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187
[1911
The Committee made some further suggestions to medical practitioners
in view of the conflicting opinions regarding the precautions that should be
observed by them for the prevention of the disease, which, shortly, are as
follows:—
(a) In presumably non-infected confinements. A policy of non-interference
with respect to the mother, but with respect to the child, the
practitioner should make it his business to see that as soon as
possible after the head is born, and as soon as the eyes are open, the
eyelids are cleansed with sterilized wool and that separate water is
used to wash the baby's head and body. Where, however, the
confinements are of mothers where infection is known or expected to
exist, they should take steps to examine bacteriologically any
morbid discharges from the mothers' genito-urinary passages
and that appropriate treatment should be adopted. With respect to
the child in such a case, the baby's eyelids should be carefully wiped
free from secretion and a single drop of 1 per cent, solution of
Silver Nitrate should be placed in each eye.
It might be stated that at the International Conference on the Blind held in
Manchester in 1908, the Committee appointed by the Conference to consider
the subject recommended that this disease should be added to the list of
diseases compulsorily notifiable under the Notification Act 1899, and also in
their opinion more definite teaching should be given to midwives of the
seriousness of the disease in children, and they suggested that the Central
Midwives Board should issue more stringent instructions on the danger of
" whites" in lying-in women.
The Order, adding the disease to the list of those which are already
compulsorily notifiable, casts the duty of notification alike on the Head of the
family, and upon every medical practitioner in attendance as soon as he
becomes aware of its nature; but no obligation is imposed upon midwives,
who it is estimated attend about a half of the confinements of the country.
It will thus be seen that the consensus of opinion of every person or body,
whether in England or on the continent, who has studied this question is in
favour of prompt measures being taken with this disease as soon as it is
recognised, and that these measures should consist of notification of the
disease, action by the Sanitary Authority, and treatment by properly qualified
persons.