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Boucheron, Addario, and Cuenod) is not constant. I can confirm this, 

 as Bietti and I did not see pus-forming organisms in the majority of our 

 cases of chalazia (of course, cases of acute hordeolum internum, which 

 are generally due to such organisms, especially Staph. aureus, were 

 excluded). The view that such organisms are present in the gland in 

 the early stages, cause the irritation, and then die out, while the 

 reaction continues, cannot be maintained, for quite in the early stages 

 these organisms are absent. 



Deyl found the B. xerosis very often in early chalazia, and that 

 too in pure culture ; he called the organism the ' chalazion bacillus,' 

 and considered it as causal. 



It is quite true, as I convinced myself years ago, that these 

 bacilli can often be obtained in pure culture from chalazia which 

 have only been present for a short time. As they are normally 

 present in the secretion of the meibomian glands, the question arises 

 as to whether they are not indifferent inhabitants of the chalazion, 

 and as such they could be present at the first. Deyl records the fact, 

 on which Hala has again insisted, that the bacilli disappear when the 

 lesion has existed for some time. In spite of this, however, we can 

 see that the chalazion increases and grows even when its contents 

 have been evacuated. Must we not, then, conclude that the causa 

 nocens is present during the whole progress of the lesion, as is the 

 case in other infectious diseases? If we give the Deyl bacilli an 

 etiological role, it can only be with regard to the first onset of the 

 affection, which we must consider as capable of continued development 

 after the rapid disappearance of these bacilli. 



Deyl finds support for his contention in that he was able to produce 

 small rounded tumours resembling chalazia, by directly injecting 

 about a cubic centimetre of a thick suspension of the bacilli under the 

 skin of the ear or under the conjunctiva. In such swellings the 

 bacilli rapidly disappear. 



Hala produced the same result by injecting various bacilli obtained 

 from the healthy or diseased conjunctiva, from the urine and blood of 

 typhoid cases, etc. Dead cultures produced the same result as living. 

 In these experimental chalazia the bacilli die out so rapidly that they 

 can only be cultivated during the first few days. 



These results were confirmed by Bietti working with many xerose 

 bacilli in my laboratory. It should, however, be noted that many 

 different non-pathogenic bacteria, when injected in the enormous 

 numbers which such a suspension contained, would produce a similar 

 result. Bietti produced nodes, similar except that they resolved more 



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