54 BACTERIOLOGY OF THE EYE 



they used) does not take up sufficient material. Xerose bacilli will generally be 

 obtained if we scrape the skin rather firmly near the lid margins. Further away 

 from the eye their number, relative to the cocci, diminishes, but they never 

 entirely disappear. 



Though Staphylococci and xerose bacilli are the only constant inhabi- 

 tants of the normal lid margins, all kinds of organisms can occur as 

 accidental contaminations ; they have been observed in single cases, 

 but not in large series, and are of very little interest. Cuenod 

 definitely states that the other organisms which he found were not 

 pathogenic. Micro-organisms forming chains have never been ob- 

 served on the skin of the normal lids. 



To give a comparison with the rest of the skin, I will epitomize a paper of 

 recent date : 



Siipfle (Zentr. f. Bakt., Orig., xlii., 1906, S. 304) found that the normal external 

 ear, like the rest of the skin, almost always contained large numbers of white 

 Staphylococci, both liquefying and non-liquefying, which were either identical with, 

 or closely related to, the Micrococcus candicans. They were never virulent. 

 Sarcince, in small numbers, occurred frequently. Pseudo- diphtheria bacilli were very 

 common, especially when there was much wax present (corresponding to the preva- 

 lence of B. xerosis in the Meibomian secretion and fatty degenerated epithelial 

 cells). Other bacteria, Micrococci, Staph.pyog. aureus, and other yellow cocci (Micr. 

 luteus, sulfureus, aurantiacus) , various bacilli, and moulds, were in comparison 

 very rare, so that in general it could be said that only harmless organisms were 

 present. Streptococci and Pneumococci were never found. 



The great similarity of these results with those found in the conjunctiva is 

 obvious. 



The organisms mentioned are situated in the superficial layers of 

 the conjunctiva, in the pores, the mouths of the glands and hair 

 follicles, also on the hairs (Strohschein, L. Miiller, v. Pflugk, 

 Gifford, Herzog). In the hair follicles they only penetrate down to 

 the bottom of the ampullae (Herzog). 



The presence of these saprophytes and non-virulent organisms 

 naturally complicates the bacteriology from an etiological point of 

 view. They have been the cause of mistakes in dermatology, as in 

 ophthalmology, and must therefore be carefully noted in the bac- 

 teriology of the lids. 



Blepharitis. 



The mildest form of blepharitis, the hypersemia marginalis or 

 blepharitis squamosa, is hardly a primarily infective condition. 

 The slight formation of scales, without pustules or ulceration, cor- 

 responds to dandruff formation in the scalp, and is caused by a dry 

 seborrhcea. This is confirmed by the bacteriology of the condition. 



