CONJUNCTIVITIS 113 



Eegarding the question of the clinical value of such examinations, 

 it is necessary not merely to know which organism is at work, what 

 clinical signs it produces, and to what extent it can cause epidemics; 

 but each surgeon must determine, by the study of serial records, 

 the importance of the various infections in his particular district, as 

 there are great epidemiological and local variations in these infectious 

 diseases. 



A large number of records from various countries l show to what 

 extent and with what limitations a true etiological definition can now 

 be applied to conjunctivitis. A few data 2 will be taken from the many 

 papers ranging through the whole subject of conjunctivitis. The 

 frequency and character of the various infections will first be dealt 

 with, and then the details regarding these various forms will be 

 treated of in a separate chapter. 



The secretions of 900 cases 3 of acute and chronic conjunctivitis (out of 12,000 

 patients) were examined in the Freiburg Polyclinic in the years 1902-1905 inclusive, 

 in which were found : 



519 containing Diplobacilli. 

 41 Koch-Weeks bacilli. 



34 

 12 



6 

 5 

 2 

 3 



Pneumococci. 



Gonococci. 



Loflier's Bacillus dipMJierice. 



Streptococci causing diphtheria. 



Pneumobacilli. 



Pfeiffer's (influenza) bacillus. 



In the 278 cases remaining the ordinary Staphylococci and xerose bacilli were 

 very often found ; in 9 of them Micr. catarrhalis occurred, but without any certain 

 causal significance. In some of the cases Staphylococci were more numerous, and 

 these might have been classified as staphylococcal conjunctivitis. Even when we 

 take the last group as doubtful, we have a useful slide diagnosis, on a causal basis, 

 iu something over two-thirds of the cases. In this list those organisms are given 

 which in the individual case appeared either pure, or, on account of then- over- 

 whelming numbers, to be the most important. Mixed infections are not quoted 

 separately ; regarding their frequency see the individual chapters. 



Gonin published statistics of 365 cases, which occurred in a definite period of 

 time, and from which only traumatic and phlyctenular conjunctivitis were excluded. 

 His results were as follows : 



(a) 13 cases of pseudo-membranous conjunctivitis : 

 7 containing Lomer's bacillus. 

 4 Staphylococcus. 



1 Pneumococcus. 

 1 Koch- Weeks bacillus. 



1 Records from Southern climates are scanty. Egypt, Argentina (Demaria), Paraguay 

 (Elmassiau), and Palestine (Butler), alone are available. 



2 For this purpose I have taken only the later papers. 



3 Of. the dissertation of Geis (Freiburg, 1907). 



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