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20
Harman three or more weeks after the onset of the disease. In 18
of these one or both eyes were permanently damaged. The other
38 were seen in the first week of the disease and only one suffered
any permanent injury to the eyes, and in that one the parents
lived 20 miles from the hospital and failed to bring the child for
attention.
"The remedy therefore is obvious. Get the case3 early
and treatment will be a brilliant success. At present midwives
under the rules of the Central Midwives Board are instructed to
call in a medical man if the child's eyes are inflamed ever so
slightly, and to inform the local supervising body, that is in London
the London County Council, that they have done so. But there is
no machinery at present by which to ascertain how many midwives
fail in this respect; whereas if the disease were compulsorily
notifiable to the Medical Officer of Health, his visitors would find
this out and the Medical Officer of Health would thus help to raise
the standard of work of the midwives. In cases where a medical
man is called in by the midwife and the case needs daily attendance,
but the people are too poor to pay for it, the doctor would doubtless
send the child to an eye hospital. But he has no means of seeing
that his order is carried out, and it is obvious that when the mother
is in bed it is sometimes very difficult to arrange for a child to be
taken constantly to the hospital. Here again the Medical Officer
of Health and his staff can intervene and see that the child is
adequately treated.
"Lastly, notification would result in an increased knowledge
of the prevalence and causes, essential and contributory, of the
disease The percentage of cases occurring in the practice of
medical students and midwives would be arrived at, and this knowledge
would make it possible for measures to be taken by which in
time the disease could be stamped out.
"Several of the provincial towns have obtained compulsory
notification of ophthalmia neonatorum, and it is much hoped by
those interested in the prevention of blindness that all the Metropolitan
Officers of Health will help to obtain it in every London
borough (under the Infectious Diseases Notification Act, 1889).
"The following towns have already obtained compulsory
notification of ophthalmia neonatorum: Chester, Stoke-on-Trent,
and all the other towns in the Potteries district.