THE LIDS 65 



passes into a black spreading slough, frequently surrounded by a ring 

 of superficial vessels. 1 Anthrax rarely begins as a pure oedema. 



Anthrax bacilli cannot always be found in the fresh pustules or in the slough ; 

 they have often passed into the tissues around, and in the slough we find pyogenic 

 cocci and other Bacteria. The margins of the patch should be scarified, and there 

 the anthrax bacilli will be found during the first few days. Later on it is necessary 

 to examine the blood, and even then we do not always get a positive result. The 

 organisms are readily recognized as spore-forming bacilli, Gram-positive, often 

 segmentally stained, 3 to 10 M long and 1 to 2 /j. broad. They have a clearly staining 

 ectoplasm. 



Subcutaneous inoculation in rabbits and mice causes an cedema, 

 rapidly followed by hsematuria, and death usually occurs. When the 

 virulence is low the animal may survive. Elschnig obtained such 

 attenuated forms from a case of lid anthrax. Buy since obtained the 

 B. antliracis in the serum exuding from the scarified lids in a case 

 presenting the cedematous type. Moreau describes a similar case. 



Sgrosso, Strzminski, Elschnig, Praun and Proscher, Pes, and 

 Tertsch, describe typical cases of malignant pustule on the lids with 

 the presence of the bacilli. 



In all such cases anthrax serum [Sobernheim (Merck)] should be 

 used. It is said to have good results. 



L1TEEATUEE. 



BUY, These de Paris, 1881. 



ELSCHNIG, K. M. f. A., June, 1893. 



PRAUN und PROSCHER, Zentralbl. f. Augenh., February, 1900. 



STRZMINSKI, Zentralbl. f. allg. Pathol., 1901, S. 169. 



SGROSSO, Annali di Ottalmol., 1899, p. 308. 



PES, Zeitschr. f. A., XII, 1904, S. 442. 



MOREAU, Revue generale d'Ophth., 1905, p. 193. 



Chalazion. 



Acute infections of the meibomian glands, such as hordeola and lid 

 abscesses, are caused by the common pyogenic organisms ; concerning 

 the cause of the chronic slowly- developing chalazion, however, opinions 

 differ very much. 



Baumgarten and his pupils Tangl and Wichert, and to a less 

 degree Parisotti, considered a chalazion to be a manifestation of 



1 A similar appearance may occur in other infections. Gabrielides ( ' Ophthalmologie 

 Microbiologique,' 1907, p. 310), instead of the anthrax bacillus which he expected, found a 

 facultative anaerobic Gram-negative polar bacillus, which formed on agar round, yellowish- 

 white colonies, without any odour, and in bouillon a diffuse cloudiness, with a distinct surface 

 film ; which liquefied blood-serum and gelatine, did not coagulate milk, and was very 

 pathogenic for guinea-pigs. 



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