THE LIDS 55 



Cuenod, 1 who has paid particular attention to lid bacteriology, 

 in thirty cases found large numbers of non-pyogenic Staplnjlococcus 

 albus, often in pure culture, and besides these only scattered 

 examples of non-pathogenic cocci and bacilli of various species. The 

 only difference from the normal lids was that the number of colonies 

 was greater and their development freer ; they were not, however, 

 pathogenic for the rabbit's cornea. Along with these we occasionally 

 find yellow cocci, which are only sometimes virulent. Bayersdorf er - 

 came to a similar negative conclusion. 



Burchardt cannot be supported when he states that the connexion 

 between Staphylococci and blepharitis is so intimate that he can 

 diagnose ' latent lid eczema ' merely from the presence of these 

 organisms, without any other changes. 



The slight importance of the presence of Stapliylococci is shown by 

 the fact that they also occur in comedones. Cuenod found them also 

 in milium. Those cases, too, where the skin and margins of the lids 

 are affected with acne rosacea cannot be considered as primary. 



The occurrence of hypersemia and seborrhcea of the lid margins is 

 due to a combination of various influences anaemia, scrofula, irrita- 

 tion by dust, puberty, the menopause, eye-strain, uncorrected errors 

 of refraction, etc. 



The lid margins participate in inflammations of the conjunctiva. 

 Herzog considers that the increased secretion of fluids is the cause of 

 this. Boder and True 3 lay too much stress on lacrymal affections. 



It is possible that this seborrhrea prepares the way for the true lid 

 inflammation by blocking up the mouths of the sebaceous glands. 

 Such a condition is well known to have considerable influence on the 

 determination of acne vulgaris. 



Eczema. 



An acute eczema of the lids is just the same as an eczema elsewhere. 

 A moot question will be discussed in the chapter on ' Scrofulous In- 

 flammation,' as to whether the inflammation is to be ascribed to the 

 presence of Bacteria, especially Staph. pyog. aureus (Unna, etc.), or 

 whether this organism is only a chance contamination (almost in- 

 variable), which influences the latter course of the disease (cf. p. 234). 

 Straub has paid special attention to eczema of the lids in scrofulous 

 subjects, and found large numbers of Stapli. aureus. The almost 



' Bact. et Parasit. Clin. des Paupicres,' These de Paris, 1894. 



2 Quoted by Derby, Amer. Ophth. Congress, 1906. 



3 True, Rec. d' Ophth., 1897, p. 575 ; Roder, K. M. f. A., 1887, S. 261, 



