Infantile ophthalmia (blennorrhoea neonatorum) and its prevention : read in the Section of Ophthalmology at the Annual Meeting of the British Medical Association, held in Leeds, August, 1889 / by Karl Grossmann.

  • Grossmann, Karl.
Date:
[1889]
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Credit: Infantile ophthalmia (blennorrhoea neonatorum) and its prevention : read in the Section of Ophthalmology at the Annual Meeting of the British Medical Association, held in Leeds, August, 1889 / by Karl Grossmann. Source: Wellcome Collection.

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    2] And how did this come about when we know it could have been prevented if taken in time ? The same sad old tale: Three or four days after birth baby caught a cold. The mother either did nothing to it, or if she did anything at all it usually was a bread and milk poultice or something similar. The near connection of infantile blennorrhoea with'gonorrhoeal discharge has been conclusively demonsirated for a great number of cases by the presence of that peculiar micro-organism to which the name of gonococcus or diplococcus pyogenes is given. It occurs in agglomerations or two, which form the shape of an 8; hence the latter name. Whether this diplococcus, which is so constant in gonorrhoeal discharges, is also to be made answerable for all cases of purulent ophthalmia in the newborn is a question which is at present still an open one. 1 have repeatedly failed to discover it in discharges from the conjunctiva; and my observa- tions in this direction are not uncorroborated. At the fifty- seventh meeting of the German Medical Association, Dr. Kroner of Breslau gives the result of his examinations of ninety-two cases of blennorrhoea. He was unable to discover the gonococcus in twenty-nine cases, in spite of the most careful examinations; in sixty-three cases, however, the micro-organism was readily detected. This led him to the conclusion that the ophthalmo- blennorrhoea may be produced not only by the gonorrhoeal secre- tion of the maternal vagina, but also by other vaginal discharges of a less specific nature. Be that as it may, the fact remains that the ophthalmo- blennorrhoea of the newborn admits of a cure—I should almost like to say, in the words of the label on the Ofen bitter water, speedy, sure, and gentle. We know it is far more probable to cure quickly purulent ophthalmia in a child than in an adult. Evidently the infantile cornea is better supplied with nutrition, and chemosis does not occur so easily; and whereas in the adult we have to fear destructive processes in the cornea sometimes within a few hours, which we cannot always keep off, the eye of the newborn shows much greater tolerance, and usually only gives way after a few days of irrational treatment, such as poulticing and other domestic remedies. I have tried different drugs—nitrate of silver, corrosive sub- limate, liquor chlori, iodoform, sulphate of copper, carbolic acid, peroxide of hydrogen—and I must say they all give good results, either alone or in combination. I have done this in order to con- vince myself that there is no special remedy particularly to be recommended as a specific; they all answer admirably, although I have chiefly relied upon nitrate of silver until lately, when I have used /3-naphthol with great advantage. It does not matter much which of these remedies we apply on the whole, iodoform being rather objectionable on account of its odour, and I mention them only in order to show that as far as treatment is concerned we have ample means to cope with it successfully and quickly. But the little patients are brought to m usually when the gravest harm is already done. To have shown where the root of this deleterious disease lies, and how we can readily get at it, is the great merit of Dr. Cr6d6, of Leipzig. He pointed out that it was far more within the range of the obstetrician than of the oculist to prevent ophthalmc- blennorrhoea in the newborn altogether. In a paper ^ which I read 1 An abstract of this paper is published in the first number of the Liverpool Med.-Chir. Journal, 1881.