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186
1911]
notification, they say that it is advisable to urge upon the Local Government
Board that the notification of Ophthalmia Neonatorum should be made
compulsory, and that it shall be the duty of the Local Sanitary Authority
upon receipt of notification to inquire as to the facilities for treatment, and if
this be deficient, to arrange for the efficient treatment of the disease, but that
its treatment should not involve separation of mother from child if this can
be avoided. They also recommended that bacteriological examination of
certain maternity discharges and discharges from the eyes of the infants should
be undertaken free of charge by the Local Sanitary Authority when such a
request is made by a medical practitioner; and further, as an educational
measure, that notices relating the dangers of Ophthalmia Neonatorum should
be issued by the Local Sanitary Authority, and that they should also be
exhibited in post offices and other public places; further, that such notices
should be periodically distributed by the Local Supervising Authority, which
in London is the London County Council, to every midwife whose name
appears on the Roll of Midwives for the particular area concerned. It was
also a recommendation that the presence of purulent vaginal discharges should
be included by the Rules of the Midwives' Board among the conditions for
which medical help should be summoned, and, finally, they recommended that
among the members of the medical staff of every maternity hospital there
should be included an ophthalmic surgeon.
With respect to the medical measures, they recommended that in every
case in which a medical practitioner is not in attendance, the midwife or
nurse should adopt the following routine procedure. (1) Directly the head is
born and before the eyes are open, the lids of the surrounding skin should be
wiped clean on each side with separate pieces of sterilized wool. (*2) That
nothing should be dropped into the baby's eyes. (3) That the face and body
should not be washed in the same water, but that fresh water should be taken
with each. With respect to the mother, they recommended that when there is
purulent vaginal discharge, whether in pregnancy or labour, medical help
should be obtained and that in such cases if a doctor is not already present
when the child is born, he should be sent for immediately in order that any
necessary application to the child's eyes may be made, and that if there is
any inflammation of the eyes, however slight, such as redness, swelling, or
discharge, the midwife or nurse must explain that the case is one in which the
attendance of a registered medical practitioner is required, and medical help
must be obtained in accordance with the Rules of the Central Midwives
Board.