Genitourinary medicine?

When I use a word', said Humpty Dumpty in a rather scornful tone, 'it means just what I choose it to mean- neither more nor less.' Alice Through the Looking Glass Historical backgroundIn 1916 the Venereal Disease Regulations defined three venereal diseases, syphilis, gonorrhoea, and chancroid, and clinics for their diagnosis and treat- ment were established.In the pre-antibiotic era much expertise was needed, The arsenicals used for the treatment of syphilis were given intravenously once or twice a week for many months, and local and systemic reactions from these toxic drugs were frequent, requiring skilled management.Late syphilis was common and presented a further series of diagnostic and therapeutic problems.In the treatment of gonorrhoea in men intraurethral irrigations, although largely ineffective, nevertheless needed expert nursing care; furthermore, the management of local complications, common in those days-such as epididymo-orchitis, prostatitis, and periurethritis with ensuing urethral strictureall required medical and nursing skills of a high order.For reasons which are not clear chancroid fairly rapidly dropped out of the picture and is now a very rare infection in Britain.The pioneers of clinical venereology, dealing with the designated venereal diseases (DVD)-in effect syphilis and gonorrhoea-rose to these challenges and throughout the 1920s and 1930s became unrivalled in this difficult but rewarding field.However, with the introduction of penicillin in 1943 the therapeutic situation was revolutionised.Syphilis could be cured with a course of treatment lasting for two weeks or less, and in the ensuing years the prevalence of its late manifestations declined.Gonorrhoea usually responded to a single injection, and the acute local complications became rare.Many of the technical and medical skills of physicians and nursing staff were no longer needed, and the end of venereology as a rewarding, or