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16 OPHTHALMIA NEONATORUM
As a general conclusion it may be said that the inquiries made indicate that two forms
occur, one in which the inflammation occurs very early after birth and a second with a much
later onset. The distribution noted during 1919 resembles more closely the ante-war
experience than does that of 1920.
Attendance at Birth.—From enquiries made it appears that the births of 19 of the infants
suffering from ophthalmia during 1919 were attended by midwives, and 13 during 1920. If it
may be assumed that the births notified by midwives receive no attention from medical practitioners,
the following comparison suggests a slightly greater prevalence of the disease in 1919
among midwives' cases than that among cases attended by medical practitioners. Too much
significance should not be attached to the figures.

Venereal Disease.—The information obtained as to this cause cannot be regarded as satisfactory.
In 1919 bacteriological tests were reported in four cases only, of which one yielded
gonococcus. In 1920 vaginal discharges prior to parturition were admitted in 4 instances, one
being almost certainly gonorrhceal.
Legitimacy.—Only two of the 30 cases reported in 1919 occurred in illegitimate children,
and 3 (out of 29) in 1920. Expressed as percentages the proportions of cases among illegitimate
children were 6.6 and 10.3 respectively while the proportions of illegitimate children to all
children born were 9.7 and 7.1.
Order of Birth.—In 1919 just half the cases occurred among first-born children including
the 2 illegitimates. In 1920 13 cases (44.8 per cent.) were first borns, including the three
illegitimates.
Institutional Treatment.—During the two years 22 cases received in-patient institutional
treatment, equal to 37.2 per cent. of reported cases. During 1914-18 the proportion was 27.8
per cent. Of the cases reported in 1919, 43.3per cent. were removed and of those reported in
1920, 31 per cent. Of the 22 cases removed 16 went to St. Margaret's (M.A.B.) Hospital, 5 to
Poor Law Infirmaries and one to St. Mary's Hospital.
For the patients remaining at home the services of the Nurses belonging to the St.
Marylebone and Paddington District Nursing Association are available. In 1919 those Nurses
attended 11 children and in 1920, 12. Offers of the Nurses' services were refused in 6
instances.
Final Result.—It is satisfactory to be able to report that in no instance was any injury to
the eyes reported on the termination of the attacks.
"Meningitis" Group.
This designation has been adopted to include those infectious diseases whose characteristic
symptoms are of a nervous origin.
Cerebro-Spinal Meningitis—otherwise cerebro-spinal fever—including posterior basic
meningitis. During 1914-18 35 cases (including 5 errors) were notified of which 20 ended
fatally—fatality 66.6 per cent. In the past two years 8 cases (7 in 1919, 1 in 1920) were
reported (males 3, females 5) including one error (in 1919). This disease was therefore about
one-half as prevalent during 1919-20 as in 1914-18, but the fatality (7 deaths among 7 verified
cases) was higher. Verification of the diagnosis by lumbar puncture was reported in that year.
5 out of the 6 cases in 1919, and contacts were swabbed, with negative results, twice Swabbing
of contacts has been practically given up since about the middle of 1919.
In addition to the 7 deaths among the notified cases 4 other deaths occurred during the
two years (1 in 1919 and 3 in 1920) from this cause without notification to the Department.
One of the 3 deaths in 1920 occurred in the country, and had been notified to the local medical
officer of health.