WOUND INFECTION 95 



have seen five more cases of panophthalmitis from pneumococcal 

 infection after cataract, and three from Stapliylococcus aureus, in one 

 of which the infection spread from a conjunctival suture. 



Streptococci : Two cases by Duclos (loc. cit.), one of which had also 

 influenza bacilli. 



The Pneumoeoccus therefore is by far the most important 

 organism in post-operative infection of the globe. A dacryo- 

 stenosis, a conjunctivitis, occasionally the Pneumococci of the normal 

 conjunctiva, and the sputum (Flugge), 1 which may infect sterilized 

 instruments, form the sources of contamination. Hotta 2 infected 

 rabbits' corneae with sputum, and in about one-third of the cases 

 pneumococcal infection resulted. 



Transference from the mouth or nose can only occur by external 

 contact. Under no circumstances can the pneumococcal infection 

 pass through the healthy ductus naso-lacrimalis (Bach), 3 nor can they 

 pass up when there is a permeable stricture (Hauenschild). 4 



In the case of panophthalmitis after wounds the conditions are 

 somewhat different. Pneumoeoccal infection is not so preponderant 

 in these cases, as in many cases the body causing the wound carries 

 with it the organism which produces the reaction. 



Streptococcus pyoyenes here plays an important part (Gallenga, 5 

 Deutschmann, De Schweinitz, 6 Enslin and Kuwahara, loc. cit.}. I 

 have grown it five times. 



Pyogenic stapliylococci : (Leber, Sattler, Gallenga). I have grown 

 them many times. 



Pyogenic bacilli are often found : Subtilis and its allies (vide supra) ; 7 

 also B. pyocyaneus (Sattler, 8 Hanke 9 ), B. coli (Eandolph 10 ). 



B.pyogenes Passet (Monti, Scimeni, Gallenga 11 ). The bacillus grown 

 by Finlay 12 must be classed here. Chaillous 13 found an anaerobic pyo- 

 genic bacillus the B. perfringens in the vitreous in two cases of 

 traumatic panophthalmitis after splinter wounds. In both cases 



I K. M.f. A., 1903, Bd. ii., p. 474. 2 Ibid.. 1905, Bd. ii., p. 237. 



3 A.f. 0., xl. 4 OpUh. Klinik, 1898, Xo. 16. 



5 Rassegna di Scicnza Med., 1888, p. 1. 6 Ophth. Rev., 1896, p. 32. 



7 Urbahn reported that he had occasionally grown Proteus (Ophth. Klin., 1903, 

 p. 226). 



8 Ophth. Congr., Heidelb., 1892. 



9 Zeit. f. A., 1904, x. 373. Hanke recorded his findings as Bacillus proteus fluorescent. 

 According to MacNab (K. M. f. A., 1905, ii. 542), it really was B. pyocyaneus. 



10 Am. Jour, of Med. Sciences, 1893, p. 440. 



II Cf. Gallenga, Rassegna. di Scienza Med., 1888, iii. 2. 



12 Ann. d'Ocul., 1893, t. cix., p. 130. 



13 Ibid., August, 1905, cxxxiv. Till then this bacillus was only found in appendicitis, 

 otitis, gangrene of the lung, and putrid sinus empyema, and always mixed with other 

 bacteria ; but here pure cultures were found in the eye. Veillon and Morax found another 

 anaerobic bacillus in a case of dacryo-pericystitis gangrrenosa. 



