PURULENT CONJUCTIVITIS OF THE NEWBORN: This affection, also called ophthalmia neonatorum, is the result of septic infection of the eyes at birth. It is caused by the eyes of the child coming in contact with the diseased vaginal secretions of the mother as the child is passing out of the mother's body. Its symptoms are less violent than purulent conjuctivitis of adults and the consequences are less severe.

Medical men recognize three sources--i. e., infection by the staphylococcus, pneumococcus and the gonococcus. The gonococcus (in gonorrhea! ophthalmia) is considered the most virulent of these three types of germs.

Gonorrhea and purulent endometritis (inflammation of the lining of the womb) are considered the chief sources of infection. Someday it will be recognized that a leucorrhea which does not drain well, or which is bound on the mother by pads, will generate enough putresence to infect the eye or eyes of the infant. Indeed, Gould and Pyle say; "severe cases have been caused by the secretions of nonspecific vaginitis." A clean mother cannot infect her child. An unclean mother who throughly douches her vagina immediately before or during labor greatly reduces the likelihood of infection.

The present-day practice of physicians and nurses of rupturing the "bag-of-waters" as soon as the os uteri is distended, robs the child of part of its natural insulation during passage and, undoubtedly, increases the likelihood of infection. Dry births act in a similar manner.

The medical notion is that most of these cases are due to gonorrhea in the mother and that, as Dr. Cabot expresses it, ''propel obstetrics and the putting into every new-born baby's eyes a proper antiseptic, will stop the disease in every single case." Practically all of our states have a law requiring the use of an antiseptic in the eyes of every child at birth. How successful this is, is shown by the fact that over half of the cases of blindness are still attributed to Purulent Infantile Ophthalmia, as it was formerly called.

Dr. Tilden says of the practice: "In these days of much medical delusion we hear that children should have a weak solution of nitrate of silver dropped into their eyes as soon as they are born, to prevent ophthalmia neonatorum--a venereal inflammation of the eyes of newborn babies. Doctors who gain their experience from free clinics, hospitals, and slum practice become deluded with the idea that all mankind are tainted with venereal diseases. Their delusion should not be taken too seriously.

"There may be a little danger of this infection in the slums, but the danger is nil among the representative, better class of poor as well as among the well-to-do of this country."

SYMPTOMS: The symptoms are usually less violent and progress less rapidly than in purulent ophthalmia of adults. A few days (two to five), or a week after birth the eyelids become slightly red and swollen, with a purulent secretion. The swelling of the eyelids increases, the conjuctiva becomes greatly infiltrated, swollen, and roughened. The secretion becomes thickened and of a yellow or green color. The disease is self-limited and runs its acute course in four to six days, after which time there is a longer period of mild trouble.

The cornea soon becomes affected. If the affection of the cornea should result in a scar over the pupil, blindness may result. Even if it is but a small scar there may be a serious impairment of sight.

One of the first things a medical man does when he is called upon a case of this kind is to make a smear for the bacteriological examination. The condition is seen, at a glance. The diagnosis is easily made. Why, then, the bacteriological test? Because the trouble, in his view, may be due to either one of several types of organisms. But it makes no difference in the treatment which type he finds. The treatment is the same whether he finds the staphylococcus, the pneumococcus, the gonococcus, or some other coccus. Why, then, the test? Echo answers, why?

PROGNOSIS: Under medical care these cases usually recover in six to eight weeks, although chronic blenorrhea (a purulent discharge) and blindness, due, no doubt, to the suppressive measures employed, are common aftermaths. Medical authorities tell us that "the prognosis depends on the severity and the nature of the infection and the time at which the patient comes under treatment." Dr. Cabot says: "if the disease has taken hold of the baby's eyes, vigorous treatment in a hospital will cure a great many who otherwise would go on to partial or total blindness." The danger of blindness is reduced to almost nil by proper care from the start.

Dr. Trall, on the other hand, declared, "the common lotions and potions, washes and swashes, are very apt to aggravate the disorder, deform the eyelids, or destroy the sight."

PREVENTION: Health, cleanliness -- these two words sum up the whole of the work of preventing the condition. The pregnant mother should give more attention to her own health and cleanliness than most of them are willing to devote to these. A clean, healthy mother cannot possibly infect her child. We are frequently told that if we give prospective mothers the necessary knowledge their mother instincts will prompt them to live, eat and care for themselves in a way to insure the highest welfare of their unborn child. This is only partially true. A woman does not lose her love of pleasure, indulgence and indolence and greatly add to her self-control when she becomes pregnant. She is still inclined to follow lines of least resistance.

Cleanliness of the child's eyes is important. It is unfortunate that mothers and nurses do not know how to thoroughly and properly clean a child's eyes. The poor job that most of them do is lamentable. Nurses are trained to sterilize and not to cleanse the eyes. Dr. Tilden declares that:

"If the eyes are kept clean--not pretty nearly clean--there will be no excuse for carrying out the medical supersitition of medicating the eyes of every newborn infant with argyrol, to prevent the possibility of ophthalmia neonatorumi--gonorrheal inflammation of the eyes developing; a sort of left-handed compliment that all mothers have gonorrhea. Gonorrhea is a disease of filth, and will end when the human family learns the art of keeping clean (not near clean)."

The eye; should be carefully cleansed with warm water, using pledgets of absorbent cotton instead of the usual washcloth. Eyes, mouth, anus and genitalia should not be washed with a cloth, for the secretions and excretions from the eyes, nose and mouths of infants should be removed with absorbent cotton and not with the hankerchief. Parents should learn to clean the eyes of a child and not trust a careless or inefficient nurse.

There should never be any trouble with the eyes of infants except for the careless use of wash-cloths by mothers and nurses. Dr. Tilden says: "Few if any mothers know how throughly to wash a child. When they learn how, there will be fewer blind, deaf, and catarrhal. Skin diseases will disappear if personal liberty ceases to be abrogated by manufacturers of vaccine and serum through their henchmen, the vaccinators, and such diseases as infantile paralysis, meningitis epilepsy, and rheumatism will be heard of no more."

He also says: "Cleanliness is more far-reaching than prayer under such circumstances. The mother who will neglect her child in every way except prayer will probably send her child to heaven very early.

CARE OF THE PATIENT: Prompt and persistent action is necessary in order to prevent infection or possible ulceration of the eyes. Cleanliness is the great desideratum. The swelling of the eye lids closes the eyes, the secretion glues the lids together and drainage is prevented. Herein is the real element of danger.

The eye lids must be opened and the eyes thoroughly and completely cleansed every two hours day and night. The discharge must not be permitted to become pent up and septic. Drainage is absolutely essential if the eyes are to be saved.

Medical men employ solutions of silver nitrate, borac acid, bichlorid of mercury, argyrol, and other antiseptics in the eyes. In severe cases ice compresses are constantly applied until the inflammation is suppressed.

The application of ice to the inflamed lids and eyes has the following distinct disadvantages: It suppresses the inflammatory process, reduces the number of white corpuscles, devitalizes the tissues, reduces resistance to infection and perhaps, also, impairs the antiseptic secretions. Coupled with the frequent employment of antiseptic washes which also devitalize the tissues and lessen resistance to infection, this must favor the spread of the infection.

The application of the ice bag, by suppressing the inflammation reestablishes drainage and makes it easy to cleanse the eyes. As drainage and cleanliness are the factors most needed, this constitutes a distinct benefit.

In each case, therefore, the practitioner must carefully weigh the disadvantages and the advantages of the ice pack and decide the procedure in each individually. Where the inflammation is not great enough to materially interfere with drainage the ice pack should certainly be avoided. Where drainage is absent, the ice pack becomes the lesser of two evils and should be chosen. It should be understood, however, as suppression and the after-care carefully provided for.

Thin pledgets of cotton are placed over the eyes (over the affected eye if only one is infected) and so arranged that no weight rests on the eye. Small pieces of ice are placed on the cotton and renewed when necessary. This should not be carried further than is essential to insure drainage and perfect cleanliness.

Dr. Trall said: "the eyes should be bathed several times a day in moderately tepid water at first, and finally as cold as may be found consistent with comfortable sensations after the application."

Some drugless healers use lemon juice solutions in bathing the eyes, while others resort to the antiseptics. Dr. Tilden advises a salt water solution.

If one is not fully free of fear of germs, argyrol is probably the least harmful of the antiseptics and is usually employed in a 10 per cent solution, although this is probably too strong.

Thorough washing with plain warm water is probably enough. But the germ theory has so frightened everyone, even the drugless men who profess not to accept it, that men and women lack the courage to depend on cleanliness. Indeed, they do not know what cleanliness is; they think only in terms of sterility and antiseptics. Trall and others who lived before the germ theory produced the present insanity, cleansed the eyes of these cases with plain water and enjoyed a remarkable success. The water did not injure the eyes, while, unlike the present anti-septic practice, germs never become adapted to cleanliness as they do to anti-steptics. I say germs, because I find Naturopaths, Osteopaths, Chiropractors, etc., all accepting the germ theory and living in constant dread of their activities.

Cleanliness is the great need. The secretions must not be permitted to become pent-up and force absorption after they have become septic. An aseptic condition must be maintained, as far as possible, until recovery is complete. This is all there is to be done. Nature alone does the healing. Vigilance should not be relaxed at any time. Where but one eye of the child is affected every precaution should be used to prevent the infection from reaching the other eye, and to prevent it from reaching the nose and mouth. The child's hands must not be permited to rub its eyes and then be carried to its mouth.

Attendants should use every precaution not to infect their own eyes, or the eyes of others. Strict cleanliness on their own account should be the rule.