Ophthalmia neonatorum / by Sydney Stephenson.

  • Stephenson, Sydney, 1862-1923.
Date:
1914
Catalogue details

Licence: In copyright

Credit: Ophthalmia neonatorum / by Sydney Stephenson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    i per cent, silver acetate (Zweifel), and 5 per cent, sophol (v. Herff). For the former it is claimed that it gives rise to no reaction (the so-called Argentum Katarrh), and that it has no tendency to become concentrated still further by evaporation, since the solution employed is already practically a saturated one. Sophol is said to be as efficient as it is non-irritating. At the same time, the use of these or other chemicals would be a misfortune, if it led to the neglect of simple precautions, such as careful cleansing of the baby’s eyelids and knuckles, and scrupulous care about the first bath ; in brief, the strictest attention to asepsis in the broadest sense of the word. Of recent years, nothing of special importance has been published regarding the bacteriology of ophthalmia neo- natorum. On the basis of 1,829 cases, partly personal and partly collected, I found 4 some years ago that the gonococcus was responsible for the malady in 64*56 per cent.—that is to say, in about two-thirds of the cases. Subsequent investiga- tions by other workers have not invalidated the general truth of the estimate. For example, Wharton5 found the gonococcus in 75 per cent, of the cases; Zade 6 in 64*17 per cent.; and Stadtfeldt7 in 54*65 per cent. The figures quoted refer mainly, if not exclusively, to patients of the hospital class. In trying to estimate how far they apply to other classes of the population, two points should be borne in mind : first, that many mild cases of ophthalmia are never brought to hospital ; and, secondly, that the higher the social standing of the parents, the lower is likely to be the proportion of the gonococcal cases. The discovery of the gonococcus in a given case depends upon several things, the most obvious of which are the bacteriological competence of the surgeon, the stage of the disease, and the method of treatment that has been adopted. With regard to the last point, Dorland Smith 8 has made the definite suggestion that vaseline (much used in the States in conjunctival infections) has accounted for his not infrequent failure to identify gonococci in cases of undoubted ophthalmia neonatorum. It does not appear to be widely known that gonococci may persist for long after the acute symptoms of