(3)
X.—How far the disease has increased or decreased.
This year there have been 22 cases of primary syphilis and eight of secondary, against
21 of primary and five of secondary in the year 1876. I append the following table for
comparison :—
1874.
1875.
1876.
1877.
Syphilis, primary
..
..
. .
..
28
12
21
22
Do.,
secondary ..
. .
..
..
..
16
19
5
8
Gonorrhœa
..
. .
..
..
..
136
109
119
78
Bubo..
..
..
..
. .
..
. .
2
. .
. .
C ondyloma
..
..
..
..
..
..
..
..
1
Warts
..
..
..
..
..
..
..
. .
1
Ulcer of cervix
..
..
..
. .
..
..
..
..
1
Soft ulcer ..
..
..
..
..
. .
..
..
. .
3
'Total ..
180
142
145
114
In comparing the above, it will be seen that there has not been much diminution of
primary syphilis ; but here I wish to make a remark regarding the cases of primary syphi-
lis this year. Among those 22 cases, I may state that there are a few cases which ought not
to have been classed under the head of "Primary syphilis," but under the head of "Ulcer." At
first, I classed all cases of ulcer under the head of " Primary syphilis ;" but latterly, seeing
that to do so tended to falsify the good that the Act was doing for the last three months of
the year, I did my best to form a more accurate classification. I am aware it is difficult
to always form an accurate diagnosis ; still, everyone is aware that we may often see ulcers
on the genitals of prostitutes, both externally and on the os , which have nothing specific
about them. I think there are, as far as I can remember, five cases which should not
have been entered under the head of "Primary syphilis," and that would leave 17 ; so
that, on the whole, there is a reduction. The last two years have shewn a marked reduc-
tion in the cases of secondary syphilis, and the last year also in gonorrhœa, even although
the 78 cases include all cases of purulent discharge from the vagina and os utiri. Here,
also, I am sure that many of these cases are cases of utirine catarrh or leucorrhœa, and
are not infectious, although I think it better to retain them all for treatment. I append a
table of venereal diseases at the General and Seamens' Hospital and Dispensary :—
Diseases.
1874.
1875.
1876.
1877.
Out -door.
In-door.
Ou t - d o o r .
I n - d o o r .
Out - door .
I n- door .
Out - door .
I n- door .
Syphilis, primary..
. .
. .
..
..
13
2
9
7
16
6
17
3
Do.,
secondary
..
. .
. .
..
15
6
17
2
1 9
3
18
3
Do.,
hereditary ..
. .
. .
..
1
..
. .
..
1
..
1
. .
Gonorrhœa
..
..
. .
. .
47
..
41
4
36
5
42
5
Bubo
..
..
..
..
..
15
4
19
4
13
6
9
4
Phimosis ..
..
. .
..
. .
..
. .
5
1
1
. .
1
. .
Paraphimosis
..
. .
..
. .
1
..
1
. .
..
..
1
2
Stricture ..
..
..
..
..
. .
2
2
..
. .
1
2
2
Hydrocele ..
••
. .
. .
..
..
. .
1
1
..
. .
..
..
Orchitis .. ..
..
. .
..
5
1
9
1
. .
1
..
..
Hæmaturia
..
. .
..
..
..
..
..
. .
1
. .
..
Sinus
..
..
. .
..
..
. .
..
. .
..
. .
..
1
..
Suppression of urine ..
..
..
..
. .
. .
..
..
. .
1
. .
..
Gonorrhœal rheumatism
..
..
..
. .
. .
..
..
. .
. .
3
. .
Syphilitic
do.
..
..
..
. .
. .
. .
. .
. .
..
..
14
4
Do.
iritis
..
. .
. .
. .
. .
. .
. .
. .
. .
..
1
..
Total
..
97
15
104
20
86
24
110
23
It will be seen from the above table that during all these years in Akyab there has
been not any great difference in the totals till the present year, when the total among
the out-patients is considerably larger ; but in looking at the table, the chief difference is
due to the large number of cases of syphilitic rheumatism, of which 14 cases are entered,
and three of gonorrhœal rheumatism. Whether these shew an increase in the amount of
syphilis, or only a better diagnosis of cases of rheumatism, I am unable to state. I am
not aware whether syphilitic rheumatism was put down under " Secondary syphilis," or