Medicine, Knowledge and Venereal Diseases in England, 1886–1916 by Anne R. Hanley

Author:Anne R. Hanley
Language: eng
Format: epub
ISBN: 9783319324555
Publisher: Springer International Publishing

General Practitioners, Club Practice and National Health Insurance

In the absence of public health measures prior to the establishment of the RCVD, it is important to consider how venereal diseases were dealt with in the privacy of general practice, club practice and a variety of institutional settings. Yet few sources pertaining to the diagnosis and treatment of venereal diseases in general practice have survived, making it difficult to determine the clinical experiences of most general practitioners.

Articles and editorial correspondence in medical journals offer important glimpses into the world of private practice. As we have seen in Chapter 2, in the letter written to the BMJ in 1885 by the ‘junior member’ seeking advice for his soon-to-be-married patient, general practitioners faced many challenges in the diagnosis and treatment of venereal diseases. 36 Ten years later Arabella Kenealy, a doctor and eugenicist, also wrote to the BMJ, recounting a house call. According to Kenealy, the diagnosis was ‘indubitable’. The patient, ‘a wreck of a young woman’, had suffered three miscarriages and borne a child who demonstrated clear symptoms of congenital syphilis. Pregnant again, the young woman was haemorrhaging. The letter is interesting for a variety of reasons, not least because it is the first known example of a woman doctor treating venereal diseases in private practice. 37 Although Kenealy’s account drew heavily upon medical, pseudo-scientific and social debates over hereditary and racial decline, it also demonstrated some of the problems encountered when treating venereal diseases in private practice.

Textbooks written by doctors such as Jonathan Hutchinson and Alfred Cooper also contained accounts of venereal cases treated in private practice. 38 But most general practitioners did not enjoy the same facilities as these noted authorities, who held hospital appointments that brought them into regular contact with venereal diseases, as well as cutting-edge knowledge claims and technological developments. The evidence that emerges from private practice is impressionistic, making it difficult to draw definitive conclusions about how venereal cases were diagnosed and treated. Diagnosis and treatment depended greatly upon the knowledge possessed by individual doctors, the facilities at their disposal, the class of patients they attended and the extent to which they encountered venereal diseases. It also depended upon the individual doctor’s willingness to experiment with new ideas and technologies.

Witnesses before the RCVD were divided over whether general practitioners encountered venereal cases with sufficient regularity to develop their knowledge and clinical skills in any meaningful way. Some assumed that general practitioners had limited access to venereal cases and therefore limited means of augmenting and refreshing their knowledge. Others argued that doctors working in urban areas would probably encounter a number of venereal cases across the course of their careers. However, most thought that doctors had little opportunity to make full use of such cases to enrich their knowledge and experience. James Sequeira cited an example of a general practitioner under his medical care who had

... an ordinary crack alongside one of his fingernails and he had a little sore there which did not heal. He put on ordinary antiseptic dressings; and then he came to me because a rash had come out on his body.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.