116 BACTERIOLOGY OF THE EYE 



In Egypt, generally in double-sided trachoma, Meyerhof found in 304 cases of 

 acute purulent conjunctivitis : 



157 containing Koch-Weeks. 



80 Gonococci. 

 37 ,, Diplobacilli. 



10 ,, Pneumococci. 



4 Streptococci. 



2 influenza (L. Miiller's bacillus). 



1 Pneumobacilli. 



7 negative cases. 



Duane and Hastings in 132 cases of catarrhal conjunctivitis found : 



1 containing Gonococci. 



45 ., Koch- Weeks bacilli 



(10 pure, 8 + xerose bacilli, 17 + xerose bacilli + 

 Staph. albus, 4 + Staph. aureus, 2 + Micr. 

 catarrhalis, 1 + Pneumobacilli). 

 23 , Staph. albus 



(18 pure, 5 + Micr. catarrhalis). 

 B ,, Staph. citreus. 

 6 ,, Staph. aureus. t 



2 . , Streptococci. 

 22 ,, Pneumococci 



(All more or less mixed with other organisms). 



5 ,, Diplobacilli. 



2 ,, Diphtheria bacilli (pseudo-membranous cases). 

 30 ' infection with xerose bacilli.' 

 22 negative. 



The 30 cases with xerose bacilli should be considered as indeterminate, and 

 recorded with the negative ones ; we then have (considering the Staphylococci as 

 positive), 80 positive results, and 52 negative or of no value. 



Duane and Hastings insist that a mixture of several organisms is found in slight 

 cases of conjunctivitis, giving the impression that the bacteria hindered 1 each 

 other's activity. 



Duane and Hastings go too far when they conclude that from the clinical aspect 

 of the case no evidence can be gained as to the causal organism. I do not agree 

 with them in considering the simultaneous presence of xerose bacilli, and in many 

 cases the white Staphylococci, as indicating a mixed infection in the true sense of 

 the word, seeing that we cannot attribute to these organisms any definite agency in 

 the production of an inflammation, and at the very most they have only a sym- 

 biotic function (cf. ' Normal Conjunctiva '), or else are purely secondary. True 

 mixed infection i.e., the simultaneous pathogenic activity of different organisms on 

 the conjunctiva is by no means so frequent. When the margins and angles of the 

 lids are avoided in collecting the secretion, pure cultures are very often obtained. 

 Those cases should not be considered as mixed infections in which a few stray 

 facultative pathogenic organisms occur amongst large numbers of the causal one. 



In the acute secretion of a trachomatous conjunctiva Duane and Hastings 

 generally found a secondary infection (Koch- Weeks bacillus alone, or with Staph. 

 Pneumococcus or Micr. catarrhalis, or else the last alone or mixed). Besides these, 

 they found in three cases only Staph. albus, and in one case a negative result. 



They attribute a special power of causing a complicating keratitis to the Staphy- 

 lococci, especially Staph. aureus, when thus present. There is no proof that such is 

 the case. They very definitely assert that when it becomes virulent the white 



