SPECIAL FORMS OF CONJUNCTIVAL INFECTION 153 



rarely indeed in such large numbers as are shown in Fig. 18, which is 

 drawn from a secretion specimen. Such cases of dacryocystitis have 

 nothing to do with trachoma, as Miiller alleged ; the frequency of the 

 bacilli in the sac makes this obvious. After the work of Rymowitsch 

 and Giarre, we have no doubt that individual organisms are by no 

 means rare on the healthy conjunctiva. These last writers state 

 that they found the ' Bacillo luemojilo ' in 5'8 per cent, of healthy con- 

 junctivee, in 90 per cent, of acute epidemic catarrhal conjunctivitis 

 (Koch- Weeks is here taken along with the influenza bacillus), in 

 83 per cent, of cases of measles (in such Morax met them once and 

 Meyer often), in 66 per cent, of cases of influenza, and in a trachoma 

 they never found them a striking contrast to the results of others. 1 



The foregoing facts regarding the Koch-Weeks bacillus show generally 

 that this organism does not need to rely on the presence of haemo- 

 globin for its growth to the same extent as does Pfeiffer's bacillus 

 (ride supra). 



While Pfeiffer's influenza bacillus has a definite pathogenicity for 

 animals, especially apes, rabbits, and guinea-pigs (peritoneum !), in 

 which it produces a toxic disease, generally without any multiplication 

 of the bacilli,- inoculation of animals with Koch- Weeks bacillus has 

 always given a negative result. Rymowitsch alone attributes to the 

 bacillus which he found the same toxic characters as the influenza 

 bacillus. Piymowitsch's bacillus was simply not the Koch- Weeks 

 organism. His own photographs, which are here given (Fig. 19) show 

 influenza bacilli. It appears to me desirable that further experiment 

 should be made with the Koch-Weeks bacillus on animals, as the 

 inoculation of large doses appears never yet to have been made. On 

 account of the failure of all efforts to produce in animals an immunity 

 to the influenza bacillus, no tests relying on specific immunity can be 

 employed to identify these organisms. 



Clinically, too, a complete identification of the Koch- Weeks with 

 the influenza bacillus would be quite opposed to the fact that when 

 the Koch-Weeks organism has produced its inflammation, especially in 

 widespread epidemics, no disturbances of the general health have 

 occurred which could at all be considered as symptoms of influenza 

 (we except a slight discomfort and cold in the head at the height of 

 the attack). The conjunctival attacks, too, do not occur parallel with 



1 Note that Siegrist found influenza bacilli in an orbital abscess. Duclos found them 

 with Pneurnococci in the pus from a post- operative panbphthalmitis ; I once found the 

 same, and also obtained them once in the orbital pus from a frontal sinus. Morax obtained 

 influenza bacilli from an infected conjunctival cyst ; Yon Kriidener in purulent dacryo- 

 adenitis ; Panja, Dianoux, and Casali in metastatic influenzal ophthalmitis. 



2 See Kolle and Delius, Zcit. f. Hyg. u. Infekt., Bd. xxiv. 



