66 BACTERIOLOGY OF THE EYE 



tuberculosis, on account of the presence of cell nests and Langhan's 

 giant cells. This view cannot be completely justified. 1 Direct im- 

 plantations of the contents of ehalazia into susceptible animals 

 have repeatedly been made by Weiss, Deutschmann, Yossius, Asch- 

 heim, Strzminski, and also by myself, without ever causing tuber- 

 culosis. Tubercle bacilli have only been found in rare cases, and 

 caseation has never been seen. The balance of evidence is against 

 tubercle, especially when we consider that the presence of epithelioid 

 and giant cells is not a certain indication of tuberculosis. We can 

 only say that the rare tuberculosis of the tarsus (as also tumours and 

 syphilis) can resemble a chalazion. When carefully and exactly 

 examined, a tuberculosis is found not to begin inside the gland tubule, 

 like a chalazion, but in the surrounding tissue ; this point is, however, 

 very difficult to determine clinically. Stock, in his experiments with 

 tubercle of the eye, produced a peri-acinar tuberculosis which broke 

 through into* the interior of the gland, and the clinical appearances 

 greatly resembled those of a marginal chalazion. Baumgarten has 

 lately weakened in his views. The occurrence of giant cells, which 

 presumably correspond to the epithelium of the acini, is referred by 

 Henke to the absorption of lime salts. The blockage of secretion 

 appears to be of considerable importance in the disease, although, as 

 E. Fuchs has shown, it cannot alone explain it. 



It is not at all unlikely that some infective agent, as well as the 

 retention of secretion, is at work. In favour of this view we have the fact 

 that a second chalazion often occurs on the other lid at the point of 

 contact, and also the considerable inflammatory reaction which some- 

 times occurs. The common pyogenic organisms are not always found in 

 the interior of the chalazion. Priouzeau certainly reports that, in the 

 great majority of a long series of inoculations, he found the various 

 pus-forming organisms, most often white Staphylococci, less often 

 Diplobacilli, Pneumobacilli, 2 and Streptococci ; he considered that the 

 Staphylococci had a causal significance. Along with Dianoux he claims 

 the existence of an infective ' chalazion conjunctivitis.' On the 

 other hand, it appears to be conclusively shown by Deyl, Hala, and 

 others, that when the contents of the chalazion are isolated without 

 contamination by conjunctival secretion, in many cases no pyogenic 

 organisms can be found; and it is quite clear that the presence of 

 Staphylococci (Sattler, Dianoux, Vassaux, Lagrange, Poncet and 



1 Nor can they be classified as ' tuberculids ' of the skin, being considered by Hallopeau, 

 Darier, and L. Dor as uon-bacillary results of general tuberculosis (para-tuberculosis). The 

 subjects are often quite healthy, and show no tuberculin reaction. 



2 Maklakow (A. f. A., 1901, Bd. xliii., S. 10) described a case with Pneumobacilli. 



