134 BACTERIOLOGY OF THE EYE 



In New York Weeks observed an acute conjunctivitis, varying in intensity first 

 in a small family epidemic, then in large epidemics especially in spring and autumn, 

 and in the interval in numerous sporadic cases. In the secretions he constantly 

 found small, fine rods, which tended to lie in the pus cells or else free in small 

 clusters. (His drawings agree exactly with later findings.) Their cultivation 

 presented great difficulties, and "Weeks only succeeded in obtaining a growth of 

 the small bacilli along with a club-shaped bacillus (so-called B. xerosis) on O5 per 

 cent, agar ; the mixture could be cultivated to the sixteenth generation. He 

 correctly distinguished the two forms of bacilli in the mixture, and gave corre- 

 sponding drawings ; a pure culture was not obtained. In this first paper Weeks' 

 findings regarding the conditions of growth are therefore incomplete, and, to some 

 extent, inaccurate. He demonstrated the great probability of the pathogenic 

 significance of these small bacilli by inoculating on the human conjunctiva the 

 club-shaped organism readily grown in pure culture on 1 per cent, agar, and 

 also the mixture of the two bacilli. The mixture alone produced a conjunctivitis, 

 which in five cases presented the clinical type, and had an incubation of thirty-six 

 to forty-eight hours. The infection was always transferred from the inoculated eye 

 to the other. He therefore rightly considered the club-shaped bacillus as a casual 

 contamination of the conjunctiva. 



Kartulis (Alexandria) found the small Koch bacilli. He definitely stated that this 

 bacillary conjunctivitis had no essential connexion with trachoma, but was very 

 often associated with it. Kartulis obviously did not obtain pure cultures, for his 

 descriptions refer to the unavoidable xerosis. This is also the explanation why, in 

 five out of six inoculations with his cultures, no result followed. 



In 1890 Weeks reported at the International Congress in Berlin that he had now 

 obtained pure cultures of the small bacilli and successful inoculations with them. 

 He had obtained this bacillus in over 1,000 cases. In a further communication in 

 the year 1895 Weeks again referred to these pure cultures, and concluded from tho 

 drawings that in every particular they were identical with the cultures which Morax 

 had obtained in the interval. 



In 1894 Morax furnished a very particular and exact description of the growth of 

 the Koch-Weeks bacillus. From the clinical picture, which he had studied since 

 1891, he was aware that the intensity of the inflammation can vary. The little 

 bacilli were absolutely non-pathogenic for animals, but, on the other hand, Morax 

 produced on himself a typical acute conjunctivitis with one drop of a serum bouillon 

 culture (third generation) after an incubation of forty-eight hours. In a later paper 

 Morax states that the colonies are very like those of influenza; and in a still further 

 communication Morax and Petit note that the name Conjonctivite aigue 

 contagieuse did not correspond merely to that conjunctivitis due to the Koch-Weeks 

 bacillus ; but, as Axenfeld and Gifford had shown, a pneuniococcal conjunctivitis 

 can also occur in an acute contagious form. 



In the same year (1894) Wilbrand Saenger and Staehlin reported that they hod 

 found the bacillus in an extensive epidemic in Hamburg, freely mixed with 

 Diplococci which resembled Gonococci, but were not decolorized by Gram's stain. 

 In such cases there was a great development of follicles ; this, however, did not 

 occur in those cases which only contained the bacilli. With regard to their cultures, 

 there were definite variations which made it doubtful whether these authors did 

 really obtain pure cultures. A later communication from Wilbrand (discussion on 

 Axenfeld's paper, Heidel. OjiJi. GeseU., 1896) stated that since the great epidemic 

 in Hamburg sporadic cases were continuously being observed. 



Further comprehensive researches were communicated by Weichselbaum and 

 Mliller regarding a relatively slight epidemic in Ziersdorf (Lower Austria). The 

 authors point out the want of agreement among, and even the contradictory state- 

 ments of, the earliest workers on the Koch-Weeks bacillus, and attribute them to the 



