104 BACTEKIOLOGY OF THE EYE 



along them into the deeper parts, having arisen in an epithelial lesion which 

 possibly had rapidly healed again. Terson* and others have recorded further 

 examples of this, and in several cases I have been convinced that this was the case. 

 It cannot be denied that circulating organisms can settle in such eyes as a locus 

 minoris resistentia;. 2 Such a mode of infection, which has been emphasized by 

 E. Meyer, is certainly very rare. These late infections of adherent scars have 

 mostly been due to chain-forming cocci and Pneumococci. Experimental inocula- 

 tions into adherent scars in the rabbit's cornea have been made by Dolganow and 

 Sokolow (A.f. A., 1903, xlix., p. 361). 



All these circumstances must be taken into account when dis- 

 cussing endogenous infection in any wounded or perforated eye, and 

 we must not presume that any individual case is endogenous with- 

 out very strong evidence, especially if there be no indication of 

 any disease predisposing to metastasis. 



Cases which were probably endogenous complications of a wound, are recorded 

 by Axenfeld 3 (in the case of a woman who some days previously had had a pleuro- 

 pneumonia, with splenic enlargement ; on the twelfth day, after a cataract 

 operation, a deep suppuration occurred) ; by Hjort (two cases of suppuration during 

 influenza) ; by Panas and Weeks (deep suppuration after a pure contusion) ; Stock 

 (twenty days after healing of an operation wound, deep pneumococcal suppuration 

 during influenza K. M. f. A., 1906, ii., p. 431) ; and Wopfner (pneumobacillary 

 metastasis in a case of cataract extraction K. M. f. A., 1906, xliv., p. 386). In the 

 literature of cataract occasional cases are recorded. 



This factor must only be considered as very occasional, and 

 wound infection must generally be attributed to eetog-enous 

 infection. 



Endogenous wound suppuration has been experimentally produced 

 by Panas (Soc. fran9. d'Oph., 1897), Tornatola (Ann. di OttaL, 1899, 

 xix., p. 480), and von Koratkow (Wratsch, 1903, No. 50; Ann. 

 d'OcuL, 1904, cxxxii., p. 152). They induced a septic pyaemic con- 

 dition in animals (Panas with Bac. coli and Tornatola with pyogenic 

 cocci), and then subjected the eye to a trauma (Panas by an injection 

 of nicotine, Tornatola by a perforating wound). Suppuration occurred 

 on the injured side. Moll (Zcnt.f. A., August and December, 1899) 

 obtained the same result with Pyocyancus. 



The researches of Stock (K. M. f. A., 1903, xli., 1, p. 81), 

 Selenkowski and Woizechowski (A. /. A., 1903, xlvii., p. 299) have 

 shown that metastases in the eye, usually double-sided, very readily 

 occur in rabbits whose blood has been infected with virulent 

 organisms. In the case of Selenkowski and Woizechowski, who 

 worked with subvirulent organisms, the localizing influence of an 



1 Ann. d'Ocul., 1898, cix. 116. - A.f. 0., 1894, xl. 2, p. 113. 



3 Ibid., xl. 3. 



