SPECIAL FORMS OF CONJUNCTIVAL INFECTION 199 



such experiments in large series. Treatment for weeks and months with increasing, 

 and finally enormous, doses of xerose bacilli gave no protection against death from 

 diphtheria, but rather accelerated a fatal termination. The results obtained by 

 M. Xeisser, Petrie, 1 Lewandowski, 2 and others were similar. 



Certain experiments in serum therapeutics have been made lately in the Freiburg 

 clinic with reference to the B. xerosis. 



Behring holds the view that these bacilli under favourable conditions can pass 

 into the virulent form and produce all grades of toxic action, even mild atypical 

 affections, which he calls ' diphtheroid,' from which greater or less immunity may 

 result in the body. 



This would certainly explain the fact, established by Wassermann, that the serum 

 of adults, even when they have not suffered from any demonstrable diphtheria, 

 always shows a definite action against the diphtheria antitoxin. 



With relation to these diphtheroid conditions, Gelpke and Pes take the view that 

 they are very common on the conjunctiva, and that the great majority of the 

 simple catarrhal inflammations, especially the epidemic forms, are really attenuated 

 diphtheria. They claim that this can be inferred from the fact that, when the 

 bacilli are cultivated and inoculated under the conjunctiva, a slight local inflam- 

 mation (oedema) results, which will more rapidly disappear under the influence of 

 diphtheria serum. 



With such bacilli obtained from cases of simple catarrh Gelpke sometimes 

 obtained a slight inoculation conjunctivitis in man. The patients affected had 

 previously suffered from scrofulous inflammation of the conjunctiva, slight increase 

 of which did not represent an acute catarrh. Del Monte, with three such strains, 

 obtained a slight traumatic conjunctivitis after superficially wounding the con- 

 junctiva. This, however, does not prove a diphtheritic action, especially as control 

 injuries without an inoculation and inoculations on diphtheria-immunized animals 

 were not carried out. Large numbers of experiments carried out at my instigation 

 by Bietti and Naito^ have not confirmed this view of simple catarrh. In a hundred 

 cases there was only one showing diphtheria bacilli, so that we must admit that 

 the hypothesis of Pes is not generally true. Gromakowski's results were quite 

 similar : in sixty strains, mostly obtained from catarrh of the conjunctiva, no patbo- 

 genicity for animals could be established. In my experience diphtheroid affections 

 in this sense are very rare on the conjunctiva. Behring's serum treatment does 

 not apply to simple catarrh nor to epidemic conjunctivitis. 



As we have already said, many diseases have been ascribed to the Bacillus 

 xerosis, and some of those who are in favour of the identity of the organisms, 

 especially Deyl and Hala, 4 see in this an evidence that the B. xerosis has the power 

 to produce disease, and that it may be looked on as an intermediate form towards 

 virulent diphtheria bacillus. The presence of the B. xerosis in (1) chalazion, 

 (2) in the interior of the eye in experimental injection, in wound infection, and also 

 exceptionally in metastatic infected eyes, 5 comprises the evidence available. 



The statement that the Bacillus xerosis is the cause of chalazia, those infectious 

 tumours inside the tarsus, is based by Deyl on the fact that he found this bacillus 

 regularly in the very first stages of the chalazia, and by injecting a thick suspension 

 of a culture under the skin of rabbits he was able to produce small nodules 

 which consisted of granulation tissue. When the bacilli were injected into the 

 vitreous, a marked inflammation resulted. These inoculation results were first given 



1 Jour, of Hyg., 1905, v. 134. 2 Zent.f. Bald., 1904, xxxvi. 336, etc. 



3 K. M.f. A., 1903, -Festsch. fur Manz.' 



4 Z.f. A., 1901, vi. ; 1903, ix. 107 (see here the literature). 



~ a Of. the work of Demaria in my clinic, ' Endogenous Mixed Infection of Tubercle 

 Bacilli and Pseudo-diphtheria Bacilli.' ' Panophthalmitis Tuberculosa, ' K. M.f. A., 1905, 

 xliii., Bd. ii., Beilageheft. 



