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72
One other case of ophthalmia neonatorum brought to our notice was that of
a patient born in the Borough of St. Pancras, whose mother afterwards moved into
this Borough.
This case was notified to the Medical Officer of Health of St. Pancras, the
disease was severe, hut no injury to the sight resulted.
Four patients were admitted to St. Margaret's Hospital, Kentish Town, an
Institution of the Metropolitan Asylums Board set apart for the in-patient
treatment of this disease. Any infant requiring such treatment can be admitted
with its mother on the application to the Metropolitan Asylums Board of a
medical practitioner or of a midwife. The baby should be sent in as early as
possible and especially before any haziness of the cornea sets in. In this connection
earlier notification of the disease would be of service.
Six babies were attended in their own homes by the District Nurse, three
being under the arrangements made by the Council for such nursing.
A footnote in the book of rules of the Central Midwives Board is sometimes
regarded by Certified Midwives as relieving them from the duty of notifying cases
of ophthalmia neonatorum, except when medical help has not been obtained. It
would avoid a possible cause of delay in notification if it could be made clear that
the notification should be sent to the Medical Officer of Health by the midwife,
whether medical help is obtained or not.
As regards prevention the routine application of a suitable preparation of
silver to the eyes of a child at birth would undoubtedly very much lessen the
disease. This has been the experience in the United States of America. In
practically every Federal State the midwife is required by law to treat the eyes of
every newly-born infant with a solution of nitrate of silver; the Government supply
small doses in sterilised containers free of charge.
Recently a circular has been issued by the Scottish Board of Health to
medical practitioners "strongly recommending the installation of silver nitrate
solution into the eyes of newly-born children and intimating that they will in
future require a report with particulars of treatment from Medical Officers of
Health on all cases in which there occurs loss of vision."
The procedure recommended is a practical means of prevention, ready to-day,
and proved to be efficacious.
The numbers of cases of the disease notified in England and Wales in the
three years 1918-1920 was 25,484; the number of cases notified in New York
during the same period was 72. If the attack rate in England and Wales had been
no greater than the attack rate in England and Wales had been no greater than
the attack rate in New York during the three years, the number of cases would
have been only 1,381.
The Council addressed a communication to the Ministry of Health suggesting
that the Ministry "should take steps to bring to the notice of medical practitioners
and midwives the advisability of the routine application of a suitable silver
preparation to the eyes of all newly-born children."