41 



frequently in the secretions from dacryocystitis. As the infection in 

 many of such cases comes from the conjunctiva, they must not be so 

 rare in this situation ; or else we must conclude that dacryocystitis 

 has a tendency only to occur in those people who have Pneumococci. 



At any rate, the results of the earlier researchers, who never found 

 them at all on the normal conjunctiva, are not conclusive ; although 

 from the recorded findings, the Pneumococci may not be demonstrable 

 in a short series of cases. It is unnecessary to emphasize the fact 

 that this occasional occurrence of the Pneumococcus on the conjunctiva 

 can be reconciled with its frequent pathological significance (cf. chapter 

 on ' Pneumococcal Conjunctivitis ') 



The Pneumococci which we cultivated from the normal conjunctiva 

 were of low vitality, and very slightly, or not at all, pathogenic for 

 animals. They evidently suffered from a want of nutrition in the 

 conjunctival sac. A danger of wound infection could only arise from 

 them under very exceptional circumstances. That they can, however, 

 play a part here is proved by many occurrences of wound infection, 

 and especially by a case in our clinic published by Oertzen (cf. 

 ' Pneumococcal conjunctivitis ' literature). 



Streptococci rarely occur on the normal conjunctiva. The recorded 

 cases in the literature, the evidence of which is merely from cultures, 

 can be regarded with a strong suspicion that they were really Pneumo- 

 cocci. The latter readily grows in chains, and when all the differen- 

 tiating tests are not carried out, especially the inoculation of a mouse 

 and examination of its heart's blood for lancet-shaped capsulated Diplo- 

 cocci, a differential diagnosis is often quite impossible. This test, how- 

 ever, has only been applied to a very few of the so-called Streptococci. 



The following isolated, and generally non-pathogenic organisms, 

 have been found, which need not be further considered; into their 

 differential diagnosis I will not go : 



Micrococci : 



Diplococcus or Micrococcus roseus l (Bach, Basso) ; Diplococcus fluorescens 

 liquefaciens liquidus (Bach, Basso) ; Micrococcus prodigiosus (Schmidt) ; 

 Micrococcus cinnabareus (Bach) ; Micrococcus aquatilis (Basso) ; Micro- 

 coccus carneus (Basso) ; Pediococcus cerevisice (Basso) ; Micrococcus coro- 

 natus (Lachowicz) ; Micrococcus coryzce (Bach). 



Bacilli : 2 



Bac. nodosus parvus (Marthen); Bac. luieus (Wilbrand, Sanger, Stahlin, 

 Jackson); Bac. cvticularis (Bach); Bac. inflatus (Bach); Bac. mesentencus 

 (Bach, Franke, Basso) ; Bac. prot. vulgaris (Fick, Bach, Puccioni) ; Bac. 



1 These are classed together by Lehmann and Neumann. 



2 The identification of many of these bacilli is not very satisfactory. 



