96 BACTERIOLOGY OF THE EYE 



there were fever and vomiting. From a slide which was very kindly 

 sent me Fig. 5 on Plate III. is prepared. 



The bacilli appear in the secretion as large (1 /* by 3 to 9 //) Gram-positive 

 bacilli, often granular and staining irregularly, sometimes growing in filaments, 

 and in form and size greatly resembling the B. subtilis depicted alongside, from 

 which indeed, they cannot be microscopically distinguished with certainty. The 

 two figures differ considerably, but Subtilis can also show similar appearances in 

 pus to those of the Perfringens here depicted, and vice versa (cf. figure in text, p. 80) 

 The bacilli are surrounded by clear spaces, which however, are not true capsules, 

 but a retraction of the medium. They have no spontaneous movement and no 

 spore formation. Growth is only anaerobic. Free gas-formation occurs on sugar 

 media ; in bouillon clouding, with formation of a deposit. Offensive smell in all 

 cultures. On agar small, flat, grey colonies. Gelatine not liquefied. Subcutaneous 

 injection causes an emphysematous inflammation in guinea-pigs, but not in rabbits. 

 Injection into the vitreous of rabbits causes panophthalmitis, into the anterior 

 chamber a purulent iritis. 



In microscopic preparations of the enucleated globe dense masses of bacilli are 

 found, but only at some distance from the vessels, corresponding to their anaerobic 

 nature. 



The B. pc rf ring ens, first described by Veillon and Zuber, 1 must 

 always be considered, as well as Subtilis, when dealing with large Gram- 

 positive bacilli in pus, and in such cases it is advisable to make an 

 anaerobic culture. On account of the omission of cultures Chaillous 

 was doubtful whether this organism was present in two further cases 

 of ' panoplitlialmie gazcuse ' recorded by Darier (La Clin. Ophth., 

 1906). In another case of ' oplithalmie gazeuse ' enucleated by 

 Gayet, Arloing cultivated bacilli from the fluid obtained by puncture. 

 These were very small, resembling those of mouse septicaemia, and 

 produced an inflammatory emphysema in guinea-pigs (Soc. de Biologie, 

 November, 1887; quoted by Gabrielides). 



Regarding panophthalmitis following a direct perforating* wound 

 with a pneumococeal infection, see cases by Gasparrini, Lucciola, 2 

 Cue" nod (loc. cit.}, De Lapersonne and Painblau, 3 Mayweg, 4 and 

 Lagrange. 6 I have often seen such an infection. If we add to the 

 cases of wound infection those in which septic hypopyon-keratitis, 6 

 especially ulcus serpens, follows on an abrasion of the epithelium, 

 then pneumococeal cases form the great majority of wound 



1 Arch, de Mid. Experiment., 1898. 



2 Ann. di Ottal., 1893, xxi. ; Giorn. Med. di R. Esercito, August, 1896. 



3 Rev. G6n. d"0phth., 1897, No. 6 ; These de Lille, 1897. 



4 Cf. Axenfeld, ' Serumtlierapie Infekt. Augenerkrankungen,' Freiburg, 1905. 



5 Recueild'Ophth., 1901, p. 551. 



6 See chapter on ' Cornea ' for such corneal infections, also for other forms of traumatic 

 infective keratitis, and those from the moulds (Aspergillus fumigatus). We should here 

 note that in rare cases a perforating mould infection has been observed (Leber and Nobbe, 

 Romer, Kampherstein, Schirmer). In Romer's cases cultures of Aspergillus fumigatus 

 were obtained. 



