210 BACTERIOLOGY OF THE EYE 



the human subject, also the serum of Marmorek, in which the Streptococcus is 

 used after an intermediate passage through an animal) ; and for the same reason 

 we have their variable action in treatment. We find, however, in gynaecology 

 (puerperal infection and prophylaxis in operations) and in medicine (scarlet fever) 

 that good results are being obtained. Serum treatment should therefore be carried 

 out in all severe ophthalmic cases. 1 



When inoculated into the eye, virulent Streptococci produce very severe necrosis 

 and suppuration ; other strains produce far less irritation. 



Regarding the contagiousness of pseudo-membranous conjunctivitis, the general 

 facts known about cases due to the diphtheria bacilli are applicable to those which 

 are due to this organism. 



Small epidemics introduced by children affected by such a croupous conjunctivitis 

 have often been observed in hospitals (Schirmer, Vossius). Severe diphtheria of 

 the throat has occurred in connexion with a diphtheria of the conjunctiva. 



True epidemics due to infection with the Streptococcus are not yet recorded, 

 though the observations of Vossius favour the possibility of a contact infection. 



LITEEATUEE. 1 



AMMANN, K. M. f. A., 1897, S. 135. 



AXENFELD, Beitrage zur Atiologie der Conjunctivalentziindungen. Heidelberger 



ophthalmologischer Kongress, 1896. ' Ergebnisse,' von LUBARSCH-OSTERTAG, 



1894-99 (1900 to 1905 by ZUR NEDDEN). See here literature of 'Conjunctiva! 



Diphtheria.' 



AUBINEAU, Ann. d'ocul., 1906, CXXXVI, p. 197. 



BASSO, XV. Congresso dell' associazione oftalmologica italiana. Torino, 1898. 

 BECKER, Inaug. Diss., Jena, 1897. 

 BIETTI, Annali d'ottalm., 1898, vol. 27, p. 441. Ibid., Festschrift fiir Manz, 



Beilageheft, K. M. f. A., 1903, Bd. 41. 



BLANCO, T., Inn. pseudomemb. Arch, de oft. hispano-amer., 1907, VII, p. 153. 

 BRAYLEY and EYRE, Ophth. Soc., London, November 19, 1896. Ophth. Review, 



1896, p 338. * 



CHRIST, Beitrage zur Augenheilkunde, 1905, Heft 63. 

 COPPEZ, H., Des conjonctivites pseudomembraneuses. Bruxelles, 1897. 

 DEYL, Uber Atiologie des Chalazion. Prag, 1893. 

 DEMARIA, K. M. f. A., 1904, XLII, Bd. 2, S. 246. 

 DORET, Recherches experim. sur la virul. des xerosebacilles. These de Geneve, 



1904. 



DUTOIT, Korrespondenzblatt fiir Schweizer Arzte, 1906, Nr. 19 u. 20. 

 FRANKEL, C., Hygien. Rundschau, 1898, Nr. 7. 

 FRANKEL, K , Zeitschr. f. Hyg. u. Inf., 1899, Bd. 31, Heft 2. 

 GALLEMAERTS (1893), quoted by COPPEZ. 

 GELPCKE, Bacillus septatus. Karlsruhe, 1898. 

 GUICHARD, Des formes attenuees de la Diphtheric conjonctivale. These de Paris, 



1905. 



1 For further information regarding the present position of this question, cf. my paper 

 on 'The Senim Treatment of Infections Diseases of the Eye,' Freiburg, 1906. I have lately 

 seen two very severe cases of streptococcal necrosis of both corneoe and conjunctive in 

 children. The general symptoms were so severe that we had expected a fatal result ; 

 after the use of Merck's serum the children began to improve. Of course the eyes 

 were lost. Marten, Basso, Boucheron, and others, have reported similar results with 

 Marmorek's serum. 



2 Cf, the literature under ' Bacillus Xerosis.' 



