278 MEDICAL SECTION 



I need not dwell upon the labours themselves, 

 since on them, and on them alone, the attention of 

 the public and the midwife too often of the training 

 school also is apt to be focussed. Our teaching in 

 this respect is probably not materially behind that 

 of other countries, although I imagine that in those 

 where the problem of the decreasing birth-rate has 

 long made itself felt the condition of the child would 

 be ascertained more frequently than with us, and that 

 symptoms of distress in the fcetal heart sounds would 

 be regarded as a more determining factor in the line 

 of treatment. Look through the notes of almost any 

 midwife on a long case which she has conducted herself 

 from start to finish. The number of internal exam- 

 inations, each one a danger to the patient, may be 

 large, or it may be small, according to the views of 

 the trainirig school plus the timidity of the nurse, but 

 if you find in the notes a really full and accurate 

 description of even one abdominal examination, I 

 shall be surprised, still less a faithful following from 

 hour to hour of the child's condition as revealed by 

 its heart sounds. 



It is also not necessary to do more than glance 

 at the subject of infantile ophthalmia. It is generally 

 recognized now that our blind asylums have been 

 filled year after year by people who would never have 

 been there at all if their eyes had been scientifically 

 treated at the moment of birth. The most optimistic 

 statistics give one quarter of the cases of blindness to 

 this cause ; others speak of one-third, and others again 

 of one-half. Again and again the subject is brought 

 forward, spoken about, written about, discussed ad 

 nauseam, but in spite of all, that precious asset, the 

 eyesight of the nation, is left in the hands of midwives, 

 some of whom have had a three or four months' course 

 of training and some have not, but in any case the 

 majority of them are still, in 1913, rough, unskilful 

 women, with practically no knowledge of either the 

 advantages or the dangers of antiseptics, so that it is 



