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98
Annual Report of the London County Council, 1910.
6. Vaginal discharge in mother. Silver nitrate and boracic lotion used for eyes at birth. Onset
on second day and medical help obtained at once.
Result.—Opacity over lower half of left pupil and healed corneal ulcer. Slight opacity over
inner half of right pupil. Infant can see with both eyes.
7. No history of discharge in mother. Boracic lotion used for eyes at birth. Onset on the
second day and medical help obtained on the fourth day.
Result.—Opacity of both corneæ.
8. No history of vaginal discharge in mother, but previous child, two years old. had ophthalmia
and is blind. Perchloride of mercury solution used for eyes at birth. Onset of symptoms on seventh
day and medical help obtained at once.
Result.—-Very slight scar in centre of right pupil.
9. Vaginal discharge in mother. Perchloride of mercury solution, followed by boracic lotion,
used for eyes 15 minutes after birth (infant was born before midwife arrived). Onset on the fifth day
and medical help obtained on sixth.
Result.—Slight opacity over left eye. Child seems able to distinguish light from darkness with
that eye.
10. Vaginal discharge in mother. Perchloride of mercury used for eyes at birth. Onset on the
seventh day, medical help obtained on eight day.
Result.—Opacity over the lower half of right cornea and pupil.
11. Vaginal discharge in mother. Boracic lotion used for eyes at birth. Onset on fifth day,
medical help obtained on sixth day.
Result.—Cornea of one eye quite opaque.
These results summarised are as follow :—
Blind in both eyes 1 case.
Blind in one eye, other damaged 1 „
Blind in one eye, other uninjured 2 cases.
Both eyes damaged 2 „
One eye damaged 5 „
In eight of the cases where there was impairment of vision, the onset occurred on or before the
fifth day of life, and in seven instances a history of vaginal discharge in the mother was obtained.
The 165 cases of inflammation of the eyes occurred in the practices of 102 midwives—
One midwife and her assistants had 10 cases during the year 10
One „ „ 9 „ „ 9
One ,, ,, ,, 7 ,, ,, 7
One midwife had 6 cases during the year 6
One midwife and her assistants had 5 cases during the year 5
Three midwives each had 4 cases during the year 12
Three ,, ,, 3 9
Sixteen „ „ 2 „ „ 32
Seventy-five „ 1 case „ 75
165
All the midwives who had three or more cases during the year have extensive practices, and with
one exception the cases occurred at intervals throughout the year. The exception was a midwife who
had three cases in one week. The mothers of two of these three infants gave a history of vaginal discharge
during pregnancy, and in the third case it was found that three other members of the family
had chronically unhealthy eyes; the midwife is said to have disinfected her hands with corrosive sublimate
after treating the eyes. So far as could be ascertained, in no case was there evidence that infection
had been carried by the midwife from one case to another.
Some of the cases of inflammation of the eyes were treated as outpatients at hospitals and a few
of these were subsequently admitted as inpatients. When an infant is breast fed it is not, of course,
advisable to take it from the mother if arrangements can possibly be made to admit the mother also
to the hospital. With a view to ascertaining whether it would be possible to secure the removal of the
mother and child in very severe cases, the various ophthalmic hospitals were approached, but it was
found that accommodation was not available in these institutions.
Further endeavours have been made by the Council to secure hospital accommodation for mother
and infant in severe cases and the matter is still receiving attention.
Classes for
Midwives
The Council has arranged classes at four centres for the instruction of midwives, and these
classes have been attended by midwives who have been in practice for many years, and also to some
extent by pupils to supplement the training they were receiving for the examination of the Central
Midwives' Board. Midwives showing lack of knowledge of their work have been advised by the
Council's medical inspectors to attend these classes.
Midwives
Bill
A Bill based, for the most part, on the report of the Departmental Committee appointed in 1908
to consider the working of the Midwives Act, 1902, was introduced into the House of Lords in March,
1910, by the Lord President of the Council. The Bill was amended in the report stage, but finally not
proceeded with. The main provisions of the Bill were :
1. To amend the constitution of the Central Midwives Board.
2. To apportion the financial deficit of the Board among the various counties and county
boroughs on a basis of population instead of in proportion to the number of midwives giving
notice of intention to practice.