190 BACTERIOLOGY OF THE EYE 



SECTION 4. PSEUDO-MEMBEANOUS CONJUNCTIVITIS. 



DIPHTHEEIA BACILLI AND THE SO-CALLED XEEOSE 



BACILLI. STEEPTOCOCCI. VAEIOUS OEGANISMS. 



Eecent researches unanimously show that the bacterial findings vary 

 with the varying intensity of pseudo-membranous conjunctivitis. The 

 formation of a pseudo-membrane is a symptom occurring in various 

 forms of infection, though it must be admitted to especially indicate 

 the presence of either Loffler's diphtheria bacillus or the Streptococcus 

 pyoycncs. The variations of the clinical appearances in relation to 

 bacteriological findings are fully set out in the monograph by Coppez. 

 As the result of experiments and microscopical examinations, Sourdille 

 states that the same chemical agent can produce any degree of re- 

 action, from a slight catarrh to a croupous membrane with severe 

 diphtheritic necrosis, according to its amount, concentration, and time 

 of action. 



The presence of diphtheria bacilli or Streptococci is always sug- 

 gested in slight cases of croupous conjunctivitis, as well as in those 

 severe forms which clinically have that peculiar diphtheritic ap- 

 pearance. Croupous conjunctivitis can be quite well distinguished 

 clinically from diphtheritic conjunctivitis (Saemisch, Zur Nedden, 

 Christ); etiologically, however, this distinction does not hold good. 

 The clinical diagnosis, therefore, requires amplification by examina- 

 tion of the secretion. 



A clinically mild croupous conjunctivitis can be associated with the 

 presence of virulent Loffler's bacilli. This has been definitely estab- 

 lished by the important works of Sourdille, Frankel, and Uhthoff, as 

 well as by the less well-known previous works of Gallaemerts (1891) 

 and Deyl (1892), and has been since confirmed on all sides (Schirmer, 

 Vossius, Coppez, Gosseti-Jona, Jessop, Sidney Stephenson, etc.). 1 



The differential diagnosis of the diphtheria bacillus and its relation 

 to the so-called Bacillus xerosis requires further statement. 



Loffler's Diphtheria Bacillus (Corynebacterium Diphtherias 

 Lehm ann-N eumann) . 



(See PLATE A, FIG. V., a and b.) 



Morphology. Rods of variable length, 1-5 to 8 n and over, of an average breadth 

 of 0'5 to 1 fi ; sometimes also intermediate forms, which are spindle or lancet 

 shaped, the smallest forms often pointed at one or at both ends, the longest ones 



1 Full statistics in Axenfeld, ' Bakt. des Aug.'; Lubarsch-Ostertag, 'Ergebnisse,' 1894- 

 1900. 



