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position is more satisfactory, mainly as the result of preventive treatment
carried out at the time of the birth of the infant. Because of its potentialities
for harm the disease is treated seriously. It has been made
notifiable and authorities have been empowered to assist in home treatment
or in providing hospital treatment for those afflicted. Should the
severity of the attack warrant admission of the young patient to hospital,
it is in its interests that mother be admitted as well. Before the war
infants needing hospital treatment were admitted by arrangement with
the L.C.C. to St. Margaret's Hospital, Hampstead. During the war years
admission has been to Whiteoak Hospital, Swanley, though at times,
because of shortage of accommodation, patients are admitted to one of
the Isolation hospitals. For home treatment the Council has an arrangement
with the local District Nursing Association to whom patients are
passed for treatment, as it is inadvisable that a midwife should continue
on her ordinary duties while in attendance on a patient suffering from
ophthalmia neonatorum.
It is a requirement of the Central Midwives' Board that midwives
summon to their assistance a medical practitioner by issuing a medical
aid notice whenever an infant is suffering from any discharge from the
eyes, however slight. In some cases the doctor summoned appears to
adopt the same standard in assessing the case for notification. For this
reason not all cases notified are in fact suffering from the condition
ophthalmia neonatorum as defined in the regulations.
While in general on the occurrence of ophthalmia neonatorum in an
infant born in an area not that in which the parents normally reside,
notification is sent to the medical officer of health of the area in which the
birth occurred, this practice does not prevail in the case of births in
hospitals in London. Such notifications are transferred to the areas in ,
which the parents reside. For this reason notifications are received of
ophthalmia occurring in babies born in London and who frequently are
cured of the complaint before they arrive here.
During the year 1945, of the five notifications received, one related
to a baby born in a hospital in London. Of the remaining four, three
were treated at home, the fourth being admitted to a hospital. All cases
made complete recovery with vision unimpaired.
Pemphigus.
This is a disease of the skin which occurring in the new born can be
of the utmost severity, at times resulting in death. Outbreaks have
occurred which seem definitely to be related to the practice of a particular
midwife, though if a midwife is responsible for the conveyance of infection
it is quite undecided what the mode of transmission is. For this reason
the disease, even though of comparative rarity, is one to be treated with
the greatest respect. Pemphigus is then the one disease for which this
Authority has made application to, and obtained sanction from, the
Ministry to add to the list of those notifiable in the area.
It is most inadvisable for anyone to continue midwifery practice
while in attendance on such patients. Cases, then, which occur in the
practice of one of the mdwives are passed over for treatment to the staff
of the District Nursing Association, unless they are of sufficient severity