224 BACTEKIOLOGY OF THE EYE 



cellular in few cases ; more often they lay in clustered masses. None 

 of our cases were acute, but only showed the scanty secretion of 

 chronically inflamed conjunctiva, in which were also to be found 

 numerous xerose bacilli, Stapliylococci, and in one case the Diplo- 

 bacillus. The numbers of the Gram-negative cocci contrasted strongly 

 with the small amount of irritation. This also was noticeable with the 

 Krukenberg cocci in the series by Plaut and Zelewski, referring to the 

 flora of the conjunctiva after extirpation of the lacrymal sac ; here 

 also large numbers of xerose bacilli and Staphylococci were found. 

 In all these cases (and in a number of others clinically recorded, but 

 from which cultures were not made) the cocci definitely appeared 

 to be saprophytic in their habit, the more so as there was always 

 sufficient ground for the associated irritation (extirpation of the sac, 

 dacryostenosis, ectropion of the punctum, blepharitis, etc.). 



The following questions remain undecided : Are not many of the 

 Gram-negative Diplococci which are found in pus from cases 

 which present the clinical appearances of a blennorrhcea the Micro- 

 coccus catarrhalis ? Is it possible for a blen'norrho3a to arise without 

 organisms, and for the Diplococci to have grown secondarily ? Does 

 the Micrococcus catarrhalis possess the power, like the Gonococcus, of 

 producing a blennorrhcea ? To what extent is it pathogenic on the 

 conjunctiva? 



We cannot yet give definite answers to these questions. "What we 

 do know is that in every case of blennorrhcea with Diplococci 

 resembling the Gonococcus in appearance, staining, and arrangement, 

 when cultures have been made, they have been shown to be true 

 Gonococci. 



In this respect Groenouw's results agree with those obtained in my 

 own laboratory. There is, therefore, no proof that the Micrococcus 

 catarrhalis has the power to produce a blennorrhcea. Nor is it likely 

 that it can originate any process which can develop into a suppuration. 



We cannot exclude the possibility that it may cause a simple catarrh 

 though there is no proof that it can. In Urbahn's case, there was 

 a severe catarrh, though not blennorrhcea. As in the cases by Abelsdorff 

 and Neumann, so here, these cocci were in such large numbers that the 

 preparation gave the impression of a gonorrhcea. In post-operative 

 conjunctivitis in three cataract cases Abelsdorff and Neumann found 

 their Gram-negative Diplococcus. This organism is very closely allied 

 to the Micrococcus catarrhalis, only differing in the power of slowly 

 producing liquefaction in gelatine, and in the milky white colour of the 

 colonies. Its occurrence is, of course, no proof that it has any 



