SPECIAL FORMS OF CONJUNCTIVAL INFECTION 181 



resembling trachoma is not due to the pneumococcal infection 

 alone. 



Gasparrini has stated that a trachoma is improved by the occur- 

 rence of a pneumococcal infection. Ferri recommends inoculating 

 the conjunctiva with Pneitmococci in the treatment of trachoma. 

 Rymowitsch is of the same opinion ; he hoped in this way to found 

 a bacterial treatment of trachoma. We cannot yet say whether this 

 expectation will be generally realized ; Gifford and Junius, who often 

 saw this combination, record no improvement from it. The Pneumococcus 

 must have some special curative power on trachoma, for the other 

 secondary infections, especially the common ones due to Koch- Weeks 

 bacilli or Gonococci, cause no appreciable improvement in the granular 

 condition. Augstein considered that there was an antagonism be- 

 tween trachoma and Pneitmococci, to the extent that the trachomatous 

 cornea is much more resistant to that organism. 



Infection. Susceptibility. 



Inoculation of pneumococcal conjunctivitis on animals is only rarely 

 successful ; Gasparrini reports positive results after scarification of the 

 conjunctiva. Uhthoff and Axenfeld saw severe conjunctival inflamma- 

 tion develop on one or two occasions after corneal inoculation. In 

 general the rabbit's conjunctiva is very slightly susceptible, as the 

 negative results of Noeldeke's experiments show. 



A pathogenic significance of the Pneumococcus for the human 

 conjunctiva is, nevertheless, quite compatible with these findings. 



Contagiousness can be inferred from the occurrence of epidemics 

 characterized by the presence of large numbers of Pneumococci in the 

 secretion. Definite proof is furnished by Gifford and by Pichler, who 

 both obtained the same appearance in the human conjunctiva by 

 inoculating with pure cultures ; along with their results we have also 

 those of Hauenschild and Veasy, and the four positive inoculations 

 which Banziger and Silberschmidt obtained with attenuated cultures. 

 The last-mentioned authors produced in one case a typical con- 

 junctivitis by the transference of secretion. 



Pichler gives no details of his inoculations. At first Gifford obtained 

 no results with aerobic cultures, but with anaerobic, as also with 

 secretions, a conjunctivitis occurred (Hauenschild obtained similar 

 results) ; the incubation period was forty-eight hours. According to 

 Halle, the incubation period sometimes appears to be longer than 

 this. He observed the onset after seven days, in a doctor whose eye 

 had been infected with empyaemic pus. 



