THE NOEMAL CONJUNCTIVA 29 



Ortzen examined eighty conjunctivas with a double-looped needle, using 

 glycerinated agar, proved susceptible to Pneumococcus, as the medium, and found : 



Per Cent. 



Bac, xerosis 57'5 \ /rri , , , ,-, . . , 



Staph. albus 96-25 , < The ?* r of B ' xero 1S low 



Pneumococcus ... 4 because of the use of agar.) 



Various single organisms 5 ) ( Aureus not found m thls s ees.) 



In considering the micro-organisms of the healthy conjunctiva, we 

 must first devote special attention to the so-called Bacillus xerosis 

 (Bacille en massue). Other synonyms : Keulen bacillus, Bacillus sebi 

 meibomiani (Keymond and Colomiatti), Bacillus septatus (Gelpke), 

 Bacillus pseudodiphthericus vulgaris (Heinersdorff), Bacillus granulosus 

 (Lachowicz). 



Those who would study the bacteriology of this region of the body 

 at all, or would make any clinical diagnosis from it, must be quite 

 conversant with the occurrence of this organism on the healthy 

 conjunctiva, and must have personal experience on this point. 

 Explanation and discussion of this subject would then be greatly 

 facilitated. Erroneous doubts and useless controversy would then 

 disappear, and those who have not gone deeply into the matter, but 

 have followed the question in the literature, and would like to make 

 practical use of their knowledge, would not then be confused and 

 bewildered so easily. 



It is instructive to glance at the history of the literature of this 

 organism : 



Bezold in 1874, in a case of xerosis and keratomalacia, found bacilli ' having the 

 appearance of leptothrix,' whose fuller description resembles that of the later 

 B. xerosis. Bezold was of the opinion, to which we have now returned, that a 

 harmless inhabitant of the conjunctiva had greatly increased in number owing to 

 the general disturbance of nutrition. In 1880 a short analogous notice by Denk 

 followed. In 1881 Reymond, Colomiatti, and Perroncito published fuller de- 

 scriptions, gave the organism the name B. sebi meibomiani, and considered it 

 non-pathogenic. In 1882 Homer obtained similar results to Bezold in a case ef 

 keratomalacia. 



The larger work of Kuschbert and Neisser, appearing in 1883, brought forward a 

 new view. They insisted that the organism which they had found, occurred always 

 and only in cases of xerosis of the conjunctiva. They attributed to the organism 

 a causal significance, although an infection of the normal conjunctiva gave no 

 result. Shortly after, but independently, came the well-known paper by Leber, 

 who at first considered the organism as the cause of xerosis, but afterwards found 

 these bacilli in the internal organs. Schultze had similar results. Leber furnished 

 an exact morphological description. 



In the same year Schleich reported that he had obtained pure cultures ; he also 

 found the same organism in the secretions in chronic conjunctivitis. Sattler and 

 he found the organism in pus from the lacrymal sac, and threw doubt on its 

 pathogenicity. Michel (1884) found the organism on normal conjunctivas. Schleich 



