View report page

105
(2) Profuse vaginal discharge in mother (child born before midwife's arrival).
Symptoms on 3rd day, and medical help obtained at once. Result—Opacity covering greater
part of right cornea.
(3) No history of discharge in mother. Symptoms 3rd or 4th day; medical help
obtained on 6th. Result—Opacity over lower part of right pupil, very small opacity over left
pupil.
(4) Slight leucorrhoea during pregnancy. Symptoms noticed on 4th day, medical help
obtained on 10th day. Result—Opacity nearly covering right cornea.
(5) Leucorrhoea during pregnancy. Symptoms noticed by midwife on 10th day and
medical help obtained on 11th. Result—Leucoma over left cornea covering whole of pupil.
(6) Leucorrhoea during pregnancy. Symptoms on 3rd day, medical help obtained
same day. Result—Lens lost in right cornea. Opacity covering lower half of left cornea.
(7) No discharge during pregnancy. (Edema at birth, pus on 6th day, when medical
help was called. Result—Lens of right eye extruded. Opacity covering cornea of left eye,
except a place the size of a pin point over left pupil.
(8) Leucorrhoea during pregnancy (child born before arrival of midwife). Symptoms 2nd
day, medical aid obtained 2nd day. Result—Leucoma covering right cornea entirely;
opacity covering lower half of left cornea.
(9) No history of discharge during pregnancy. Onset on 5th day, and medical help
obtained same day. Result—Leucoma covering right cornea. Opacity covering left cornea.
(10) Vaginal discharge during pregnancy. Symptoms first seen on 2nd day, and
medical help obtained at once. Result—Thick opacity covering almost the whole of left pupil.
(11) Vaginal discharge during pregnancy (child born before midwife arrived),
symptoms noticed on 8th day, medical help advised on 9th, but not obtained until 11th, and
then seen only once. Taken to hospital 15th day. Result—Dense leucoma covering the cornea
of the right eye.
The result of these eleven cases may be summarised as follows:—
Blind in both eyes 2 cases.
Blind in one eye, the other eye damaged 1 case.
Blind in one eye, the other eye recovered 4 cases.
Impaired vision in both eyes 2 cases.
Impaired vision in one eye 2 cases.
In 8 of these cases a weak solution of perchloride of mercury and in 3 boracic lotion was
used for cleansing the eyes at birth.
In 8 of these 11 cases it will be noticed that there was a history of vaginal discharge during
pregnancy, and in nine of them the onset was on or before the fifth day of life.
The 165 cases were in the practice of 68 midwives:—
1 midwife and her 2 assistants had 20 cases during the year 20
1 midwife and her assistant had 15 „ ,, 15
1 midwife had 10 „ „ 10
1 8 „ „8
1 „ ,, 7 „ 7
1 „ 6 „ „ 6
1 „ ' „ 5 „ „ 5
5 midwives had 4 cases each during the year 20
4 „ „ 3 „ ,r 12
10 „ „ 2 „ „ 20
42 „ „ 1 case each during the year 42
165
Investigation was made into the 20 cases which were attended by one midwife and her two
assistants, and no reason was found for thinking that infection had been carried by the midwife or
assistants. Nineteen of these cases occurred during the four months January to April, and in 10 of
them there was a definite history of leucorrhoea in the mother during pregnancy, and in 2 other cases
it was found that other members of the family had inflammation of the eyes at the time of the birth
of the infant. The remaining 7 cases were of a slight character. A complete cure was eventually
recorded in all the 20 cases. This midwife and her assistants attended some 170 cases of midwifery
during these four months. Subsequent to the occurrence of these cases, the midwife at all births
she attended for a period of one month used a 2 per cent. solution of silver nitrate, one drop of which
was instilled into each eye as soon after birth as possible, and during that time no case of inflammation
of the eyes occurred in her practice. In the remaining months of the year one other case was
reported. With regard to the midwife and her assistant who reported the occurrence of 15 cases,
enquiry proved that these were for the most part of a very slight character. The midwives with
10, 8 and 7 cases respectively had one case each in which there was serious impairment of
vision.
On the assumption that 30,000 of the London births were attended by midwives, the number
of cases in which serious impairment of vision occurred was .37 per 1,000 births.
In my report for 1908 reference is made to a circular which it was proposed to issue to