SPECIAL FORMS OF CONJUNCTIVAL INFECTION 171 



hypopyon-keratitis, while the Morax-Axenfeld type is more prevalent 

 by far in conjunctivitis. It is best to speak generally and collectively 

 of diplobacillary conjunctivitis and diplobacillary keratitis, and to 

 recognize that both the common Morax-Axenfeld and the rare Petit 

 varieties can produce the same clinical appearances. 



Pathogfenieity. 



Morax asserted that his Diplobacillns possessed no pathogenic powers 

 for laboratory animals, either locally, subcutaneously, or intraperi- 

 toneally. Apes and birds were also quite refractory to it. All the 

 later investigators came to the like conclusion. Eymowitsch alone 

 stated that he had obtained a severe plastic iritis by injections into the 

 anterior chamber ; and this has been confirmed by Eupprecht in my 

 laboratory. Injection into the vitreous produced an abscess. The 

 Petit type has a greater action (MacNab), and occasionally produces a 

 slight hypopyon-keratitis in rabbits. 



Morax, by instilling a twenty-four-hours ascites bouillon culture 

 into the conjunctiva of one of his colleagues produced a typical sub- 

 acute conjunctivitis. This began after four days' incubation. Shortly 

 after inoculation no Diplobacilli could be found in the conjunctiva, but 

 when the discharge began they were numerous, and again completely 

 disappeared when sulphate of zinc had produced a cure. 



Axenfeld introduced into a healthy conjunctiva a loopful of a 

 forty-eight-hour culture on bullock's blood-serum which had already 

 begun to liquefy. The result was negative, perhaps because of the 

 medium used for culture and the degeneration of the bacilli which 

 had occurred. The inoculation of a fleck of secretion, which when 

 first rubbed on serum produced a pure culture of Diplobacilli, resulted 

 twice in a typical diplobacillary conjunctivitis, with four days' incuba- 

 tion, and a profuse pure culture of the Diplobacilli in the secretion. 

 The conjunctivitis passed over into the other eye, and rapidly healed 

 under zinc. 



Hoffmann and also Gifford obtained similar positive results on 

 inoculation. The course was a little different in Hoffmann's case, as 

 the secretion commenced on the second day, though the discomfort 

 was only felt on the fourth. 



There is a widespread susceptibility to this disease, and exceptions 

 are rare. The investigations of Plaut and von Zelewski in my 

 laboratory have shown that such exceptions do occur, as they found 

 the Diplobacillns twice on practically normal conjunctiva in cases of 



