The douche fulfills the requirements of cleanliness, which are so essential. Critical ease referred to which recovered under systematic irrigations with the douche of a 1-per-cent. solution of boric acid. In this and other cases the other well-known methods had been tried and failed. Holt (Jour. Amer. Med. Assoc., Jan. 5, 1901).
Treatment. —The treatment is the same as has just been given under the gonorrhmal ophthalmia of adults, with the exception that the protection of the sound eye and the application of com presses are not, as a rule, feasible.
Oonorrlueal conjunctivitis in fifty seven newborn infants treated with calomel. The gonococcus of Neisser was found in the discharge in all the eases. The conjunctival mucous membrane hav ing been syringed with a. 2-per-cent. solu tion of boric acid, and well dried with absorbent cotton, was dusted with calo mel. One day after the first application the discharge and swelling of the mucous membrane dhninished, even in severe cases. Sometimes the dusting had to be repeated two or three times. The treat ment lasted only for a week, and in neglected cases of long standing not more than a fortnight. The results were very satisfactory. Pukalof (Wrateh, No. 27, '97).
In purulent ophthalmia ill the newborn the lids are first cleansed, then 1-per-cent. to 2-per-cent. solution of copper sulphate applied; 5-per-cent. ichthyol salve is to be used three times daily. Elze (Woch. f. Therap. tt. Hyg. d. Auges., Nov. 11, '98).
Silver-nitrate solutions should only be used in the later stages of the disease, after the intense swelling of the eyelids has begun to subside and the discharge is more purulent. A 2-per-cent. solution may then be applied to the conjunctival surface and neutralized with salt solu tion. Nothing, however, should ta,ke the place of the constant cleansing. Solutions of protargol seem less reliable than silver nitrate. The edges of the eyelids and the surrounding skin should be protected with vaselin. In patients who are in poor physical condition, the application of heat will often prove bet ter than cold. If the cornea becomes hazy and a, small ulcer forms, the irri gation should be continued and a. 1-per cent. atropine solution applied three times a day, with hot applications. In
some cases of marginal ulceration solu tion of eserine, 1/2 grain to the ounce, ma.y be used every four hours, but with care. In adults, if the disease has only affected one eye, the other eye should be a,t once protected by covering it with a small pad of absorbent, cotton and gauze. C. II. Williams (Boston Med. and Surg. Jour., Feb. 7, 1901).
The best results, as shown by an ex tensive investigation, were obtained when a 2-per-cent. solution of silver nitrate was used immediately after birth, following the suggestion of Cred6. Only 0.65 per cont. were affected with the disease when this solution was used. Almost equally flS good results were ob tained from a 1-per-cent. solution of sublimate, but weaker solutions were attended by higher percentages of oph thalmia. Furthermore, irritant elTcets from this drug are so rare that they are hardly worth considering, and substi tutes for silver nitrate seem to be un necessary. Recently protargol in 20 per-eent. solution has been employed with good results, and it is claimed that it is unirritating. the treatment of this affection it is said that the sfage in which a ease of infantile ophthalmia is seen should be its worst stage. From the time when applications of a 2-per cent. solution of silver nitrate once every twenty-four hours to the inner surface of the everted lids are begun the condition should commence to improve. Cold compresses are also useful. E. T. Collins (Practitioner, April, 1902).
Notwithstanding the application of Cred6's method there are still a large number of eases of blennorrhcca in the newborn. This method was applied to 902 children born in the clinic for women in Berlin, and 1.5 per cent. suffered from blennorrhcea.
The clinic for diseases of women in Gottingen shows better results with Cred6's method. In the period since 1888 there were 1917 births in which no single case of early blennorrhcett oc curred, and only 3 of late infection, and all of these were slight. Gonorrlica is a frequent disorder in the inaternity; in a series of eases in which this infec tion was carefully looked for it was found present in nearly 25 per cent.