WOUND INFECTION 99 



possible (Gifford, Bach), especially when these are combined with 

 the action of some substance which dissolves fat (benzene or 

 alcohol, according to Pflugk 1 ), or with an antiseptic dissolved in oil 

 (Panas 2 ). 



It is different in lids inflamed by the various forms of blepharitis. 

 Here pyogenic organisms are much more plentiful, especially Staph. 

 atircus. A preliminary treatment is necessary before operation. 



The Serum Treatment of Infected Wounds. 



When in cases very liable to infection (general debility, diabetes, 

 etc.) Pneumococci are found to be numerous, or when the operation 

 has gone badly, I give an injection of 10 c.cm. Bomer-Merck's anti- 

 pneumococcal serum (vide infra] either just before or immediately 

 after the operation. I do this even although repeated experiments, 

 which I have carried out with Drs. Zade and Brons, have shown that 

 the interior of the eye partakes to but small degree in the general 

 pneumococcal immunity, be that active (including the so-called 

 4 aggressin ' immunity), passive, or simultaneous, even although the 

 experimental animal be immunized with the actual Pneumococcus 

 used for infection. 



The results of infecting the anterior chamber with highly diluted cultures did not 

 differ in the immunized animal from' the control. At most only in a few instances 

 was a slightly milder suppuration produced. 



In similar infections of the vitreous the influence was even less apparent. This 

 is what would have been expected, for Homer and Wessely have shown that 

 protective bodies of the hsernolysin (cytotoxin) group do not pass into the vitreous ; 3 

 and, according to the latest results of Wessely, only repeated tappings of the 

 anterior chamber can cause a transference of albumin into it. To a less extent 

 even can the passage of precipitins occur (von Dungeon). (Receptors of the second 

 order complements according to Possek, 4 are present in the vitreous.) A passage 

 of haemolysin . into the anterior chamber cannot be demonstrated under normal 

 conditions, but after irritation (subconjunctival injections of saline, tapping of the 

 anterior chamber) such may occur. Homer and Bymowicz obtained a positive result 

 in the case of many agglutinins e.g., for typhoid agglutinin even in the absence 

 of irritation. Schneider 5 found small amounts of alexins in the aqueous. The 



1 A. f. A. 1902, xlv., S. 176. The benzene also possesses a certain antiseptic power. 

 Gifford (Jour, of the Anier. Med. Assoc., October, 1903) could not demonstrate that the lid 

 margin could thus be quite sterilized. Cocci remained in the mouths of the follicles. 



2 Acad. de Med., Paris, September, October, 1893, and Arch. d'Ophth., November, 

 1893. 



3 According to Possek, however (K. M. f. A., 1907, i. 339), an immune serum can be 

 obtained in rabbits by subcutaneous injection of vitreous substance, and this serum contains 

 hfemolytic amboceptors. His results contradict those of Paul (K. M. f. A., January 1, 

 1907), who made similar experiments. 



4 Possek, ' tiber die Antigenetische Wirknng des Glaskorpers, ' K. M. f. A., 1907, i. 329. 



5 ffiinch. Med. Woch., 1907, p. 146. 



72 



