London, since 1947), Acta dermato-venereologica (Stockholm, since 1920), Indian Journal of Dermatology and Venereology (Bombay, since 1955), Annales de dermatologie et syphiligraphie (Paris, since 1868), Dermatologische Wochenschrift (Leipzig, since 1882), and Dermatologiia i venerologiia (Sofia, since 1962). Soviet monthly publications dealing with the subject include Vestnik dermatologii i venerologii (Moscow, since 1957; previously published under other names) and Meditsinskii referativnyi zhurnal (since 1957; called Sovetskoe meditsin-skoe referativnoe obozrenie from 1948 to 1956).

REFERENCE

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

I. IA. SHAKHTMEISTER

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