160 CLINICAL BACTERIOLOGY. 



metritic process. The bacteria pass by continuity from the 

 mucous membrane of the uterus to that of the tube, and 

 from this to the ovary. The most frequent cause is, there- 

 fore, gonorrhea. In addition, the presence of streptococci, 

 staphylococci, coli-bacilli, and Frankel's pneumobacilli has 

 been demonstrated. A special position is occupied by 

 tuberculosis of the tubes. Exceptionally, the oviducts are 

 attacked by actinomycosis. The oophoritis that occurs in 

 the course of some infectious diseases is due to the excit- 

 ing agents of the primary disease, or they are caused 

 secondarily by pyogenic microorganisms. 



Perimetritis and Parametritis. Primary inflammation 

 of the perimetrium and the parametral connective tissue is, 

 almost without exception, dependent upon puerperal in- 

 fection (streptococci, staphylococci, bacterium coli, in mixed 

 infection also proteus), in the course of which the exciting 

 agents of suppuration gain access to the perimetrium and 

 the pelvic connective tissue by way of the lymph-channels. 

 Secondary inflammation exhibits the same etiologic rela- 

 tions as salpingitis and oophoritis, of which it constitutes a 

 complication. Gonorrhea frequently and tuberculosis less 

 commonly are of etiologic significance in this connection. 



INFLAMMATORY DISEASES OF THE EYE. 



Conjunctivitis. The following microorganisms have 

 been cultivated in cases of simple conjunctivitis : Staphylo- 

 cocci, streptococci, pneumococci. Diphtheric conjunctivitis 

 is excited by the diphtheria-bacillus, gonorrheal conjunc- 

 tivitis by the gonococcus, and tuberculous conjunctivitis 

 by the tubercle-bacillus. 



Keratitis. Some cases of keratitis owe their origin to 

 the common exciting agents of inflammation and suppura- 

 tion, which at times gain access to the tissues through a 

 lesion of the cornea. Hypopyon originates in a similar 

 manner. 



Iritis and Choroiditis. Inflammation of the deeper 

 structures of the eye arises secondarily by extension of the 

 pyogenic organisms from the cornea (contact-infection), or 

 metastatically through dissemination of the bacteria by 

 means of emboli (puerperal fever, pyemia, etc.). The same 

 statement applies to panophthalmitis. Primary inflamma- 

 tion of the choroid and retina is usually dependent upon 



