42 BACTEEIOLOGY OF THE EYE 



latericius (Bach, Bosso) ; Bac. sporiferus (Lachowicz) ; Bac. subtilis (Puccioni, 

 Shongolowicz, Bach, D. Smith Jameson) ; Bac. fluorescens putridus (Lacho- 

 wicz) ; Bac. fluorescens liquefaciens (Fick, Basso) ; Bac. diffusus, Bac. 

 butyricus, Bac. aurantiacus, Bac. albicans, Bac. pateriformis, Bac. lio- 

 dermos, Bac. au/reus, Bac. ochraceus (all by Basso) ; Aerobac. citreus 

 (Jameson) ; Bac. coli communis (Jameson). 



Here and there isolated colonies of Streptothrix (von Michel, Cazalis, Bach, 

 Gombert, Axenfeld) ; Moulds (Fick, von Michel, Bach, Plant, von Zelewski) ; Hefa- 

 colonies, especially Rosa Jiefa (Fick, Bach, Axenfeld, Fortunati). 



The foregoing resume illustrates the truth of the conclusion, arrived 

 at from pure clinical observation, that the normal conjunctiva in the 

 majority of cases contains no virulent pyogenic organisms ; in a small 

 minority isolated instances may occur, but rarely are they present in 

 numbers. The ordinary flora cannot be considered as absolutely 

 causing no danger, 1 though the risk of infection from the normal 

 conjunctiva is relatively slight. 



The number of organisms in the conjunctiva is considerably less 

 than in the adjacent lid margins, and their conditions are not favour- 

 able to vigorous growth. The temperature of the conjunctival sac, 2 

 although at least 2 C. lower than the mouth, is certainly more 

 favourable than that of the lids, and is quite high enough for the 

 growth even of delicate bacteria ; on the one hand, however, the tears 

 form a bad medium for growth, 3 and on the other the number of the 

 organisms is continuously being lessened by the flow of sterile tears 

 through the sac into the nose. This last condition, the mechanical 

 flushing, is of great importance respecting its organismal contents. 

 The importance of the blinking of the lids as a factor in purifying the 

 sac was first stated and emphasized by Horner, Widmark, 4 and 

 van Genderen-Stort. 5 After numerous experiments with the easily 

 distinguishable red Kieler water bacillus, Bach 6 showed that, after 

 an artificial infection of the human conjunctiva, the bacilli could very 

 soon be found in the nose, and in a few hours had quite disappeared 

 from the conjunctiva, and that more rapidly when the patient blinked 

 vigorously. Schirmer 7 demonstrated that, in the absence of winking, 

 there was no transmission into the nose, for the passage of tears 



1 Compare Gifford, Journal of Amer. Med. Soc., October 3, 1903. 



2 Compare here, and also concerning the temperature of the various parts of the eyeball, 

 the works of Dohnberg (Inaug. Dissert., Dorpat, 1876), Galezowski (Recueil d'Oph., 1877, 

 p. 275), Michel (A. f. 0., 1886, xxxii., p. 266), Silex (A. f. A., 1893, xxvi., S. 141), Giese 

 (A.f. A., 1894, xxviii., S. 292). 



3 It contains albumen, 0'5 per cent. ; NaCl, 1 to 1J per cent. ; NA 2 C0 3 , O'l to 0'2 per 

 cent. ; MgSO 4 , 0'05 per cent. ; Na 3 P0 4 , 0'05 per cent. The extent of the bactericidal 

 powers of the tears is discussed in the chapter on 'Wound Infection.' 



4 Beitragez. Ophth., Leipzig, 1890, S. 179. 



6 A.f. Hyg., 1892, xiii. 4. 6 A.f. 0., 1894, xl. 3. 



7 2nd edit, of Saemisch's 'Handbuch,' 1904, and Zeit. f. A., 1905. 



