80 BACTEEIOLOGY OF THE EYE 



According to the previously mentioned experiments and results of Gosetti and 

 Jona, 1 which were confirmed by De Bono and Frisco, the tears should show an 

 antitoxic property against diphtheria toxin. If tears be added to the lethal dose the 

 experimental animal should not die so soon as the control. Coppez 2 had already 

 expressed doubts on this point; and Demaria 3 conducted a full investigation into 

 the matter. Absolutely no diphtheria antitoxic action could be found in the tears 

 of voluntary subjects. As it is possible that the amount of antitoxic substance in 

 the blood depends upon some previous diphtheritic attack, we have inoculated our- 

 selves with large doses of Behring's antitoxic serum. Even then, however, our 

 tears were not antitoxic, nor were those of convalescents from diphtheria. And as 

 under normal conditions a higher antitoxic power than that investigated does not 

 occur, we have proof positive that no antitoxic action against diphtheria bacilli 

 occurs. To what extent the lacrymal gland can allow the passage of other anti- 

 bodies, is not yet determined. Neither had the tears of Demaria's immunized 

 persons any agglutinating action on the diphtheria bacilli. Rymowicz 4 obtained the 

 same negative result with dogs immunized against typhoid and cholera. The same 

 author, using Pfeiffer's experiment, could obtain no bactericidal action with the tears 

 of a dog immunized against cholera, although the blood gave a very marked positive 

 result. The attempt to demonstrate the presence of hsemolysin in the tears of an 

 animal previously treated was negative. 



Schulz, 5 Dieulafoy, Widal, and Siccard, opposed to Rymowicz, have found that 

 the tears of many typhoid patients show the Widal reaction (agglutinate typhoid 

 bacilli). 



The last-mentioned observations have been made in only a few cases and need 

 enlarging. 



The prevention of wound infection, 6 in the case of a healthy 

 conjunctiva only necessitates therefore simple and mild procedures, 

 and it is fortunate that such is the case. The energetic use of soap, 

 alcohol, and disinfectants, as in other surgical areas previous to 

 operation, is quite out of the question when dealing with the con- 

 junctiva or eyeball; the skin of the lids alone can thus be treated. 

 Gentle mopping with a swab soaked in non-irritating sterile or anti- 

 septic fluid is all that can be allowed, for any stronger disinfecting or 

 irritating substance will cause a catarrh, with an increase in the 

 organisms, and thus favour an infection. Many surgeons there- 

 fore content themselves with sterilized saline, and obtain good 

 results. 



A post-operative conjunctival catarrh, a * post-operative con- 

 junctivitis,' 7 is not dependent merely on the methods used for 



1 Eiforma Med., 1897, iv. 543-555. 2 Arch. d'Ophth.. 1899, xix. 565. 



* K. M.f. A., 1905, Beilageheft (research in Axenfeld's laboratory). 

 4 Arch. PMS. de Path, et de Mt<d. Clin. et de Bad., 1902. 



6 Med. Klinik, 1905, 54. 



8 An infection from bacteria of the nose through the nasal duct can be put aside, 

 according to Bach's (loc. cit.) experiments. Even when there is a previous stenosis such 

 does not occur (Hauenschild). It is naturally very different with bacteria from a diseased 

 lacrymal sac. 



7 I refer to uncomplicated healing, excluding cases where secretion results from infection 

 of the globe ; also cases where a contact epidemic has occurred. 



