“1. The ophthalmia of infancy is an infectious germ disease.
“2. By the instillation of a silver salt in the eyes of a new-born infant the disease is prevented from developing in all but an exceedingly small number of the cases in which it would otherwise have appeared.
“3. In practically all those few exceptional cases the disease is absolutely curable, if like treatment is employed at a sufficiently early period.
“Since these facts are no longer subjects of discussion, but are universally accepted by all educated medical men, the natural inquiry follows: Why, as a common-sense proposition, are not these simple, harmless, preventive measures invariably employed, and why, in consequence of this neglect, does a nation sit quietly and indifferently by, making no attempt to prevent this enormous and needless waste of human eyes?
“The reasons are three-fold, and lie—first, with the medical profession; second, with the lay public; third, with the state.
“For the education of its blind children annually New York alone pays per capita at least $350, and a yearly gross sum amounting to much more than $100,000. If, as sometimes happens, the blind citizen is a dependent throughout a long life, the cost of maintenance is not less than $10,000, and the mere cost in money will be multiplied many times in that a productive factor, by reason of blindness, has been removed from the community.
“If, therefore, as an economic proposition, it were realized how vitally it concerns the state that not one child shall needlessly become blind, thereby increasing the public financial burden, there is no doubt that early and effective measures would be instituted to protect the state from this unnecessary and extravagant expenditure of public funds.
“Eleven states have passed legislative enactments requiring that the midwife shall report each case to the proper health authority, and affixing a penalty for the failure to do so. As has been intimated, however, it is not by any means always under the ministration of midwives that these cases occur, and, like all laws behind which is not a strong and well-informed public sentiment, this law is rarely enforced. A more effective method must be devised. Every physician having to do with the parturient woman, every obstetrician, every midwife, must be frequently and constantly advised of the dangers and possibilities of this disease, the necessity of prevention, and the value of early and correct treatment. They must then have placed in their hands, ready for instant use, a safe and efficient preparation, issued by the health authorities as a guarantee as to its quality and efficiency.
“An important step was taken in this direction when a resolution was passed by the House of Delegates at the annual meeting of the New York State Medical Society, requesting the various health officers of the state to include ophthalmia neonatorum among contagious diseases which must be reported to the local boards of health.
“The second essential, in order that the cause of infantile ophthalmia be abolished, is that a solution of the necessary silver salt be prepared under the authority of somebody capable of inspiring universal confidence, and that it be distributed by the health department of every state gratuitously to every obstetrician, physician or midwife qualified to care for the parturient woman. The nature of the solution, together with the character of the descriptive card which should accompany it, should be determined by a committee, chosen by the president of the American Medical Association, which should have among its members at least one representative ophthalmologist, one obstetrician and one sanitarian. The conclusions of this committee should be reported back to the House of Delegates, so that the preparation and its text should carry with it, on the great authority of this association, the assurance that the solution is entirely safe and necessary, and that its use should invariably be part of the toilet of every new-born child. The solution, probably silver nitrate, could be put up either by the state itself or by some trustworthy pharmacist, at an insignificant cost; its purity and sterility should be vouched for by the board of health of the state. It should be enclosed in specially prepared receptacles, each containing a special quantity, and so arranged that it may be used drop by drop. These, properly enclosed, accompanied by a brief lucid explanation of the danger of the disease, the necessity of this germicide, the method of its employment, and the right subsequent care of the eyes, should be sent to the obstetrician on the receipt of each birth certificate.