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*The Ladies' Home Journal, January, 1907.

We all know that a large number of people become blind every year. But it is not generally, known that many human eyes are needlessly lost which, if right corrective and preventive measures were employed, would be saved to the service of the world. And what we should know, in particular, is that much of this blindness can be prevented by the mothers themselves.

We live in an epoch of reform. I read that men and women are valiantly contending against the greed and neglect that condemn thousands of children to dwarf their minds and bodies in labour; I hear that we are striving to protect ourselves against impure food and dangerous "patent medicines." But of all ignorance which needs to be dispelled by the spirit of regeneration among us, none is more intolerable than that which wantonly permits children to be plunged into the abyss of blindness.

Two fifths of all blindness could have been prevented by precautionary or curative treatment. Of this, one quarter, or one tenth of the whole, is due to what is called "ophthalmia neonatorum" -- that is, "infantile ophthalmia."

"What is ophthalmia neonatorum?" It is an inflammation of the eyes which attacks the new-born child and is one of the most prolific causes of blindness. It is occasioned by germs finding an entrance in the eyes of the child during the process of birth. In from twenty- four to sixty hours after the birth of the child whose eyes have been infected the eyes grow red and a watery secretion comes from the lids. This soon grows thicker and more profuse until a creamy discharge pours out from the eyes. The lids become swollen, hard and red. If this condition is allowed to continue, the eyeballs become ulcerated until finally they rupture and the child in many cases becomes blind.

All this can be prevented. If, at the time of birth, the baby's eyelids are gently wiped dry with a little absorbent cotton and the lids held open while the eyes are flushed with a saline solution -- as warm and as salt as normal tears -- the malignant germs may be washed away and the danger averted.

But as it is not always possible for those with untrained hands to accomplish this skilfully and thoroughly, and as under any circumstances we cannot be certain that all of the virulent microscopic germs are removed, it is necessary as a further step that one or two drops of a solution of nitrate of silver of a determined strength be dropped in each eye of the new-born child. Should a strong solution be used, as it may be by the physician, it should be immediately neutralized by a few drops of slightly salted boiled water; with a weaker solution this neutralization is not necessary. This silver preparation destroys the germs without injuring the eyes and its use practically eliminates this frightful disease as a cause of blindness.

As it is never possible to know in which baby's eyes the germs have found lodgment, and as the use of the silver is safe and sure, the preventive solution should be invariably employed at every birth. To delay or omit it is to invite unnecessary danger.

It happens, however, in a few cases, even where silver nitrate is used, that some of the microbes escape destruction and remain to threaten the sight. This does not mean that all is lost, that the child's chances are gone. The same remedy judiciously applied at a sufficiently early period in the progress of the disease and under competent medical advice will destroy the germs and thereby control the inflammation and still prevent blindness.

Since the value and importance of this measure is universally conceded, and its employment commended by the medical profession, it would seem remarkable that it does not form a part of the toilet of every new-- born child, and the inquiry is naturally suggested: why is it not always employed in the eyes of the new-born? How can it ever happen that so simple a preventive measure can be omitted, when its neglect leads to such disastrous consequences? In almost all the large hospitals and in the practice of nearly every careful scientific physician it is, indeed, a routine measure, but ignorance, indifference, and negligence are still abroad in the land, and until those shall be aroused who feel a moral responsibility in defending the rights of the helpless infant thus cruelly assailed, babies will be blinded and lives will be blighted, world without end.

There would seem to be three reasons why every physician (and every midwife who takes the physician's responsibilities at a birth) does not invariably employ a silver solution in the eyes of every new-born child: first, many who have to deal with the expectant mother are not acquainted with the character of this germ disease and have not yet learned the importance and necessity of preventive measures; others hesitate to employ this valuable specific from a wrong impression that it may harm the tender eye of the infant child; but the neglect in far the greater number of cases is due to the fact that the silver solution does not happen to be present at the moment at which it is needed, and as the" majority of children escape infection, the chance is taken that each child may be one of the fortunate. The propitious moment at which the silver nitrate might be effectively employed is allowed to pass, and when next the opportunity comes it may be too late.

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In order that this pitiable condition be not allowed to continue, two things should be done at once. A campaign of education should be inaugurated and every expectant mother should be made acquainted with the peril which may threaten her child so that she may insist that it be protected; and then the State should freely and gratuitously place in the hands of every accoucheur an aseptic silver solution that carries with it the assurance on the part of the highest medical authority as to its necessity, its purity, and its safety.

There is but one reason why this great movement should not quickly and effectively succeed in abolishing infantile ophthalmia as a cause of blindness, and that is general apathy. In order that the necessary and uniform legislation be secured in every State, efforts must be made. The mothers in every State must demand it. In every class of society the women should know of the cause and dangers of this disease.

If the mothers of America could be made to realize that their babies are in danger of losing their sight, and that the dread calamity can be warded off by applying a simple, precautionary remedy at the right time, they would be quick to demand of those in authority that the symptoms of the disease shall be known by those whose duty it is to know them, and that for safety the remedy shall be at hand before the symptoms appear.

A careful examination of the children of the New York School for the Blind for several years showed that among city children ophthalmia neonatorum causes one case of blindness in three. In the country the relative number of cases resulting from infantile ophthalmia is greater than in the cities. The reason for this is that, though the disease is widespread, a physician in a small community may never have seen a case. He may not recognize the disease if it appears. If he knows about the nitrate of silver treatment he may fail to use it because he wrongly fears that it may injure the delicate eyes of the child. He may not see the child again for several days; then the disease has got beyond his control. The cornea is destroyed and the infant's sight irrecoverably lost! The safe rule for physicians is to regard with suspicion the slightest inflammation in the eyes of an infant, and it is the rule for mothers, too; for the mother who is watchful and informed will know how to make the right demand upon her physician.

The mother thinks with joy and pride that her child will grow in God's light to be a strong man, able to do a man's work. Suddenly she is plunged into the cruelest anguish by the discovery that her child's beautiful eyes are put out forever. Not till then does she realize how terrible is the foe that has lurked by his cradle. Imagine her feelings if afterward she learns that this disaster was needless, that it could have been avoided by prompt, efficient measures. Her grief is embittered by indignation against the physician in whose hand she had placed the safety of her child. Whatever may be done to soften the misfortune of the child, her heart will never be whole again.

Blindness in infancy is worse in some ways than blindness in late childhood, or even in adult life. It arrests development. The plight of the blind baby is indeed heartrending. He loses much of the physical activity and incentive and the various intellectual experiences of the normal child. Even in the best of homes it is not often possible to give him the special, constant care, teaching and encouragement that he requires. He is not admitted to the kindergarten for the blind, if there be one, until he is five years old. In the meantime he grows weak and deformed in body and mind, and acquires nervous habits which it is extremely hard to break when his education begins. Your heart aches as you look at him, feeble, pitiful, enervated, beside his strong, merry comrades who have lost their sight at a later period, and who can go forward with firm steps where he halts and stumbles. Even if he is successfully taught, and develops capabilities, even if he is not doomed in his mature years, as are so many of the blind, to idleness and dependence, his loss of sight is irreparable. A blind person, however well instructed, however carefully equipped, can never be so free, so self-reliant as if he had his eyes. In this country, until very recently, little has been done to enable the grown-up blind to work for a livelihood, to earn their limited share of independence and self-support. They are for the most part poor, and if no relative or friend cares for them they become objects of charity, a burden to the State. Such is the lot of thousands of men and women who a generation ago needlessly lost their sight. Such is the fate that threatens our little ones to-day.

It is true that we are preparing to take better and better care of the blind. Intelligent work is going forward all over the country to lighten the burden of blindness. But, however merry our blind children, however brave and self- reliant our blind men, I say, could the utmost dreams of education for the sightless be realized, the dark is still the dark, and blindness an irremediable calamity.

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Therefore I say, let us check this dread disease and danger. The State should require that every case of disease of the eye in the newborn be reported. If blindness follows, then an investigation should be instituted. The certainty that such an investigation would surely follow would compel physician and nurse to exercise the utmost care in the treatment of the new-born.

By such vigilance on the part of the Commonwealth hundreds of individuals would be spared misery and dependence, and the Commonwealth itself would be saved expense. The entire cost of preventing ophthalmia is indeed an ounce of prevention to the many pounds that avoidable blindness costs the State. The cost of educating a blind child in a good school is three hundred dollars a year. The special expense necessary to make a blind man self- supporting, even in conditions far better than now exist, must be an extra expense to the State. If, as is the too common case, a blind citizen becomes dependent through a long life, the average sum spent for his maintenance is ten thousand dollars. This sum must be multiplied many times to determine the total loss; for by blindness a productive breadwinner is removed from the community.

If a tithe of the money we now spend to support unnecessary blindness were spent to prevent it, the State would be the gainer in terms of cold economy, not to speak of considerations of happiness and humanity. How, then, can a wise Commonwealth suffer a single case of avoidable blindness to pass unquestioned? We pay money in advance to insure our property and the property value of our lives. Yet we have not the foresight to insure our children against the bitter and costly evil of blindness!

In ancient times disease was looked upon as a curse to be conjured away. Later it was regarded as a necessary misfortune to be cured or alleviated. In our own time it is known to be the result of wrong living, and therefore to be avoided and prevented. Prevention has come to be the all-important aim of medical science. The fight to exterminate yellow fever and tuberculosis is a greater battle than any that the doctors have waged against disease after it has seized upon the patient. If our physicians have undertaken to exterminate so subtle an enemy as tuberculosis, they should make short work of ophthalmia neonatorum, which is obvious and easily cured. To do battle with it our physicians must march as soldiers have gone forth before, ordered by the State and urged on by women. American women can accomplish almost anything that they set their hearts on, and the mothers of the land together with the physicians can abolish infantile ophthalmia, yes, wipe it out of the civilized world.