THE LIDS 



59 



Hordeolum, Lid Furuncle, Lid Abscess. 



The mild form of hordeolum, and the deeper furuncle of the lid 

 are pyogenic infections of the lid glands of varying severity. 



The accompanying Fig. 5 shows a lid furuncle arising in an infected sweat gland. 

 The tubule of the gland and its duct are plugged with a (black) mass of cocci ; 

 around is necrosis and inflammatory reaction. The cylindrical column of organisms 

 forms a zooglcea mass, which extends beyond the usual calibre of the tubules. A 

 similar, but more superficial, infection of the skin of the lid, and one arising from 

 the lanugo hairs, is shown in Fig. 6. The hairs have fallen out, and their places are 





FIG. 5. FURUNCLE OF LID ARISING IN A SWEAT GLAND. 

 ORGANISMS BLACK. 



MASS OF 



taken in the skin by plugs of cocci, surrounded by unstained necrotic tissue, outside 

 of which is a reaction zone, which finally will cause the separation of a surface 

 slough. Such may be called superficial furuncles. 



The surface necrotic area is not usually so extensive as this in a hordeolum. 

 The hair is usually cast off early, as has been microscopically demonstrated 

 by Herzog, who showed that the spread of the cocci was not only along the hair 

 follicle, but that from a folliculitis externa the cocci could break through into the 

 sheath of the hair. 



These preparations were obtained from a newly-born child which had inflamma- 

 tory nodules and pustules of varying size on its face and eyelids, and finally died of 

 streptococcal sepsis. 1 I did not take cultures from the pustules, as that would have 



1 For the intra-ocular condition (haemorrhages in the retina containing cocci), see 

 Axenfeld, 'Eitrige Metast. Ophth.' (A. J. 0., 1894, xl., S. 206). 



