junctivitis in man by anyone who has experience with it 1 (re B. 

 influenza, vide infra). 



Its appearance, combined with its reaction to Gram's stain, is quite 

 characteristic, and Jundell is incorrect in warning against giving a 

 diagnosis from the smear preparation. He did so because in several 

 cases where such an appearance was presented no such Bacteria could 

 be found in a blood-agar culture, Bacillus xerosis and cocci resembling 

 Pncumococci alone growing. He was incorrect, because the use of 

 Gram's stain would have absolutely excluded any confusion with these 

 organisms in the smear. The literature also teaches us that the Koch- 

 Weeks bacilli often fail to grow on media made from animals' blood. 

 The smear preparation in these cases often gives more information 

 than the cultures. The one and only organism with which there is a 

 similarity is the influenza bacillus, and the morphologically and 

 biologically similar L. Miiller's bacillus. 



What is the relation, then, of the Koch- Weeks bacillus to the in- 

 fluenza bacillus (Pfeiffer), and with the Miiller's bacillus which is 

 practically identical ? 



Is it identical with them, so that the conjunctivitis can be called 

 'influenza bacillus conjunctivitis,' as has been lately proposed by 

 Jundell, Smitt, Eymowitsch, Giarre, and Picchi ? 



In reviewing this question we must first establish that in fact there 

 is a conjunctivitis with an organism present which in every particular 

 agrees with Pfeiffer's bacillus. 



The Bacillus Influenzas (Pfeiffer). 

 (PLATE I., FIG. 2, a-d.) 



Morphology and Culture. Very small rods, slender, with rounded ends, with- 

 out spore formation, almost like cocci, and shorter than the Koch- Weeks bacillus 

 which more resembles the bacillus of mouse septicaemia ; they lie singly or in pairs, 

 often like Diplococci. They are Gram -negative, often show distinct polar staining, 

 and are obligate aerobes, only growing at temperatures above 26 C., and with 

 certainty on media containing blood, especially pigeon's, which is so rich in 

 haemoglobin. Exceptionally they grow on serum media (due to an admixture of 

 haemoglobin), and occasionally on haemoglobin-free media, in symbiosis with other 

 organisms which favour their growth (various Staphylococci, but especially the 

 B. xerosis). Grassberger and Gohn by prolonged cultivation have been able to make 

 some strains grow on the ordinary media. 



In the discharge the bacilli tend to occur in clusters (cf. Fig. 18), like shoals of 

 fish. In cultures longer rods occur. 



1 The glanders bacillus and the Ducrey bacillus of soft sore are also Gram-negative, but 

 they are larger, and almost never occur in acute conjunctivitis. The Bacillus pyocya-neus 

 is of no importance in conjunct! val inflammations, although it is often observed in the 

 cornea. 



