THE NORMAL CONJUNCTIVA 51 



General Infection arising* from the Normal Conjunctiva. 



The Bacteria washed away from the conjunctiva by the tears come 

 in contact with the mucous membrane of the nose and pharynx. 

 A path of infection is thus supplied for many organisms. Certain 

 experiments on animals have shown that a fatal infection may arise 

 from the normal conjunctiva, though it certainly does not occur in 

 the manner stated by De Bono and Frisco, 1 who affirmed that 

 B. pyocyaneus or prodigiosus (both so-called saprophytes), B. anthracis, 

 the tubercle bacillus, and Staphylococcus pyogenes aureus, could find 

 their way directly through the intact conjunctiva into the globe, the 

 orbital tissues, or the ethmoid cells. They arrived at this conclusion 

 from operations involving the extirpation of the lacrymal sac, or the 

 obliteration of the canaliculi. 



Stock,' 2 using the most careful technique, was absolutely unable to 

 confirm these striking assertions. We certainly can exclude the 

 possibility of any passage of organisms from the normal conjunctiva 

 into the healthy globe. The epithelium is a certain protection, and 

 Bacteria can only penetrate it when it has become affected by 

 inflammation or such like. 



Eomer, 3 to whom we owe a thorough examination of this subject, 

 could only find a direct penetration of organisms into the conjunctiva 

 when mechanical or chemical damage had been done to the epithelium. 

 Mayer, 4 Hirota, 5 Hertel 6 came to the same conclusion. 



The organisms of plague (German Plague Commission), anthrax, 

 mouse septicaemia, chicken cholera, the Pneumococci, the organisms of 

 mouse typhoid, glanders, " psittacosis Nocard," tuberculosis, tetanus, 

 hydrophobia, the pseudo-tubercular bacillus of Pfeiffer 7 (Deyl), Eibbert's 

 bacillus of gastric diphtheria 8 (Braunschweig, Conte, Romer, Hertel, 

 Mayer, Hirota), very readily produce a general infection in white mice 

 and rats, less readily in guinea-pigs and rabbits. If a small quantity, 

 e.g., of plague organisms is introduced into the conjunctiva, death 



1 ' Sulla permeabilita verso i microorganismo delle mucose congiuiitival e nasale intatte 

 in raporto alle infezioni endoculari ' (Arch, di Ottal., viii., p. 401). 



a ' Uber Infektion vom Conjunctivalsack und von der Nase aus ' (K. M. f. A., 1902, 

 ft. 16). 



3 ' Experimentelle Untersuchungeii liber Infektion vom Conjunctivalsack aus ' (Zeit. f. 

 Hyg. u. Inf., xxxii., 18, S. 285). 



4 ' Zur Kenntnis der Infektion vom Conjunctivalsack aus' (Wien. Med. Woch., 1901, 

 No. 9), 



5 ' tiber die Infektion vom unverletzten Bindehautsacke aus ' (Zent. /. Bakt., xxxi., 

 Heft 6, S. 190). 



6 Report from the Kaiserl. Gesundheitsamt, 1904, xx., S. 3. 



7 ' Experimental Research concerning Pseudo-tuberculosis, especially in the Eye ' (Prag 

 Acad. des Sc. de 1'Empereur Francois Joseph I., 1894). 



8 Forts h. d. Med., 1889, S. 809. 



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