CHAPTEE IV 

 WOUND INFECTION 



COMPARED to the frequency of secondary healing in other parts of the 

 body, post-operative suppuration in the eye, even in the pre-antiseptic 

 days, was singularly infrequent. The loss by skilled operators in the 

 period of the flap section was about 10 per cent., and this was con- 

 siderably reduced by A. von Graefe's linear section. The relative 

 smallness of the wounds and the short duration of operations on the 

 globe, which in themselves tend to lessen the danger of infection, do 

 not completely explain this relatively favourable state of matters, as 

 they are offset by the vulnerability of the eye 1 and the low power of 

 resistance presented by its almost avascular tissues. The true expla- 

 nation, according to modern science, lies in the fact, already fully 

 considered, that the surroundings of the eye, when in a healthy 

 condition, do in fact possess a relatively lower tendency to infection 

 than most other parts of the body. Even if the self-cleansing of the 

 conjunctiva is unable to make it quite sterile, still it greatly lessens 

 the number of organisms present, and produces a condition of nutrition 

 most unfavourable to their increase or virulence (cf. p. 42). 



The direct bactericidal influence 2 so often attributed to the tears 

 is of comparative insignificance in comparison to the mechanical 

 factor discussed under ' Normal Conjunctiva,' and plays a very small 

 part in the auto-sterilization. 



Van Genderen-Stort (loc. cit.) found that the tears had no lethal 

 action on Bac. coli ; on the contrary, Bernheim 3 found that they had 



1 Bossaliuo (Ann. di Ottal., 1904) has thoroughly established this low resistance of the 

 eye relatively to the subcutaneous tissues, by a special series of experiments with Staphylo- 

 coccus aureus (see also under ' Saprophytes,' p. 91). 



2 The opinion of Muck (Munch. Med. Woch., 1900, SS. 1168 and 1732) that the action 

 of the tears depends on their containing sulphocyanides still requires confirmation. The 

 sputum, which is secreted by the parotid and its allied glands, is stated by Clairmont 

 (IVien. Klin. Woch., 1906, No. 47) to have a restrictive action on the development of 

 small numbers of pyogenic Staphylococci and Streptococci. Generally, however, the sputum 

 has no bactericidal action. 



3 'On the Antisepsis of the Conjunctiva and the Antibacterial Action of the Tears' 

 (Beit. z. Aug., 1893, Bd. viii., S. 6). 



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