570 DISEASES OF UNKNOWN ETIOLOGY 



Halberstadter and Prowazek 1 have described endocellular bodies 

 lying within the conjunctival epithelium and usually near the cell 

 nuclei, which are minute oval or round granules frequently occurring 

 in pairs, of somewhat variable size, but smaller than ordinary cocci. 

 They are typically enclosed in a somewhat indefinitely defined homo- 

 geneous matrix which is regarded as a reaction product. The earlier 

 lesions contain moderate-sized oval or round bodies which stain a 

 faint bluish color with Giemsa's stain; later very minute oval or 

 spherical bodies appear, which color reddish with the same stain. 

 These observations were soon confirmed. Somewhat later the same 

 investigators described inclusions in the conjunctival epithelium of 

 uncomplicated cases of blennorrhea neonatorum which were prac- 

 tically identical histologically with those described. This observation 

 naturally led to new investigation of the subject. 



Berterelli and Cecchetto 2 claimed to have reproduced trachoma in 

 a Macacus monkey with a filtrate (Berkefeld) prepared from a human 

 case. Nicolle, Guenod and Blaisot 3 were unable to infect monkeys, 

 but stated that anthropoid apes were susceptible to the trachoma virus. 



Herzog 4 believed that the "trachoma bodies" were involution forms 

 of the gonococcus which, under certain unknown conditions, develops 

 into very small forms that are indistinguishable from the trachoma 

 bodies when they are within the epithelial cells. Herzog claims to 

 have developed these very minute forms (microgonococci) in artifi- 

 cial media through a series of rapid transplantations, and he states 

 that this minute state in the development of the organism is the one 

 which leads to trachoma. Williams 5 has studied trachoma extensively 

 and believes that the cellular inclusions characteristic of trachoma are 

 degenerated hemoglobinophilic bacilli. Noguchi and Cohen 6 have 

 cultivated an organism from cases of conjunctivitis in which the 

 inclusion bodies were present, and from an older case in which no 

 inclusion bodies were found, which repeats in culture many of the 

 important morphological appearances of the trachoma bodies. It is 

 certainly neither a gonococcus nor a member. of the group of hemo- 

 globinophilic bacteria, but its identity with the trachoma bodies is 



1 Deutsch. mod. Wchnschr., 1907, xxxiii, 1285; Arb. a. d. Kais. Gesundheitsamte, 1907, 

 xxvi, 44. 



2 Centralbl. f. Bakt., Orig., 1908, xlvii, 432. 



3 Compt. rend. Acad. sc., 1911, clii, 1504. 



4 Centralbl. f. Bakt., Ref., 1910, xlviii, 276; Arch. f. Ophth., 1910, Ixxiv, 520; Ueber 

 die Natur und Herkunft d. Trachomaerregers, Berlin and Wien, 1910. 



6 Arch. Ophth., 1913, xlii, 506; Jour. Inf. Dis., 1914, xiv, 261. 

 6 Jour. Exp. Med., 1913, xviii, 572; 1915, xxii, 304. 



