SPECIAL FORMS OF CONJUNCTIVA! INFECTION 159 



Many surgeons who have studied this subject in my clinic have 

 told me that they have found the DiplobacitttM very frequently in their 

 own practices. 



It is therefore quite certain that the Morax DiplobaciUua is very 

 widespread over the globe. This can readily be understood when we 

 consider the extraordinary contagiousness, as shown by inoculation 

 (Morax, Axenfeld, Hoffmann, Gifford, Erdmann), and the chronicity 

 of diplobacillary conjunctivitis; the more so as, according to the 

 findings of Erdmann and Biard, it can persist for a long time in 

 the nose. Plant and von Zelewski have proved in my laboratory that 

 it can occasionally be found there without any inflammation of the 

 conjunctiva being perceptible ; Rymowitsch and Erdmann have found 

 it here and there in normal persons. 



We must not, however, speak of an even distribution of this disease. 

 Junius definitely asserts that up till 1900 he had never met it in 

 Konigsberg. Statements vary regarding Egypt. L. Miiller found it 

 comparatively seldom ; Lakah and Khouri have bacteriologically 

 examined 966 cases of conjunctivitis there, and found the Diplobacittus 

 only fifteen times, contrasted with the Koch-Weeks bacillus 523 

 times, and Gonococcns 257 times. Meyerhof, on the contrary, found 

 it much more frequently in about 50 per cent, of trachoma cases. 

 The Diploliacillus is freely associated with trachoma (Peters, Hoffmann). 



How exceedingly frequent diplobacillary conjunctivitis can be in 

 other places is seen by the fact that Eyre found it in about 2| per 

 cent, of all the cases in Brailey's clinic. During six months in 351 

 consecutive cases of conjunctivitis Gonin (Lausanne) found the 

 diplobacillary infection no less than 180 times. According to Pfliiger 

 and Simon, it forms about 10 per cent, of all the patients in Berne. 

 It is just as common in Rostock (Erdmann had 342 cases in five years), 

 Freiburg (we had 529 cases in four years), and Greifswald ; in the 

 University Eye Clinic in Bonn over 500 cases were observed in one 

 year. Acute epidemics of moderate dimensions have also been ob- 

 served in these towns, though the infection has but slight tendency 

 to be epidemic. It occurs more in an endemic and comparatively 

 uniform manner, especially within the limits of families and in 

 sporadic cases. Stoewer and Erdmann are of the opinion that diplo- 

 bacillary infection of the cornea has recently become more frequent 

 in their district. That is quite possible. In many places, however, 

 where this infection has not been recognized it is found to be frequent 

 when more carefully looked for. I have often heard surgeons say 

 that diplobacillary infections did not occur with them, although 



