Europ. J. Obstet. Gynec. reprod. Biol., 13 (1982) 59-60 Elsevier Biomedical Press

CLASSIC ILLUSTRATION

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Fig. Miss J. Ward, S.R.N., in 1956, with one of the earliest of the infants given phototherapy at Rochford General Hospital.

Figure taken from: Dobbs, R.H. and R.J. Cremer (1975): Phototherapy. Arch. Dis. Child., 50, 833-836. Reproduced with permission.

002%2243/82/0000-0000/$02.75 @ 1982 Elsevier Biomedical Press

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Sister J. Ward, shown in the figure, was the sister in charge of the Prema- ture Unit at Rochford General Hospital, Essex, England. She was a keen fresh air outdoor fan and on warm summer days wheeled the more delicate infants out into the courtyard, sincerely convinced that the combination of fresh air and warm sunshine would do them much more good than the stuffy overheated atmosphere of an incubator. As Dobbs and Cremer write: ‘one particular fine summer’s day in 1956, during a ward round, Sister Ward dif- fidently showed us a premature baby, carefully undressed and with fully exposed abdomen. The infant was pale yellow except for a strongly demar- cated triangle of skin very much yellower than the rest of the body’, Sister Ward explained that jaundice was more intense where a corner of the sheet had covered the skin area.

Subsequent observations thereafter revealed that sunlight had an action on blood samples ‘behaving like traffic lights as they turned from red to yellow and then green’. Confirmation of a photo-oxidative action was given by a simultaneous increase in oxidation-reduction potential measured electrically. An apparatus was constructed to illuminate jaundiced babies, care taken to protect the baby’s eyes by a simple plastic shield. The clinical and biochemi- cal findings were published (Cremer, Perryman and Richards (1958): Lancet I, 1094).

Ten years were then to pass before phototherapy was virtually redis- covered in America, and then quickly it gained a measure of recognition and respectability. The major contribution made by Sister J. Ward and the bio- chemists P.W. Perryman and D.H. Richards should not be forgotten.

T.K.A.B. ESKES Nijmegen