200 BACTERIOLOGY OF THE EYE 



by Deyl, and afterwards confirmed by Hala and Bietti, and are of interest, because 

 HJa, the pupil of Deyl, considered this inflammatory reaction as a proof of the 

 identity of these bacilli with the diphtheria bacilli. The production of chalazia 

 would then be considered as a lower grade of pathogenic activity in a diphtheria 

 bacillus. In considering this question, it is of interest to decide whether diphtheria 

 toxin plays any part in the production of these nodes, and whether they are 

 influenced in any way by the action of the antitoxin. In uiy laboratory Bietti l 

 repeated the experiments of Deyl with bacilli which were obtained from chalazia, 

 and with other xerosis strains ; the inoculations were made on animals which were 

 previously immunized to a high degree against diphtheria by means of Behring's 

 serum. The results of inoculation, both in the vitreous and in the subcutaneous 

 tissues, were the same as in the non-immunized animals. As we were not certain 

 whether, in the case of immunized animals, the antitoxin passed into the vitreous, 

 we mixed the bacilli with the serum before they were injected. Homer's 2 experi- 

 ments show that any diphtheria toxin previously present in the interior of the eye 

 would be neutralized by such a mixture. 



Even when antitoxic serum was directly added to the bacterial suspension before 

 the injection, no variation occurred either in the vitreous or in the subcutaneous 

 tissues. It is therefore clear that the diphtheria toxin takes no part in the action, 

 and it is very doubtful whether the occurrence of such a local inflammation proves 

 anything in the way of an identity, as claimed, with the diphtheria bacillus. The 

 same is true for those local inflammations in the cornea and in the anterior chamber 

 which Gourfein and Doret produced by the introduction of large doses of bacilli 

 which they had obtained from cases of catarrhal conjunctivitis. These authors state 

 that bacilli from the normal conjunctiva did not give this reaction, and that an 

 increase in the pathogenic activity took place on the conjunctiva when in a condition 

 of catarrh. That may be so ; I myself have often noticed that bacilli from an 

 inflamed conjunctiva grow more freely. These local reactions to inoculation, 

 howerer, must not be taken as a proof of the presence of diphtheria toxin. 



It must be quite obvious that, from the point of view of clinical therapeutics, we 

 can expect nothing from the treatment of chalazia with Behring's serum. The 

 advocates of identity can test their position by this means on any chronic and 

 recurring cases. 



[Wassermann has proved that a bactericidal serum can be obtained with bacilli 

 whose toxin has been made inactive. Experiments are already being made by 

 this means to settle the much discussed question of the pseu do- diphtheria bacilli. 

 Further experiments must be carried out to see whether by this means the infection 

 of the so-called chalazion bacillus can be influenced.] 



Bietti's experiments show that this production of chalazia has probably nothing to 

 do with specific influences ; he was able by injecting other saprophytes (Sarcina 

 aurantiaca, Rosa hefa, Prodigiosus, and the so-called Pseudogonococcus), which 

 he used in large numbers, to obtain the same results. 



Vitreous injections have the same result. In the dissertation of Vogel I have 

 arranged a number of experiments to show whether the inflammatory reaction, after 

 the injection of xerose bacilli, was influenced by a previous immunizing against 

 diphtheria, or (what would be even more decisive) by a previous admixture of 

 Behring's serum. This was in no wise the case ; the changes were quite the same in 

 the animals treated with serum. 



These last experiments have a further interest. There are in the literature a few 

 cases of severe intra-ocular inflammation after operations or wounds (Kastalska, 

 De Schweinitz), and a few metastatic ones also, where, in the exudate, bacilli of the 

 pseu do -diphtheria variety occurred, which, when grown in pure culture and injected 



1 Arch, di OttaL, 1905, xii. 534. 2 A. f. 0., 1903, 1. 1. 



