Search

Competing Interests: Conflict of Interest and Sources of Funding: None declared.

Competing Interests: Conflict of Interest and Sources of Funding: None declared.

Competing Interests: The authors declare no conflicts of interest.

Competing Interests: Conflict of Interest and Sources of Funding: None declared.

It is accepted to explain increasing of venereal diseases during years of the Revolution by degradation of morality and general disorder of system of state administration and sanitary services in Russia. The cross-verification of information presented in scientific publications and primary information sources makes it possible to look into following issues: degree of venereal (syphilitic) contamination of population of pre-revolutionary Russia; influence on sanitary statistics by erroneous diagnostics and convictions of Zemstvo medicine about predominantly non-sexual path of transmission of syphilis pathogen in Russian countryside; dynamics and sources of venereal morbidity in wartime. The high indicators of pre-revolutionary statistics of venereal infections could be affected by diagnostic errors. The "village syphilis" encountered in public milieu could be completely different disease not sexually transmitted and not chronic form of disease. The primary documents allow to discuss increasing of the number of venereal patients during war years, that however, does not reach catastrophic numbers that can be found even in scientific publications. This is also confirmed by data of Chief Military Sanitary Board of the Red Army for 1920s and statistical materials of People's Commissariat of Health Care of the RSFSR. The high morbidity was demonstrated by same Gubernias that were problematic before the Revolution and only later by those ones through which during the war years passed army masses. In Russia, total level of syphilis morbidity after the end of Civil War occurred to be more than twice lower than in pre-war 1913 and continued to decrease under impact of sanitary measures of Soviet public health.

Competing Interests: Declaration of competing interest The author declares no conflicts of interest.

This article explores attempts to control outbreaks of venereal diseases among prostitutes and imperial soldiers in Cairo and Alexandria leading up to and through World War I. Seeking to move beyond the usual colonial framing of center-periphery, it considers two British imperial outposts-Egypt and Australia-in conversation. The war brought thousands of Australian soldiers to Egypt, leaving their mark on Egypt and becoming marked by their time there, sometimes in indelible and deadly ways, as bodies and bodily fluids collided, and microbes passed between colonial and imperial subjects. The article argues that the highly racialized and classed system for regulating foreign and local prostitution that British officials implemented in Egypt to protect soldiers exacerbated rather than contained the spread of venereal diseases.

In the late 17th and early 18th centuries, ancient humoral pathology was gradually complemented by new concepts of medical theory. Two important theories that emerged in this context were iatrochemistry and iatrophysics. The physician Johannes Franc (1649-1725) from Ulm and Friedrich Hoffmann (1660-1742), the first professor of the medical faculty of the Fridericiana in Halle (Saale), are representatives of these concepts. In their writings, they conveyed specific instructions for broader therapeutic treatment including various forms of medication. The iatrochemist Franc recorded his therapies in his medical diary. The treatment methods of the iatrophysicist Hoffmann are written down in his twelve-volume Medicina consultatoria. Using the examples of gonorrhea and syphilis, the goal of this paper is to analyze, on the basis of both records, how the two physicians applied the new medical theoretical concepts in the treatment of these diseases. Franc and Hoffmann held the view that these two venereal diseases represent two separate entities. Thus both physicians departed from the traditional theory that gonorrhea was a stage of syphilis. Accordingly, they used different medication therapies for these diseases. Franc and Hoffmann referred to humoral pathological ideas, the discrasia of the humors in expounding the causes of the diseases. The same applies to their basic therapeutic approaches: they implemented humoral pathological concepts in their therapeutic practice. Bloodletting, sweating cures, and water cures as well as strict diets were prescribed. Nevertheless, differences in their treatment methods are clear. Franc consistently supplemented humoral pathology with ideas of iatrochemistry, prescribing treatment of gonorrhea and syphilis with mercury. Hoffmann, on the other hand, explicitly warned against treating gonorrhea with mercury; however, he was not fundamentally opposed to the use of drugs for the treatment of syphilis.

Shortly after syphilis appeared in Europe at the time of Columbus' voyage to the New World, the big pox, as it was often known, became a serious issue in Russia for diagnosis, treatment, and prevention. Members of the Russian royal family were made aware of the disease from adolescence onward. Czar Peter the Great had many sexual contacts and could have contracted any number of sexually transmitted diseases (STDs) that were quite common in his era. Nevertheless, contributions analyzed from available sources by his contemporary doctors, and later from medical analyses, reveal no evidence that he had contracted syphilis or any other STD. Most likely, he died from acute renal failure due to urinary tract obstruction., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Hypochondriac or phobic reactions to venereal disease, specifically syphilis, have invited over three centuries of medical reification and nosological reframing. This bibliographic overview establishes that the early specification and psychiatricization of early modern concepts of melancholy and hypochondriasis, imaginary syphilis or syphilophobia , animated the early respective territorializations of venereology, infectiology more broadly, neurology, and mental medicine. Together with mercuriophobia and a wider emergent clinical sensitivity to sexual angst, the diagnosis, while evidently only sporadically made, functioned as a durable soundboard in the confrontation of emergent medical rationale with various confounders and contenders: medically literate and increasingly mobile but possibly deluded patients; charlatans and putative malpractitioners; self-referral laboratory serology (after 1906); and eventually, through psychoanalysis, the patient's unconscious. Requiring medical psychology early on, syphilology became and remained self-conscious and circumspect, attentive to the casualties of overdiagnosis, overtreatment, and iatrogenesis. Finally, patient apprehension led to makeshift forms of "moral treatment," including fear-instilling and placebos.

Competing Interests: None

The U.S. Public Health Service's sexually transmitted disease (STD) experiments in Guatemala are an important case study not only in human subjects research transgressions but also in the response to serious lapses in research ethics. This case study describes how individuals in the STD experiments were tested, exposed to STDs, and exploited as the source of biological specimens-all without informed consent and often with active deceit. It also explores and evaluates governmental and professional responses that followed the public revelation of these experiments, including by academic institutions, professional organizations, and the U.S. federal government, pushing us to reconsider both how we prevent such lapses in the future and how we respond when they are first revealed., (© 2019 by The Hastings Center. All rights reserved.)

Objectives: The 1916 Royal Commission on Venereal Diseases was established in response to epidemics of syphilis and gonorrhoea in the UK. In the 100 years since the Venereal Diseases Act (1917), the UK has experienced substantial scientific, economic and demographic changes. We describe historical and recent trends in STIs in the UK., Methods: We analysed surveillance data derived from STI clinics' statistical returns from 1917 to 2016., Results: Since 1918, gonorrhoea and syphilis diagnoses have fluctuated, reflecting social, economic and technological trends. Following spikes after World Wars I and II, rates declined before re-emerging during the 1960s. At that time, syphilis was more common in men, suggestive of transmission within the men who have sex with men (MSM) population. Behaviour change following the emergence of HIV/AIDS in the 1980s is thought to have facilitated a precipitous decline in diagnoses of both STIs in the mid-1980s. Since the early 2000s, gonorrhoea and syphilis have re-emerged as major public health concerns due to increased transmission among MSM and the spread of antimicrobial-resistant gonorrhoea. Chlamydia and genital warts are now the most commonly diagnosed STIs in the UK and have been the focus of public health interventions, including the national human papillomavirus vaccination programme, which has led to substantial declines in genital warts in young people, and the National Chlamydia Screening Programme in England. Since the 1980s, MSM, black ethnic minorities and young people have experienced the highest STI rates., Conclusion: Although diagnoses have fluctuated over the last century, STIs continue to be an important public health concern, often affecting more marginalised groups in society. Prevention must remain a public health priority and, as we enter a new era of sexual healthcare provision including online services, priority must be placed on maintaining prompt access for those at greatest risk of STIs., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

The Sexually Transmitted Disease Inoculation Study of the United States Public Health Service (USPHS) was a short-term deliberate exposure experiment into the prevention of venereal diseases. Between 1946 and 1948, over 1,300 Guatemalan prisoners, psychiatric patients, soldiers, and sex workers were exposed to syphilis, gonorrhoea, and chancroid. USPHS researchers initially proposed hiring sex workers to "naturally" transmit venereal diseases to male subjects who would then be given various prophylaxes. The researchers were interested in studying the effectiveness of new preventative measures. In other words, the USPHS study was designed to transmit venereal diseases heterosexually from an "infected" female body to the men who, it was assumed, were sexually isolated subjects. However, the researchers did record instances of male-to-male disease transmission among their subject populations, instances that challenged the presumption of heterosexuality on which the study was based.

Background: Numerous studies have evaluated the efficacy of interventions to reduce risk for sexually transmitted infections in adolescents in recent years, but their global effects remain unknown since 2008, the last date of a comprehensive review of prior studies., Aims: This study aims at evaluating the efficacy of interventions to promote sexual health, reduce STIs and unplanned pregnancies targeted to adolescents available after 2008; and analyzing the moderators of their global efficacy., Methods: We searched electronic databases and manual searches of some journals focused on STIs in May 2016. The studies evaluated the efficacy of interventions to reduce sexual risk in adolescents (age range: 11-19) anywhere in the world. Effect size of the relevant outcomes for sexual risk was calculated for every study. Analyses incorporated random-effect assumptions for each outcome. The homogeneity in the results was examined with the I2 statistic and its associated 95% confident interval., Results: Data from 63 studies (59,795 participants) were analyzed for behavioral and non-behavioral outcomes. In the short term, interventions had a positive impact in sexual health-related knowledge (Hedges'g = 1.01), attitudes (g = 0.29), self-efficacy toward condom use (g = 0.22), intention to refuse sex (g = 0.56), condom use intention (g = 0.46), and condom use (g = 0.38). In the medium term, positive effects observed at the short-term were maintained, although effect size significantly decreased in all variables. In the long term, interventions improved condom use (g = 0.47). Moderators of the efficacy are discussed., Conclusions: Sexual health promotion interventions are effective to promote sexual health through increasing condom use. Effects on non-behavioral variables tend to decrease over time, while condom use increased in the long-term. Interventions should focus on the long-term efficacy, especially in behavioral and biological measures., Competing Interests: The authors have declared that no competing interests exist.

The diary of the town physician Johannes Franc (1649-1725), handwritten in Latin, gives-among other diseases-an overview of sexually transmitted infections affecting citizens in Ulm such as syphilis and gonorrhea. Franc reported on his own experiences in the diary and also included many theoretical details on the causes of the diseases and the corresponding therapies, including ethical considerations. Even in ancient times, there are indications of venereal diseases. However, at the latest with the outbreak of syphilis around the year 1495, the treatment and control of the spread of venereal diseases became an important task of medicine. Before gonococci were detected by Neisser in 1879, sexually transmitted diseases were generally seen as a single disease. However, at the beginning of the 18 th century, there were several doctors who treated syphilis and gonorrhea as separate entities. Franc was one of them. Examining the milestones in the history of syphilis and gonorrhea, the present article reviews the existing theories that tried to explain the origins of these diseases. Franc's treatment patterns are illustrated. Franc's case reports indicate a fundamental change in the perception of STIs at the end of the 17 th /beginning of the 18 th century.

Discussion of reparations for U.S.-Guatemala STD experiments of the 1940s and 50s should be informed by a range of international and U.S. reparation experiences, so that features that impair the effectiveness of repair are avoided, and features that enhance effectiveness of repair are emulated. Two features have contributed to the effectiveness or ineffectiveness of repair elsewhere but have not been critically examined in relation to the Guatemalan experiments: Whether experimental subjects or their families have the opportunity to participate in reparations processes, and whether any group of experimental subjects is intentionally denied recognition. Three advantages of victim participation are explored, and a critique provided of one narrow delimitation of victims. Even if political and moral failings ultimately prevent reparations for Guatemalan experimental subjects, an emphasis on effectiveness and victim-centeredness should nonetheless shape reparations for other, future victims of human rights abuses in experimentation.

Dr Valentin Lucas was born in Labin on 19 March 1873. His ancestors moved to Labin from Gora (near Labin) in the 17th century. Valentin was a common name in his family. His family was well known for having many well educated members including lawyers, doctors, and priests. The last member of their family was Giacomo who committed suicide few years after the Second World War. According to now known facts, we can say that Dr Valen Lucas was the first doctor in Rijeka who specialised in gynaecology, obstetrics and venereology, with the reputation and knowledge from working in Trieste and Vienna. In Rijeka he established his private practice that was visited by patients of different social backgrounds, which we can find in Dr Valentin Lucas' medical records. Just before Ester in 1909, he accepted a job offer as a one year substitute for Dr Manzini, who was a police-doctor for Harbour Master's Office in Pula. Pula by that time had already established an image of a strategic military Austrian-Hungarian port. In hope for a better life thousands of residents moved to already overpopulatedPula. As their new environment could not render their hopes, many were drawn to refuge in immorality and women in prostitution. Dr Lucas had been fighting against prostitution in Pula, especially against secret prostitution, because that was one of his main goals as a doctor. Though his task was not easy, because there were no organised sanitary and administrative services for that popular social deviation. He died in Labin on 18 February 1932.

By the end of the 15th century, syphilis had reached epidemic proportions in Europe. Unable to ascertain its causes, physicians resorted to superstition. At the beginning of the 16th century, the sexual transmission of the disease was established. Initially, the principal measure of infection control was sexual abstinence and mutual fidelity. However, during the same period the Italian anatomist Gabriele Falloppio (1523-1562) proposed a method of preventing syphilis transmission: the medication-soaked linen sheath. Thus was born the idea of a mechanical barrier against sexually transmitted diseases: the condom.

Competing Interests: Competing interests: None declared.

For the early Turkish republic, resource shortages, illiteracy, and geography combined to hamper any achievement of the immediate and universal diffusion of state-authored lessons in public health throughout the country's populace. One of the first steps taken to overcome these obstacles involved the production and publication of a medical atlas. Ideally, this text would serve both to standardize care provided by the state's health professionals and to inform the entire population of their public health obligations and compel their compliance; longer lives, prosperity, and a stronger nation were the promised outcomes. However, utilizing public health education to institute this state-society contract also entailed framing diseases in particular ways. This was especially true with sexually-transmitted infections (STIs), and the narratives associated with STIs marginalized routinely specific subpopulations of the Turkish nation; women and girls, generally, and sex workers, in particular. Focusing on this primary text, this article engages critically with the atlas to document, analyze, and inform the nature of this promise and the types of medical and moral norms that it imposed and reinforced.

In the 1970s, groups of gay and gay-allied health professionals began to formulate guidelines for safer sexual activity, several years before HIV/AIDS. Through such organizations as the National Coalition of Gay Sexually Transmitted Disease Services, Bay Area Physicians for Human Rights, and the Sisters of Perpetual Indulgence, these practitioners developed materials that would define sexual health education for the next four decades, as well as such concepts as "bodily fluids" and the "safe sex hanky." To do so, they used their dual membership in the community and the health professions. Although the dichotomy between the gay community and the medical establishment helped define the early history of HIV/AIDS, the creative work of these socially "amphibious" activists played an equally important part. Amid current debates over preexposure prophylaxis against HIV and Zika virus transmission, lessons for sexual health include the importance of messaging, the difficulty of behavioral change, and the vitality of community-driven strategies to mitigate risk.

Surgeon General Thomas Parran Jr was once viewed as a path-breaking leader, but his legacy is now highly contested. Scholars of national health insurance have viewed Parran as an impediment to government-backed insurance, and revelations about his role in the Tuskegee Study and in the Public Health Service's experiments in Guatemala have cast a shadow over his career. Surgeon General from 1936 to 1948, Parran led the Public Health Service during the development of key features of the modern American health system and was involved in critical debates over the role of the national government in health. I argue that Parran is best understood not as an opponent of insurance but as the proponent of an approach to health policy that sought to link public health and individual medicine. A pragmatic bureaucrat, Parran believed that effective policymaking required compromise with the American Medical Association.

Background: Current guidelines recommend that all sexually active human immunodeficiency virus (HIV)-infected persons be tested at least annually for syphilis, chlamydia, and gonorrhea. We examined temporal trends in syphilis, chlamydia, and gonorrhea testing among sexually active HIV-infected adults receiving medical care in the United States during 2009-2013., Methods: Using medical record data from the Medical Monitoring Project, a population-based HIV surveillance system, we assessed the proportion of adults receiving HIV medical care who were tested for syphilis, chlamydia, and gonorrhea in the past 12 months by year and stratified by sex and sexual behavior, age, and race/ethnicity., Results: During 2009-2013, the proportion of sexually active HIV-infected adults receiving medical care who were tested in the past year for all 3 examined sexually transmitted diseases (STDs) increased from 20% to 36% (PTREND < .01). Overall testing for syphilis increased from 55% to 65% (PTREND < .01), and significant increases were noted for the following subgroups: men who have sex with men (58% to 69%), non-Hispanic whites (48% to 64%), and all age groups with the exception of persons aged 18-29 year. Overall testing for chlamydia and gonorrhea increased from 22% to 42% (PTREND < .01), and significant increases were noted for most subgroups., Conclusions: STD testing significantly increased among sexually active HIV-infected adults receiving medical care; however, the majority of persons were not tested for all 3 STDs in 2013. While increased testing indicates progress, testing remained far below recommended guidelines. Our findings suggest enhanced efforts may be warranted to screen all sexually active HIV-infected adults for syphilis, chlamydia, and gonorrhea., (Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

During 2010-2014, urgent care centers saw a ≈2-fold increase in the number of visits for chlamydia and gonorrhea testing and a >3-fold increase in visits by persons with diagnosed sexually transmitted infections. As urgent care becomes more popular, vigilance is required to ensure proper management of these diseases.

The trajectory of sexually transmissible infection (STI) incidence among gay and other men who have sex with men (MSM) suggests that incidence will likely remain high in the near future. STIs were hyperendemic globally among MSM in the decades preceding the HIV epidemic. Significant changes among MSM as a response to the HIV epidemic, caused STI incidence to decline, reaching historical nadirs in the mid-1990s. With the advent of antiretroviral treatment (ART), HIV-related mortality and morbidity declined significantly in that decade. Concurrently, STI incidence resurged among MSM and increased in scope and geographic magnitude. By 2000, bacterial STIs were universally resurgent among MSM, reaching or exceeding pre-HIV levels. While the evidence base necessary for assessing the burden STIs among MSM, both across time and across regions, continues to be lacking, recent progress has been made in this respect. Current epidemiology indicates a continuing and increasing trajectory of STI incidence among MSM. Yet increased reported case incidence of gonorrhoea is likely confounded by additional screening and identification of an existing burden of infection. Conversely, more MSM may be diagnosed and treated in the context of HIV care or as part of routine management of pre-exposure prophylaxis (PrEP), potentially reducing transmission. Optimistically, uptake of human papillomavirus (HPV) vaccination may lead to a near-elimination of genital warts and reductions in HPV-related cancers. Moreover, structural changes are occurring with respect to sexual minorities in social and civic life that may offer new opportunities, as well as exacerbate existing challenges, for STI prevention among MSM.

In the first decades of the twentieth century, a group of doctors under the banner of the social hygiene movement set out on what seemed an improbable mission: to convince American men that they did not need sex. This was in part a response to venereal disease. Persuading young men to adopt the standard of sexual discipline demanded of women was the key to preserving the health of the nation from the ravages of syphilis and gonorrhoea. But their campaign ran up against the doctrine of male sexual necessity, a doctrine well established in medical thought and an article of faith for many patients. Initially, social hygienists succeeded in rallying much of the medical community. But this success was followed by a series of setbacks. Significant dissent remained within the profession. Even more alarmingly, behavioural studies proved that many men simply were not listening. The attempt to repudiate the doctrine of male sexual necessity showed the ambition of Progressive-era doctors, but also their powerlessness in the face of entrenched beliefs about the linkage in men between sex, health and success.

This article looks at cases of venereal disease from the early 1700s and how healers presented themselves as shrewd interpreters of patients' bodies and souls. Because the disease was so stigmatizing, patients were said to be unreliable narrators of their own symptoms and health histories. Practitioners, in turn, exhibited diagnostic expertise by sagely navigating such constraints. They characterized themselves as medical detectives who gathered clues and made diagnoses in spite of patients' alleged lies and omissions. Such work entailed moral integrity, astute observations, and the ability to persuade patients to divulge their most shameful sexual secrets. These findings illuminate how a particular disease shaped constructions of medical expertise, as well as the details of early modern medical practice that we rarely have the privilege of seeing.

Ethnopharmacological Relevance: Historical medical sources can be still queried for forgotten cures and remedies. Traditional Chinese medicine has dealt with lues venerea (syphilis) since the Five Dynasties period (10th century). Chinese indigenous materia medica and remedies recorded, studied or imported by the Europeans can reveal known or quite unknown medicinal plants. The studied Jean Astruc's work is a published ethnopharmacological survey carried out in Beijing in the 1730s and it deserves a modern interpretation., Aim of the Study: This is the first proposal to identify historical Chinese medicinal plants listed in a scarcely known medical treatise De Morbis venereis… ('On venereal diseases…') by Jean Astruc from 1740. I searched for the current uses and position of the taxonomically identified herbal stock in both traditional Chinese and official medical knowledge, with special attention to syphilis., Material and Methods: Chinese names of drugs and their botanical identities (originally expressed by means of pre-Linnaean polynomials, and now interpreted as accepted binomials) were independently cross-checked with younger till most recent taxonomical and ethnopharmacological sources. Plants and drugs identified this way were queried for their modern applications in traditional Chinese and official medicine with special attention to sexually transmitted diseases (STD) and other uses which are similar to the 18th-century understanding of venereology., Results: For 24 items of medicinal stock, 34 medicinal plants have been identified or suspected: Acacia catechu, Achyranthes bidentata, Akebia quinata, Angelica dahurica, A. sinensis, Aquilaria sinensis, Aralia cordata, Aristolochia fangchi, Chaenomeles sinensis, Ch. speciosa, Clematis vitalba, Coix lacryma-jobi, Commiphora myrrha, Cydonia oblonga, Daemonorops draco, D. jenkinsiana, Dictamnus dasycarpus, Dryobalanops sumatrensis, Forsythia suspensa, Glycyrrhiza uralensis, Lonicera confusa, L. hypoglauca, L. japonica, Ligusticum striatum (=L. chuanxiong), Piper kadsura, Pterocarpus officinalis, Saposhnikovia divaricata, Sassafras tzumu, Smilax china, S. glabra, Stephania tetrandra, Styphnolobium japonicum, Trichosanthes japonica, T. kirilowii; China wax is also mentioned. Out of them, only Lonicera japonica is being used in China in late syphilis, Achyranthes bidentata in gonorrhoea, and Dictamnus dasycarpus in gynaecological problems. In the Astruc's study, 3 medicinal plant species and 5 further plant genera are correctly determined; other plant parts were misidentified., Conclusions: Antisyphilitic actions ascribed to the Chinese medical formulas and their constituents studied by Astruc, seem to have come from Hg or As compounds rather than from vegetative materia medica. The formulas contained only one species still known in TCM as a remedy for syphilis., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Ugo Foscolo, was an Italian writer, revolutionary and poet whose works rank among the masterpieces of Italian literature. Talented and well educated in philosophy, classics and Italian literature, Foscolo gave literary expression to his ideological aspirations and to his numerous amorous experiences in odes, sonnets, plays, poems and an epistolary novel. Concurrent with his rich literary output, Foscolo's correspondence represents a unique perspective from which to monitor his literary and political views and investigate aspects of his everyday life. Among other interesting information, one can find elements of Foscolo medical history which is generally unknown. In the present article we investigate the longstanding lower urinary tract symptoms as reported by the poet in his correspondence to his family and friends.

The current study presents some aspects of syphilis in the Balkan Peninsula from the 19th century until the Interwar. Ever since the birth of modern Balkan States (Greece, Bulgaria, Turkey and Serbia), urbanization, poverty and the frequent wars have been considered the major factors conducive to the spread of syphilis. The measures against sex work and sexually transmitted diseases (STDs) were taken in two aspects, one medical and the other legislative. In this period, numerous hospitals for venereal diseases were established in the Balkan countries. In line with the international diagnostic approach and therapeutic standards, laboratory examinations in these Balkan hospitals included spirochete examination, Wassermann reaction, precipitation reaction and cerebrospinal fluid examination. Despite the strict legislation and the adoption of relevant laws against illegal sex work, public health services were unable to curb the spread of syphilis. Medical and social factors such as poverty, citizen's ignorance of STDs, misguided medical perceptions, lack of sanitary control of prostitution and epidemiological studies, are highlighted in this study. These factors were the major causes that helped syphilis spread in the Balkan countries during the 19th and early 20th century. The value of these aspects as a historic paradigm is diachronic. Failure to comply with the laws and the dysfunction of public services during periods of war or socioeconomic crises are both factors facilitating the spread of STDs.

John Hunter's work included description of the nature of digestion, child development, role of the lymphatic system and proof that the maternal and foetal blood supplies are separate. His contribution to the understanding of venereal diseases is reviewed. Hunter's argument of the unitary nature of venereal diseases is examined and the progress he made in diagnosis and management is discussed., (© The Author(s) 2014.)

During the second half of the XIX century a powerful international health movement appeared as the expression of the political and economic importance of the health-disease relationship. From 1850 a long series of international health conferences on epidemics, hygiene, charity, tuberculosis, mother-baby health and rural health brought together doctors, diplomats and governors from many countries to look for political solutions to the social impact of disease. An international health diplomacy arose from this as a channel for debate and solution to the main health problems. According to official statistics, the elevated prevalence of syphilitics at the beginning of the XX century set off the alarm regarding the problems of preventing and treating the disease. Two international conferences on syphilis were convened. This article analyses the contributions and debates among the international experts, the medico-sanitary, moral and social arguments, and the political reactions, national regulations for prostitution as well as international initiatives and recommendations. The main sources used are national regulations, and the lectures, reports and debates that occurred during the two International Conferences on Syphilis, held in Paris and Brussels between 1998 and 1902.

When mortality patterns for cancer of the uterine cervix were compared with trends in incidence of sexually transmitted diseases in both England and Wales and in Scotland, there were striking associations between the temporal, social class, occupational, and geographic distributions of these diseases. The data suggest that exposure to sexually transmitted infection is an important determinant of cervical cancer. Although they are still young, women born after 1940 are already experiencing increased cervical-cancer mortality. If cervical-cancer prevention and therapy remain unchanged, this generation's high risk of death from cervical cancer will probably continue to operate throughout their lives., (Copyright © 2015. Published by Elsevier Ltd.)

In 1974, Valerie Beral published a landmark paper on the sexually transmitted origin of cervical cancer (CC) using statistics routinely available in the United Kingdom (UK). Among women born between 1902 and 1947, CC mortality rates correlated remarkably well with the incidence rates of gonorrhoea when they were 20 years old and both were highest among women born after 1940. Hence, if CC prevention and treatment had remained unchanged, the youngest generations of women would have experienced a high risk of CC death as they grew older. Fortunately, progress in CC prevention has helped avoid this scenario. The adverse consequences of the "sexual revolution" were greatly mitigated in the UK and other high-resource countries by the implementation of high quality cytology-based CC screening. An age-period-cohort analysis suggests that >30,000 cases or approximately 35% of expected CC cases may have been prevented by screening programmes in the UK between 1983 and 2007 and this percentage has been steadily increasing. In addition, the discovery of the causal role of HPV is reshaping primary and secondary prevention of CC. Cheaper HPV tests are becoming available and HPV-based primary screening may at last facilitate CC screening in low-resource countries. In the long-term, however, HPV vaccination, which has already been adopted by many countries, represents the best hope for preventing CC and overcoming socio-economic differences in CC risk within and across countries. The additional elucidation of HPV cofactors to which Beral has greatly contributed may also help control HPV infection in unvaccinated women., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Aleksandr Sergeyevich Pushkin (1799-1837) was one of the great figures of Russian poetry and literature. There are numerous publications about his life, adventures and creative work. However, little has been written about his character, mental state and the condition of his wound during his fatal duel. Furthermore, his sexual illnesses and their nature were discussed even less. This paper attempts to lift the veil from this mystery., (© The Author(s) 2013.)

In 1899 the British Medical Journal enthusiastically announced that a new postgraduate teaching college was to open in London. The aim of the Medical Graduates' College and Polyclinic (MGC) was to provide continuing education to general practitioners. It drew upon emerging specialisms and in so doing built upon the generalist training received at an undergraduate level. Courses were intended to refresh knowledge and to introduce general practitioners to new knowledge claims and clinical practices. The establishment of postgraduate institutions such as the MGC marked an important stage in the development of medical education in England. Yet these institutions, and the emergence of postgraduate medical education more broadly, have been largely overlooked by historians. Moreover the history of venereological training among medical undergraduates and postgraduates alike has been overlooked. The study of such special subjects characterised postgraduate study. This article examines the dissemination of venereological knowledge among subscribers to MGC as an important case study for the development of institutionalised postgraduate medical education in England at the turn of the twentieth century.