There is an infection of the child's eyes by gonococci possible even while the child is in the womb, but this is very exceptional; the infection happens in the vagina during delivery, as a rule. When the child's head is born its lids and eyelashes should be cleansed with vaseline, or 1 to 5000 bichloride, or carbolized oil, before the eyes are opened to put in the silver nitrate solution. This solution should be made from a pure drug or it will injure the eyes. A one per cent. solution is strong enough for routine work, but if the gonococcus is suspected, or if it is known that the mother has gonorrhea, then the lids of the infant must be everted and touched everywhere with a five per cent. solution of silver nitrate. This is neutralized with a salt solution and washed out before the lids are turned back. It is rash to trust any of the albuminoid preparations of silver, like argyrol, silvol, or protargol, in gonorrhea or suspected gonorrhea of the eyes. If the child develops ophthalmia the treatment should be turned over to an oculist when possible. When a child can have a day and a night nurse, this method should be adopted, but ordinarily there is no nurse except some woman about the house or the mother. In such cases one eye, commonly the right, does better than the other because the first eye treated is opened readily, but after the infant has been irritated it shuts the eyes so strongly that it is difficult to open them at all. The first eye treated is habitually the same. The nurse should begin to treat the eyes alternately on this account, or wait to treat the second eye until after the baby has quieted down. Iced compresses should be used, but not so long as to chill the eye very much--five to ten minutes at a time is enough. If the physician himself makes the applications of silver nitrate, the nurse should use some silver salt like argyrol. Three to eight grains of zinc sulphate to eight ounces of boric solution is a good regular eye-wash in these cases. Atropine must also be instilled to protect the iris. If only one eye is affected, the other eye should be protected under a watch glass sealed over it. All persons who have gonorrhea, or who treat gonorrhea, must be warned of the danger they are in of infecting their own eyes. A new treatment of gonorrhea is described by Weiss.[199] The gonococci are killed by a temperature of 107.6 degrees Fahrenheit, and in eleven cases Weiss subjected men to a hot bath for forty to fifty-five minutes, with the temperature of the water gradually increased from 104 to 110 degrees Fahrenheit. In one instance the body temperature was raised to 108.5 degrees F. in a forty-minute bath and the gonococci disappeared at once. In the other cases the body temperature did not go up so high, but the vitality of the gonococcus was evidently reduced, and under a few local injections they all disappeared. [199] _Münchener medizinische Wochenschrift_, November 2, 1915. CHAPTER XXI DIABETES IN PREGNANCY