Figure 13-A'very common mild case. throughout the disease.

Able to go

around

Figure 12-A common variety. Able to be up after three

or four days.

fiscal court which hestitates and hinders where immediate and decisive action is so important, will fully test the patience, firmness and tact of the most experienced and judicious health officials.

Fortunately more and more of the fiscal officials and intelligent people are recognizing the necessity of enforcing the law at the outset as a means of minimizing the expense and trouble of management. Most of our county and municipal boards are having distinctly less trouble in securing moral and financial support than in former years. If this could be further developed so that the precautions herein suggested could be effectively enforced throughout Kntucky for six weeks we would have no smallpox. If successive generations were systematcally vaccinated we would never have any more smallpox.

Reader, will you not have yourself and every one for whom you are responsible vaccinated at three places on the arm to-day? Copies of this circular for free distribution may be obtained by writing to the Board at Bowling Green.

By order of the Board,

WILLIAM BAILEY, M. D., President.
J. N. MCCORMACK, M. D., Secretary.

PREVENTION OF OPHTHALMIA NEONATORUM.

(The Disease of Babies' Eyes Which Causes Blindness.)

Circular Issued by the State Board of Health of Kentucky. To the Health Officials, Physicians and People of Kentucky:

1. Ophthalmia neonatorum is a purulent inflammation of the eyes of new-born babies. It generally begins from one to three days after birth. In exceptional cases it may appear when the infant is a week or two old, or even later.

2. The cause of this disease is infection by a micro-organism. In severe cases this is nearly always the gonococcus which is illustrated in the accompanying figure. Occasionally other organisms, such as pneumococcus and streptococcus may cause purulent ophthalmia in infants.

3. The infection generally takes place from the vaginal discharge getting into the infant's eyes during birth. When the disease begins later than the fourth day it has been caused by lack of cleanliness on the part of the attendants.

4. This disease is responsible for about one-fourth of the blind in early life and about one-tenth of all the blind in the world.

5. Blindness from this disease is the more disastrous because it means practically a whole life of blindness, whereas loss of sight from other causes oftener occurs in the declining years of life when usefulness is already on the wane.

6. So great is the burden to the Commonwealth in the care of the blind and so great the calamity to the patients and his friends that many States have passed special laws in regard to Ophthalmia Neonatorium, laying a heavy penalty upon the midwife or attendant who fails to summon a physician on the first appearance of the disease.

7. Ophthalmia Neonatorum is practically a preventable disease by a simple method of prevention.

8. In Europe Lying-in hospitals the proportion of infants having this disease has been reduced from ten per cent to two-tenths of one per cent by this preventive measure.

9. This means of prevention is as follows: As soon as the child is born the eyes should be carefully cleansed with a saturated solution of boracic acid, wiped dry with a little absorbent cotton, the lids carefully opened and one or two drops of a two per cent solution of Nitrate of Silver dropped into the conjunctival sac.

This application should neither be neutralized with a salt solution nor be repeated.

10. Even when the eyes have already been infected during birth by the gonococcus this organism is destroyed by the silver and the disease almost certainly prevented.

11. In view of the fact that a single application of two drops of a two per cent solution of Nitrate of Silver is practically harmless, its invariable application is wise.

12. Where there has been vaginal discharge or other reason to suspect infection, the application of silver is imperative. In country practice, where frequent visits from the attending physician may be impossible, this method of prevention is all the more important.

13. The more recent preparations of silver, Argyrol and Protargol, have been used in place of the Nitrate in twenty-five per cent solution, but it is not yet proven that they are equally efficient.

Where infection is suspected Nitrate of Silver should be used.