SPECIAL FORMS OF CONJUNCTIVAL INFECTION 223 



situation. It would be going too far, when the present epidemics pass 

 over, or when no epidemic occurs, were we to neglect entirely the con- 

 sideration of this organism. Sporadic cases of meningitis are always 

 being observed. Weichselbaum discovered the Meningococcus in a small 

 epidemic. The Meningococci must be able here and there to retain 

 their vitality for a considerable time, although in the convalescent 

 cases and in the healthy persons examined they could not be found 

 after a few weeks had elapsed (von Lingelsheim). 



Brons has lately recorded the first case of true Meningococci on the 

 conjunctiva of a person who had neither suffered from meningitis 

 nor come into contact with any such sufferer. Fig. 45 is made 

 from this case. The patient had a keratomalacia, due to Pneumo- 

 cocci; for almost two weeks large numbers of the true Meningococci 

 also could be found on the conjunctiva. The true Meningococcus 

 is very susceptible to dry ness (Albrecht and Ghon, Bettencourt and 

 Franca) ; if dried for twenty-four hours on glass it is quite killed out. 

 It cannot, therefore, maintain its vitality for long outside the body, 

 a circumstance which further favours its rapid disappearance after 

 epidemics. Germano's statement (cf. p. 123) that the Meningococcus 

 is very resistant, and belongs to the ' drought-resisting ' organisms 

 must, in the light of the latest control tests, be considered as in- 

 correct. He probably worked with Bacteria which belonged to another 

 variety, like the Jager organism. 



Brons has recorded an interesting case from my clinic. The patient 

 suffered from cerebro-spinal meningitis; large numbers of the true 

 Meningococcus were found in the cerebro-spinal fluid, and in the con- 

 junctival secretion a Diplococcus, which, however, in every cultural 

 peculiarity resembled the Micrococcus catarrhalis. Every Gram- 

 negative Diplococcus on the conjunctiva of a meningitis patient is not, 

 therefore, to be considered as a Meningococcus. It is impossible to say 

 with certainty whether the Diplococcus of Urbhan or of the first of 

 Krukenberg's cases really were examples of the true Meningococcus. 



The results obtained in our clinic show that the organisms of the 

 Micrococcus catarrhalis group are more frequently found on the con- 

 junctiva than was formerly thought. Neglecting the first of Kruken- 

 berg's cases (as the latest work on the variability of the Gonococcus 

 shows that its differentiation from that organism was, perhaps, 

 doubtful), in the four other cases cultures alone were examined in 

 three, and in the fourth a strong resemblance to the Gonococcus was 

 demonstrated in the secretion. In Brons' six cases the secretion 

 findings were also available in every one. The organisms were intra- 



