Ophthalmia neonatorum : especially in reference to its prevention / by W. G. Sym.

  • Sym, William George, 1864-1938.
Date:
[1894]
Catalogue details

Licence: Public Domain Mark

Credit: Ophthalmia neonatorum : especially in reference to its prevention / by W. G. Sym. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    successful treatment lies very raucli in this, that, provided your lotion be ase|)tic and non-irritating, it does not matter so very much what you use if you ensure tliat the pus is never left in contact with the cornea, and that none is allowed to remain in the conjunctival sac. For the purpose of attaining this end without dangerous pressure on the cornea various instruments are recommended, such as Doyen's (9) red rubber syringe, the Lagrange (8) and other hollow specula, and Kalt's laveur and head of water. There is, how- ever, very little need of inventing instruments for the purpose, for an ordinary hairpin bent in a direction at right angles to its length answers every requirement, and is always to be obtained wherever there is a baby. For my own part I employ frequent bathing—every two liours, or even every hour in a bad case—with lukewarm corrosive sub- limate solution (1 to 6000), free smearing of the edges of the lids with iodoform ointment, and painting with nitrate of silver solution, gr, 10 or 15 to every second day. In regard to the medical prophylaxis, besides washing out the vagina with an antiseptic before delivery, it seems best to wipe the face of the child free of any maternal secretions before any water or antiseptic is applied at all, and while yet the lids are still anointed and protected by the vernix. After this is done, hiot not till then, the eyes should be washed with an antiseptic, and either a drop of nitrate of silver solution instilled according to Cred(^'s plan ; or, as Tarnier (7) advocates now, the conjunctival sac should be dusted with iodoform powder. It is scarcely necessary nowadays to point out how very essential some such procedure is, nor to detain you with an account—thougli it is a very interesting subject—of the immense and beneficial change which has been brougiit about by Crddd and the universal adoption of his methods. The story of that highly gratifying chapter in medicine will be found in Fuchs's Causes and Prevention of Blindness. I need only say that Oi'ed^ and others reduced the proportion of cases suffering from ophthalmia neonatorum from about 10 per cent, to about '3, or even 1 per cent, by tiie use of antiseptic applications (8). The second point with which I have to deal is the question of prophylaxis in the general. And first let me point out to those who have not studied the subject of ophthalmia neonatorum specially how very serious a matter this is. It has been estimated by different writers and investigators that of all cases of blindness which occur, about 30 per cent., more or less, are due to ophthalmia neonatorum. Some consider the proportion to be higher even than this. Thus Magnus (8) of Breslau says that 34 per cent., Kafz (8) of Berlin 41 per cent., and Claisse (8) of Paris, that 46 per cent, of all cases of blindness are caused by this disease, which we must never forget is preventable or curable in 9 cases out of 10, perhaps in 49 cases out of 50. Silex (9) states that there are 1800 cases of ophthalmia