84 BACTERIOLOGY OF THE EYE 



Staph. aureus. When a virulent culture of aureus was dropped into 

 the conjunctival sac of rabbits, and then the section made, only 20 per 

 cent, were infected, while wounds made with infected instruments 

 practically always suppurated (A.f. A., 1895, xxx., S. 225). 



Morax rightly insists that a corneal pocket inoculated with count- 

 less organisms from a culture is very different from the presence of a 

 few microbes in the conjunctival sac. 1 As a current passes out from 

 every perforated corneal wound (Knapp, 2 Wilson 3 ) until it closes, the 

 Bacteria may often never come in contact with the lips of the wound ; 

 and even if they do, it is always questionable whether the ' infection ' 

 with such scattered organisms must necessarily cause an inflammation. 

 The eye does possess a power of antagonizing- and neutralizing- 

 an infection. Putting aside the question of specific immunity, the 

 result will be determined by the general and local power of 

 resistance, the initial damage to the tissues, the site of the infec- 

 tion, and the variety, number, 4 and virulence of the organisms 

 introduced. 



The aqueous fluid alone is a bad medium for the growth of Bacteria (Nuttall, 

 Buchner, Marthen, Bach). The antagonistic action of the uvea and removal 

 by the lymph stream, 6 acting with a vigorous phagocytosis, 6 ward off a simple 

 infection of the anterior chamber. By inj ecting a trace of an undiluted bouillon culture 

 of aureus into the anterior chamber in rabbits, Andogski 7 only obtained a purulent 

 iritis, which healed spontaneously : |- c.cm. undiluted bouillon was the least that 

 would cause a panophthalmitis ; very diluted bouillon culture would only cause 

 slight transient iritis. The action was the same on eyes which had been iridectomied ; 

 also in aphakic eyes, where, some time previously, the posterior capsule had been 

 removed with the lens intact. If, however, the lens had been freshly needled or 

 extracted, so that from the admixture of lens substance with the aqueous a medium 

 very liable to infection resulted, then panophthalmitis followed the injection of the 

 merest trace of the culture, and this occurred most readily when the posterior 

 capsule had been injured. This was the case in a simple needling of a secondary 



1 Schmidt-Rimpler had previously si i own that the action of the secretion of the lacrymal 

 sac was not identical with that of the Bacteria cultivated from it. 



2 A. f. A., 1886, xvi., S. 167. H. Knapp, sen., was the first to study this subject 

 bacteriologically. 



'Bacteria and Ophthalmic Surgery' (Ann. ofOphth., 1896, v. 2053). 



4 Pereles, inoculating the eye with the heart's blood of a mouse dead from pneumococcal 

 aepticfemia, only obtained a severe but transient inflammation. Using the splenic pulp of 

 the same animal, which contained a greater number of the same virulent organisms, a 

 purulent panophthalmitis resulted. 



5 According to the preparations of Andogski and Picot, the crypts of the iris have 

 nothing to do with this. The removal of the Bacteria occurs in a somewhat different 

 manner from that of indifferent granules of Indian ink (Nuel and Be"noit), and takes place 

 chiefly through the angle of the chamber. This has been corroborated by the simultaneous 

 researches of Romer (A.f. A., 1906, Iv. 4, and Ivi. 1, 2). 



6 He phagocytosis of the eye with reference to the Staph. aureus, cf. Hess, Vircli. Archiv, 

 1897, Bd. ex. ; Kalt, Ann. d'Ocuf., 1895, cxv. 61 ; Picot, Arch. d'Ophth., 1898, xviii. 341. 



7 Concerning the danger of infection in different eye operations, and the conditions 

 under which suppuration extends from the anterior chamber to the deeper structures of 

 the eye. 



