280 THE TREATMENT OF DISEASES. 



right away ; unless this precaution be taken, one child after another goes into the 

 infirmary with "bad eyes," and the cases increase in number and severity day 

 by day and week by week. Matters proceed from bad to worse; the whole 

 establishment is disorganised, nurses and helpers suffer, many eyes are irrevocably 

 injured, and a public scandal is created. When there is an outbreak, a doctor 

 should be called in at once, that he may examine systematically the eyes of every 

 child in the institution. In this way he will be able to separate the unhealthy 

 from the healthy. It is probable that the whole place will have to be fumigated 

 or disinfected in some way before the disease can be stamped out. The washing 

 arrangements will have to be so conducted that personal contact between the 

 children is avoided. Each child should receive a dry towel from the attendant in 

 charge, and should return it to him when done with. These towels are not to be 

 used again until they have been boiled, or dried in a hot closet at a sufficiently high 

 temperature to destroy their infectiousness. The same person should not attend 

 on the healthy and the sick. An epidemic of " bad eyes " in a school or other 

 institution is a most serious matter, and too much care cannot be displayed in 

 stamping it out. 



Inflammation of the eyes in newly-born infants often occurs when the mother 

 at the time of her confinement suffered from a discharge. It may also arise from 

 neglect of cleanliness, from exposure of the eyes to the glare of a hot fire, and from 

 the use of irritating substances soft soap and spirit, for example with which chil- 

 dren are often washed soon after birth. It generally comes on when the child is a day 

 or two old, and usually it is first noticed that there is a slight discharge from the eyes, 

 and that the edges of the lids are glued together during sleep. The secretion is at first 

 clear and watery, but soon gets thick, like matter. The more profuse the discharge 

 and the deeper its colour the more serious is the case. The treatment consists in 

 washing away the secretion as often as it collects with some astringent lotion, that 

 will check its formation. The lotion may be made by dissolving a drachm of alum 

 in half a pint of water. It should be used every hour, or oftener, according to the 

 amount of discharge, both day and night. The nurse should lay the child on her lap, 

 turning its head to one side or other, according to the eye to be washed out. 

 With the finger and thumb of the left hand she holds the lids open, whilst with the 

 right hand she squirts into it with a small glass syringe a good stream of lotion. It 

 should be directed outwards away from the nose, so that the lotion runs over the eye 

 into the napkin on which the child's head rests. If an efficient nurse cannot be ob- 

 tained, the lotion may be applied by means of a soft camel's-hair brush, but this is 

 far less effective than syringing. A good way of preventing the child from struggling 

 is to place it with its arms by its side on a shawl or long towel, which should be 

 wrapped round it several times, leaving only its head out. The lotion may be slightly 

 warmed by placing a little in a cup in front of the fire for a minute or two, or by the 

 addition of warm water. A little spermaceti ointment applied to the edges of the 

 lids will keep them from sticking together at night. The child should be kept in a 

 warm airy room until all inflammation has subsided, and it would be as well not to 

 have the room too brilliantly lighted. Plenty of good breast milk is essential, and 

 should the mother's supply be deficient a wet-nurse must be procured. The most 



