92 BACTEEIOLOGY OF THE EYE 



These experiments were continued and extended by Koske 1 and also by Ulbrich, 2 

 with the result that all the organisms which they used could produce inflammation 

 in the eye, even those previously held to be non-pathogenic. The severity of the 

 action varied in the different organisms. B. cyanogenns, B. flnorescens, and 

 B. indicus produce a massive exudation in the anterior chamber, but only slight 

 irritation in the vitreous. 3 B. candicans and B. acidi lactici, on the contrary, 

 produce only a slight iritis when introduced into the anterior chamber, but in the 

 vitreous a very severe inflammation. Oidium albicans at first only causes an iritis, 

 but after about eight days a hypopyon develops. 



The general tendency, however, is for inflammations in the anterior chamber to 

 heal without any serious result, while after vitreous infection the appearance of a 

 pseudo-glioma, cataract, and in the end phthisis bulbi, is the rule, the final result 

 being due to changes in the uvea. 



The action of the saprophytes is not exactly parallel to that of a foreign body, as 

 Ulbrich found no reaction on injecting concentrated carmine, suspension. It is due 

 much more to the chemical action of the disintegrating Bacteria, along with a toxic 

 activity. After injection, the great majority of these organisms rapidly die : they 

 cannot multiply in the eye ; the spore-forming bacilli (B. subtilis, mycoides, megu- 

 terium) prove more resistant, 4 and the B. acidi lactici can undoubtedly multiply. 



Ulbrich raised the question whether the subacute and insidious forms of wound 

 infection (iritis, iridocyclitis) could not be explained in many cases by saprophytic 

 infection, as the actual experimental organisms which he used, especially the spore- 

 forming ones, can, as a matter of fact (see Chapter II., ' Normal Conjunctiva ') be 

 found in the conjunctiva (Subtilis group). In a case of insidious late infection in 

 a cataract case (Hess), where the wound did not heal well on account of a capsule 

 inclusion, Eomer, 5 after two punctures of the anterior chamber, succeeded in demon- 

 strating spore-forming organisms of the Subtilis group. They did not liquefy, but 

 possessed all the other characteristics and caused severe inflammation in the 

 vitreous. The great difference in the recorded results of Perles, Lobanow, and 

 Ulbrich, concerning one and the same organism, depends partly on its variability in 

 character and virulence, and partly on the difference in the methods of research 

 employed. Perles attempted to infect perforating wounds with the loop, and 

 perhaps the organisms did not adhere. The other authors preferred injections 

 which are certain to introduce large numbers of the organism into the eye even 

 when only small doses are given (Ulbrich used O04 c.cm.\ Bietti 6 emphasizes 

 the fact that in human pathology we cannot unreservedly give the significance to 

 these organisms which the results of their experimental inoculation might seem to 

 imply. 7 He also showed that small doses would act pathogenically. Perles' 

 inoculations with the loop, therefore, much more nearly correspond to the con- 

 ditions in man than do injections. Inoculated with the loop, many otherwise 

 pure saprophytes produce a vigorous reaction in the anterior chamber e.g., 

 B. radiciformis, megaterium, mycoides, subtilis, fluorescens, liquefaciens ; others 

 do so to a less degree. 



While we must bear the possible action of many saprophytes 

 in mind, with reference to the eye we note that the great majority of 



1 What changes result from the injection of bacteria, hefre, moulds, and toxins into the 

 anterior chamber ? (Arb. aus dem Kais. Gesuttdhcitsamt, 1905, xxii. 411). 



2 A.f. 0., 1904, Iviii. 243. 



3 The predilection for the vitreous does not occur with all organisms. 



4 An injection of spores alone caused suppuration in the vitreous, but not in the anterior 

 chamber. The spores were only able to develop in the vitreous. 



5 Cf. Ulbrich. 



6 Ann. di OttaL, 1906, xxxv. 1. 1 cf. also Leber, A.f. 0., 1904, p. 324. 



