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midwives as to the treatment at birth of the eyes of infants. The issue of this circular was not proceeded
with, the Central Midwives Board having communicated to the Council for distribution among
midwives the following memorandum:—
INFLAMMATION OF THE EYES IN NEW-BORN CHILDREN.
Ophthalmia Neonatorum.
This is a very common cause of hopeless blindness, which is one of the greatest misfortunes that can happen
to a child. A very largo number of children will be saved from blindness if the following directions of the Central
Midwives Board are observed.
The disease generally arises from purulent discharges from tho mother getting into the baby's eyes at birth.
It is therefore of the greatest importance that this should be prevented:—
1. By curing such discharges if possible before labour. This requires medical treatment (Rule E. 19
(2) and (3) ).
2. By taking the greatest care that such discharges shall not be carried into the baby's eyes when it
opens them for the first timo soon after its head is born.
The discharges may be carried into the baby's eyes in the following ways:—
(а) The discharges collect round its eyes, especially the eyelashes, and easily get into its eyes.
This can be generally prevented if the midwifo observes Rule E. 14: "As soon as the child's head
is born, and if possible before the eyes are opened, its eyelids must be carefully cleansed."
They should be thoroughly wiped with clean material such as cotton-wool, lint, or rag, using
separate pieces for each eye. The reason for this is that the piece used for wiping the first eye
will be polluted by the discharges, and should not be used for the other eye.
(b) New-born babies sometimes rub their eyes with their hands. This may rub the discharges into
their eyes. When Rule E. 14 has been complied with the baby's hands must be carefully
cleansed.
(c) When the baby is bathed the discharges with which its body is covered during labour are
washed off into the bath-Water. If its face is washed in this water, matter may get into the
eyes.
N.B.—The above directions are to be observed in all cases, whether purulent discharges are known to be
present or not.
The Central Midwives Board is determined, so far as lies in its power, to secure the strict observance of its
rules and directions, and to punish any failure to comply with them, even in cases where no harm can be proved
to have followed from their neglect.
F. H. Champneys, M.D., F.R.C.P.,
December, 1909. Chairman of the Central Midwives Board.
This leaflet was drawn up and issued at the request of the Board.
Classes for midwives.—The Council has instituted classes for the instruction of midwives,
eight of which are held in different parts of London during the year. Thus eight courses of lectures
are given during the year. These classes have been utilised by midwives who have been in practice
for many years, and also to some extent by pupils preparing for the Central Midwives Board to
supplement the training received at the institution where they are undergoing training. It has been
the practice of the Council's inspectors to recommend these classes to midwives who have shown
want of knowledge in their work.
Departmental Committee.—A Departmental Committee was appointed by the Privy Council
in December, 1908, to consider the working of the Midwives Act, 1902, and in particular with
reference to the supply of midwives and the cost of training, the remuneration of medical men
summoned on the advice of midwives under the rules in pursuance of the Act, and the delegation of
their powers by county councils under the Act, and I was instructed to represent to the Committee
the views of the Council with respect to the need for a better system by which midwives could
promptly obtain medical assistance in cases of difficulty, and with respect to other matters. I also
gave evidence as to the need for the exercise of some control over lying-in homes carried on for gain.
The findings of the Departmental Committee were embodied in a Bill, which was introduced into
the House of Lords in 1910.
Memorandum on Closure of and Exclusion from School.
During 1909 a memorandum by Dr. Newsholme and Dr. Newman, medical officers
respectively of the Local Government Board and Board of Education, was issued on administrative
measures for the prevention of the spread of infectious diseases occurring among children attending
public elementary schools, with special reference to the circumstances in which the closure of schools
or the exclusion of individual scholars may be necessary.
The object of the memorandum in the first instance is to co-ordinate the action of the medical
officer of health and of the school medical officer so as to provide for the legalisation of the voluntary
exclusion of particular scholars, or voluntary closure of schools or school departments, so as to avoid
the loss of grant in the case of closure. The memorandum advises for this purpose that the medical
officer of health should embody his recommendations in certificates which are transmitted to the
school medical officer with a view to the formal authorisation required by article 53, in cases of exclusion,
and to the approval required by article 45, in cases of closure.
The memorandum also points out the need for the Education Authority to make regulations
requiring school teachers, school nurses and attendance officers, to supply information to the medical
officer of health, and to the school medical officer, regarding any children suspected to be suffering
from infectious disease, and to exclude such children temporarily.
The memorandum discusses various points of practice of which it may be said generally that
they are based on principles commonly accepted and in the main adopted in London.
Under the heading "Principles of Action" the memorandum discusses the need for knowledge by
the teachers of the early and late symptoms of infectious diseases with a view to the exclusion from the
school of children presenting those symptoms until a mcdical opinion can be obtained, and the need