74 BACTERIOLOGY OF THE EYE 



species. See chapter on ' Conjunctivitis,' p. 108. For further 

 details bacteriological textbooks should be consulted; also the articles 

 by Krajewski, ' Blepharitis von eigentiimlicher Form,' Jahresber., 

 1873 ; Tedeschi, Ann. di OttaL, xxi., p. 455 (experimental inocula- 

 tion) ; Andral (see A. Terson, loc. cit., S. 417) ; Tarnawski, These 

 de Paris, 1867. 



Ulcus molle (soft chancre), has been observed in rare cases on the 

 lids (Hirschler, 1 Coppez pere, 2 Galezowski, 3 Wiirdemann, 4 Tastoux, 

 Gaston. 5 



Just as is the case with such ulcers in other situations, so we find 

 here the Ducrey-Kref ting soft chancre bacillus in the material scraped 

 from the cleansed margin of the ulcer. 7 This organism is 1*5 to 2 //, 

 long 0*5 to 1 p broad, rather more slender in the middle, non-motile, and 

 tends to lie in pairs, or in chains a Strepto-bacilkis especially when in 

 sections. It is Gram -negative. The poles of the rather faintly staining 

 bacillus are often rather more deeply coloured than the light centre. 

 They grow on blood-agar (1 : 2 to 4) when in the incubator, forming 

 greyish prominent coherent colonies, which perish after a few genera- 

 tions. Inoculation of men or apes with a pure culture causes typical 

 soft chancre. The etiological records of soft chancre of the lid generally 

 belong to the period before the discovery of the Ducrey bacillus. The 

 certain bacteriological findings in our literature are those of Gaston 

 and Tastoux. 



The bacilli have been found in the still rarer ulcus molle of the 

 conjunctiva (see p. 249) by Vignes. 



In the differential diagnosis the Diplobacillus must be considered ; 

 it is much larger, and its cultures are quite different. The clinical 

 appearances also are very unlike. 



Greef and Kowalewski report that they have found the Spirodugta 

 pallida in ulcus durum of the lids. 



With regard to the disease described by Gilchrist 8 under the title 

 4 blastomycosis cutis,' we have only a few records from America, 

 especially the work of Montgomery (Jour. Amer. Med. Assn., 1902, 

 p. I486),' Wilder (ibid., 1904, p. 2026), Wood (Ann. of Oph., 1904, 

 p. 92). According to the review of G. S. Derby (loc. cit.), the skin of 



1 ' Blepharitis Syphilitica, ' Wien. Med. Woch., 1866, Nos. 72-74. 



2 Journal Med. de Bruxelles, November, 1894. 



3 Recue.il d'Ophth., October, 1882. 4 Amer. Jour, of Ophth., May, 1891. 



5 These de Groleau, quoted by A. Terson, loc. cit. 



6 Of. collected references by Zeissl, Zent. f. Bakt., xxxi., S. 169. 



7 As the ulcer can be freely contaminated with other organisms, the superficial layer of 

 granulations should first be removed. 



8 Johns Hopkins Hosp. Rep., 1896, vol. i., p. 206. 



