THE NOEMAL CONJUNCTIVA 35 



cocci found in the eye can be taken to correspond roughly to their power of 

 liquefying gelatine. Those which liquefy freely are generally more purulent ; those 

 which do not are only rarely so. 



Morax and Kandolph have rightly emphasized the correspondence 

 between the white Staphylococci of the conjunctiva with that form, so 

 frequently occurring in the skin, 1 which Welch has called Staphylo- 

 coccus epidermidis albus. They are characterized by an absence of 

 virulence and toxicity, and often display the features of the candicans. 

 We can conclude that the infection of the conjunctiva with these 

 organisms takes place from the skin. From time to time we find in 

 these skin organisms a relatively more frequent, though very slow, 

 gelatine liquefaction, which may be due to their different conditions 

 of life. 



Many strains of this coccus prove to be non-pathogenic for the 

 rabbit's cornea, and generally are not able to cause wound infection. 

 But still it cannot be asserted that under different conditions e.g., a 

 lowered power of resistance in the eye they cannot lead to wound 

 infection. We know that many saprophytes which remain indifferent 

 in other parts of the body, are pathogenic in the eye. Cannot this 

 also hold in the case of the white Staphylococci of the eye, the more, 

 so as they may be capable of an exaltation of virulence ? (cf. chapter 

 on 'Blepharitis,' p. 55). The action of the candicans in the interior 

 of the eye has practically never been tested ; Gifford alone reports 

 having obtained a transient reaction after its injection into the 

 vitreous. In two subacute wound infections after cataract extraction 

 which I have examined I found in the interior of the eye white cocci 

 only, which in one case would not cause a hypopyon-keratitis in 

 rabbits, and in the other only liquefied gelatine after fourteen. days. 



1 I must here mention that, according to the researches of Pfeiffer (Wien. klin. 

 1903, S. 762), Von Stanziale (Zent. f. akt., Orig., 1906, xlii. 2, 3, 4), the mucous 

 membrane of the urethra, especially in its anterior portion, like the conjunctiva, contains 

 non-virulent white Staphylococci, and polymorphic non-virulent bacilli of the diphtheria 

 group, a similar condition to that which obtains in the surrounding skin. In the 

 bacteriology of the geuitalia the pseudo-diphtheria bacilli have also been the cause of 

 confusion. A few years ago they were described as the cause of syphilis ! Bad. coli, 

 non-virulent Streptococci, and other bacilli, are also occasionally found. 



In many respects the same is true of the bacteriology of the normal nose, where pseudo- 

 diphtheria bacilli are practically always found ; Staphylococci are very frequent, and 

 Pneuiiwcocci, Streptococci, etc. , are not uncommon. Great variations occur, as the varied assort- 

 ment of organisms, taken in with the breath from the dust of the air, are precipitated, and 

 remain in the anterior part of the nose ; hence the frequency of SuUilis (Gotschlich, ' Kolle 

 u. Wass. Handb.,' 1903, i., S. 148; Hasslauer, Zent. f. Bakt., Orig., 1906, xli., S. 796). 



Formerly a bactericidal function was attributed to the alkaline nasal secretion, and 

 modern opinion tends to the view that the nasal secretion is merely a bad nutritive medium. 



Staphylococci and pseudo-diphtheria bacilli (Unna's Flasclienbazillen}, along with other 

 rarer forms, are constant inhabitants of the skin (see the most recent researches into the 

 bacteria of the normal external ear by Siipfle, Zent. f. Bakt., Orig., 1906, xlii., S. 304 ; 

 also Gotschlich, loc. cit., S. 147. 



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