THE CONJUNCTIVA 159 



The method for the recognition of the go no coccus need not 

 be further described (see p. 106), nor is it necessary to point out 

 the danger of this form of conjunctivitis, nor the fact that 

 prompt measures must be taken if the eye is to be saved. 



Other organisms somewhat resembling the gonococcus 

 sometimes occur in the conjunctiva, but I have never seen or 

 heard of a case in which they were absolutely identical in 

 appearance and distribution, and present in numbers sufficient 

 to lead to errors in diagnosis. If any doubt should arise cul- 

 tures must be made, but do not wait for them before com- 

 mencing treatment. 



The pneumococcus is not a common cause of conjunctivitis, 

 and when it occurs the prognosis with regard to the involve- 

 ment of the cornea is not serious. 



The bacillus of Koch and Weeks is extremely minute, and 

 has a close resemblance to the influenza bacillus. It is very 

 thin in proportion to its length, does not stain by Gram, and 

 is frequently intracellular, the cells then containing large num- 

 bers of bacilli, though it may be necessary to search over a 

 considerable area of film before an affected cell is seen. It is 

 advisable to search for the organisms in a thionin or Loffler's 

 blue specimen, as it will probably be more distinct than in the 

 Gram specimen counterstained with carbol fuchsin. 



If the two occurred in the same region, it would probably 

 be indistinguishable microscopically from the influenza bacil- 

 lus; they differ, however, in cultural characters. 



It causes the common self-limited variety of acute or chronic 

 conjunctivitis. There is no danger that the cornea may be- 

 come infected; the disease is very contagious. 



The bacillus of Morax and Axenfeld (Plate IV., Fig. 3) 

 causes the dry conjunctivitis which occurs especially along 

 the edges of the eyelids and at the angles of the eye, and which 

 does not tend to cure in the absence of appropriate treatment. 

 The secretion is^ usually very scanty, and not purulent ; it is 

 best collected from the caruncle, and it may be necessary to 

 use a capillary pipette for the purpose. 



It is readily recognized as a rather large, broad bacillus, 

 with the sides parallel and the angles slightly rounded, and 

 two bacilli are often seen with their ends approximated to- 

 gether. It is most frequently extracellular, but some bacilli 

 are frequently seen within the cells. Gram's stain is not 



