xii INTRODUCTION 



A distinction must be drawn between those who are students of 

 scientific bacteriological problems, and who must be expert bacteriolo- 

 gists, and the larger number who, without having acquired such 

 bacteriological skill, still wish to become familiar with this important 

 subject of etiology, and also to make use of the ascertained facts to 

 decide clinical, statistical, and therapeutical questions, as well as those 

 who desire to examine clinically the exudations in their cases. Here 

 a wide and profitable field is open. 



In the last-mentioned class the best results are got by those who 

 examine the most cases ; these people often obtain useful information. 

 The busy practitioner who considers that he has not time for such 

 examinations in his consulting-rooms will still require bacteriological 

 assistance in cases of severe epidemics, inflammations, and corneal 

 suppurations, and as a preliminary to many operations. While those 

 who wish to make use of serum and other allied forms of treatment 

 cannot do without examinations of the body fluids ; and even though 

 the methods are in their infancy, in some instances valuable results 

 have been obtained. 



Although the laboratories throughout the country for the diagnosis 

 of diphtheria can be used by the ophthalmic surgeon for many other 

 diagnoses, much will remain to be done by the surgeon who is in even 

 these favoured circumstances. 



Even in the absence of trained assistance one can be greatly 

 assisted in the examination of pathological secretions and exudates 

 if the fixation, Gram staining and mounting, be done by a nurse or 

 other person ; they rapidly learn the manipulation necessary, and 

 then the surgeon need only undertake the collection of the material 

 and its microscopical examination, and this certainly does not take 

 much time. Those who do not even have this amount of assistance 

 can at any rate rub the material on to a slide and examine the 

 specimen later. 



I am becoming more and more convinced that those surgeons who 

 will themselves make use of the Gram method of staining in the 

 examination of a smear preparation will soon give up their sceptical 

 and doubting attitude. As bacteriological apparatus is to be found in 

 every modern ophthalmic hospital, we can expect that in the future 

 every young oculist will find opportunity during his time as assistant 

 for the necessary work. Such men will never dispense with clinical 

 bacteriology, for it is the aim and the pride of the modern surgeon to 

 determine the origin of the disease with which he has to deal, 

 and to use every possible care in his treatment. Even those whose 



