CONJUNCTIVITIS 119 



SCHOLTZ and VEEMES, Szemeszet, 1907, and K. M. f. A., 1908. 



SHUMWAY, E. A., The pathogenic bacteria of the conjunctiva. Amer. ophth. Con- 

 gress, 1906. Jour, of the Amer. Med. Assoc., 1906. 



SMITH, D., Arch, of ophth., 1905, XXXIV, p. 481 ; 1906, XXXV, p. 356. 



SMITH, 100 cases with bacter. exam. Journ. of eye, ear, etc., 1904, p. 98. 



STIRLING, Montreal Med. Journ. October, 1905 (Ophthalmology, January, 1906). 



UHTHOFF, Uber den gegenwiirtigen Stand der Bindehaut- und Hornhautentziindungen. 

 Saminl. zwangl. Abhandl. von Vossius (Halle, Marhold, 1899). 



USHER, C. H., and FRASER, H., K.L.O.H. Rep., 1906, p. 430. 



VEASEY, Bacteriology of acute conjunctivitis. Ophth. Review, 1899, p. 354. 



DE SCHWEINITZ and VEASEY, Ophth. Record, 1899, p. 80 and 87. 



VALENTI, Sull,a azione di alcune sostanze tossiche sulla congiuntiva oculare. 

 Archivio di Ottalmol., 1900, VIII, p. 20. 



ZIA, Inaug. Dissert., Marburg, 1903. 



ZUR NEDDEN, ' Ergebnisse ' (LUBARSCH-OSTERTAG), 1900-1905. 



The articles mentioned and the other analogous records, taken in 

 conjunction with those which will be mentioned in the special chapters 

 later, show that there is no absolutely typical clinical picture 

 corresponding 1 to the individual forms of infection. We would, 

 however, emphatically state that relatively characteristic appearances 

 are presented in the sense, for example, that diplobacillary conjunc- 

 tivitis undoubtedly produces the appearance known as ' ophthalmia 

 angularis,' and that pneumococcal conjunctivitis tends, in very many 

 cases, to assume the characteristic appearance first described clinically 

 by the author. Similarly a relative preponderance of certain features 

 obtains in gonorrhoea, in diphtheria, and for the Koch-Weeks infection. 

 After considering reports chiefly dealing with variations, we should 

 not conclude that no causal provisional diagnosis can be made. That 

 is not the case. Eegarding contagiousness, complications, and pre- 

 disposing factors, well marked points of difference can be established. 

 The final conclusion is and this is stated on all sides that clinical 

 diagnosis and microscopical examination must supplement each 

 other, and a variable but greater degree of certainty will then ensue 

 with regard to etiology, prognosis, prevention, and treatment. A 

 glance at the work on epidemic pneumococcal conjunctivitis shows this 

 very clearly. The chapters which follow will give further details on 

 this point. 



The possibility of giving a provisional diagnosis from the clinical 

 appearances varies in different localities. In places where both 

 pneumococcal conjunctivitis and Koch- Weeks infection frequently 

 occur considerable restraint must be exercised in thus diagnosing 

 cases of acute catarrh ; for there are cases which cannot so be clinically 

 differentiated, although even in them, if the whole course and all the 

 details of the infection be considered, the experienced observer may 



