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which the patient resides is immediately informed of the condition of the case and whether the infant is
being removed to a hospital for treatment. The midwife is also visited to learn particulars as to the case,
the antiseptic precautions taken beforehand, and the disinfection adopted by her after each of her
attendances. It was found in the past in some cases that when medical assistance was obtained, the
medical practitioner, after examining the infant's eyes, gave directions to the parents as to the course
of treatment, and left instructions for them to seek medical help again if the inflammation did not yield
to treatment, and if there was no improvement in the condition of the child's.eyes. So long as the midwife
remained in attendance, the treatment was for the most part carried out, at all events once a day ; but
many of these cases had not recovered by the tenth day, the time the midwife usually ceases her attendance.
It was also found impossible for the midwife personally to attend to the infant's eyes as often as was
requisite—i.e., in some cases four or five times daily, and this duty was then left to the friends of the
patient, who were utterly ignorant of the need for using clean rags and sterile water.
It is in cases of this description that the voluntary nursing associations have rendered most valuable
assistance. Practically every street in the county is now covered by the activities of one or another of
these, and arrangements exist between the boroughs and various agencies by means of which a nurse
can always be obtained when wanted for the home treatment of a case of ophthalmia neonatorum. In
two districts (Bermondsey and Southwark) the boroughs have their own nurse available for such
cases, instead of contracting out for such services.
During the year 1,079 notices were received from midwives, stating that medical assistance had
been advised on account of inflammation of the eyes of infants, and, in addition to these, 39 other cases
came to light in which medical help was not called by the midwife.
Of these 1,118 cases 684 proved to be ophthalmia neonatorum; in addition 480 cases of ophthalmia
neonatorum not occurring in the practice of midwives were notified, making a total for the year of 1,164
cases of ophthalmia neonatorum. The percentage occurring in the practice of midwives was thus 59%
for the year.
The Council's inspectors investigated the 681 cases of ophthalmia—642 cases were reported to be
completely cured. In 15 cases there was damage to the cornea; 16 died while still suffering from the
disease, and in 11 instances the result could not be ascertained owing to the removal of the patients,
who could not be traced.
The following facts are noted relating to the cases in which impairment of vision, or any other
injury to the eyes supervened:—
No. 232.—Mother had severe leucorrhoea during pregnancy. Boracic lotion used for eyes at birth.
Onset of symptoms on tenth day, according to mother, but midwife thought eye normal. Outpatient
hospital treatment about fourteenth day. Later admitted to St. Margaret's Hospital. Result—
Corneal opacity of right eye.
No. 258.—Boracic lotion used for eyes at birth. Onset of symptoms on fourth day, and outpatient
hospital treatment the next day. Result—right eye excised.
No. 454.—Boracic lotion used for eyes at birth. Onset of symptoms and medical assistance on
seventh day. Admitted to St. Margaret's Hospital on nineteenth day. Result—sight of right eye impaired,
the other clear.
No. 495.—Mother a single woman. Boracic lotion used for eyes a few minutes after birth. Onset
of symptoms and medical assistance on tenth day. Admitted to St. Margaret's Hospital on twelfth day.
Result—Slightly impaired sight left eye, right clear.
No. 647.—History of leucorrhoea in mother. Silver nitrate 1 per cent, used for eyes at birth.
Onset of symptoms (oedema) at birth; pus the next day and medical assistance the same day. Admitted
to St. Margaret's Hospital on fifth day.—Result—Right eye removed, other eye clear.
No. 683.—No history of vaginal discharge in mother. Collosal argentum 1 in 2,000 drops used
for eyes at birth. Onset of symptoms on seventh day and medical assistance the next day. Result—
Sight slightly injured.
No. 705.—History of gonorrhoea. Weak solution (less than 1 per cent.) silver nitrate used for
eyes ten minutes after birth. Onset of symptoms on sixth day and outpatient hospital treatment the
next day. Admitted to St. Margaret's Hospital on eighth day. Result—ulceration on both corneae.
No. 756.—No history of vaginal discharge in mother. Lids swabbed with Hg Cls 1-8,000 and a
solution of protargol dropped into eyes at birth. Onset of symptoms eight hours after birth, and medical
assistance the same day. Result—slight opacity on cornea of one eye.
No. 946.—History of slight yellow leucorrhoea in mother. Boracic lotion used for eyes at birth.
Onset of symptoms on sixth day. Outpatient hospital treatment on ninth day. Admitted to St.
Margaret's Hospital on tenth day. Result—sight impaired by scars and ulcers of both corneae.
No. 1019.—Mother unmarried. No signs of disease to account for ophthalmia. Ag NO3 1 per
cent, used for eyes at birth. Onset of symptoms on fourteenth day and medical assistance on fifteenth day.
Admitted to St. Margaret's Hospital later. Result—blindness of left eye. (This baby has since died.)
No. 1,082.—No history of vaginal discharge in mother. Boracic lotion used for eyes about
twenty minutes after birth; delay owing to difficult delivery. Onset of symptoms and outpatient
hospital treatment on fifth day. Admitted to St. Margaret's Hospital on same day. Impaired sight.
Right eye blind, left eye scars and old ulcers.
No. 1,158.—Boracic lotion used for eyes at birth. Onset of symptoms on eighth day; outpatient
hospital treatment obtained by mother on sixteenth day. Midwife cautioned for failure to
advise medical aid. She said the discharge on eighth day cleared up, and eyes were all right when she
left the case on tenth day. Result—right eye sight impaired by scar, left eye sight good.
No. 741.—History of gonorrhoea. Protargol 10 per cent, used for eyes at birth. Onset of symptoms
and medical assistance on ninth day. When baby was two weeks old, mother and baby went to
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