19
Causes of increase in cases of
gonorrhœa.
5. The Medical Officers who have had charge of this Hospital have always
ascribed the amount of disease to ineffective registration,
as explained above. I see no good grounds for the state
-ment, nor has the disease been so great as not to be
accounted for in other and obvious ways. The increase in gonorrhœa amongst
the men during the year under report amounts to 7 cases, and this number of men,
as is well known, might be infected by a single woman in a day or two. The
number of cases of disease among women registered for Europeans has been 79
against 39 cases amongst the men (deducting 3 cases not contracted at Saugor
and 12 cases of relapse), consequently there has been sufficient disease amongst
the registered women to account for that amongst the men. The number of cases
of relapse in the Battery of Artillery, viz. 12 out of 20 original cases, suggests a
way in which a considerable amount of disease may have been communicated
to the women, and is sufficient of itself to account for an increased amount of
disease amongst the men. This large number of cases in the Battery of Artillery
is very unusual, and no explanation is offered in the report.
General causes of the disease
prevailing.
6. The following are some of the causes which appear to me to account for
the amount of disease generally prevailing. No examin-
ation can be made of Women who are menstruating : a
Woman consorting with a man in this condition may bring
on an illness resembling gonorrhœa, and which would be entered as gonorrhœa
in the returns ; besides this the woman may be suffering from a venereal disease
at the same time, and may communicate it to the man before she is in a fit
state for examination. The period of menstruation is very variable, and it is not
at all certain that the women present themselves for inspection directly the
period is over ; the danger which exists of contagion from this source may be
judged from the fact that 18 women whose examination was postponed on account
of menstruation, were found to be diseased when subsequently examined. The
remedy for this consists in a rule by which women who are menstruating
shall be detained in Hospital until they are fit for examination. The Me-
dical Officer informs me that cases have sometimes occurred in which he
has reason to suspect that the disease had been concealed for some time,
after having been aware that they are diseased, and disease is without doubt
often communicated to the women in this manner. I am also informed by the
M e d i c a l O f f i c e r t h a t a m a n w h o h a s s u f f e r e d m a n y t i m e s f r o m g o n o r r h œ a m a y
allow the disease to run on without being seriously inconvenienced. Inspections
of the men at uncertain periods, and punishment of the men, would help to
prevent concealment. Though natives may not usually consort with women
licensed to go with Europeans, these women do receive natives, and some of the
cases may be attributed to this cause. If the women licensed for Europeans
could be prevented from going with natives, one source of disease would be prevent-
ed. Women excused attendance at an inspection owing to fever or other illness
are visited by the Native Doctor to ascertain the fact, but they are not examined
for venereal disease. This arrangement appears to be objectionable ; a woman
may be suffering from a sharp attack of fever when visited by the Native Doctor
but after a few hours she may be sufficiently well to receive a man ; many of the
women are very poor and cannnot offord to lose any opportunity of taking money
; w o m e n e x c u s e d a t t e n d a n c e a t t h e H o s p i t a l s h o u l d I t h i n k b e e x a m i n e d a t t h e i r
own houses for venereal disease or conveyed to the Hospital at the expense of
the fund, for inspection. The number of cases (40) of leuccrrhœa among the
women is considerable. The disease arises spontaneously, as the Medical Officer
imforms me, and is believed to be capable of communication to men in the form
of a disease similar to gonorrhœa, and which is entered in the returns as
gonorrhœa. The fact that inspections are made at an interval of 7 days allows
great opportunity for the communication of disease ; the evil might be remedied
by more frequent inspections ; this seems specially necessary in the case of women
licensed to consort with European soldiers.