228 BACTERIOLOGY OF THE EYE 



contamination with infectious material, which must often occur in 

 washing, etc., does not always produce the disease. In the case of 

 babies the unilateral affection is rarer than in adults : in the former 

 Kroner found six unilateral cases out of sixty-three, Groenouw one in 

 forty-one, and Druais seven in twenty-four ; in adults, on the contrary, 

 B. Inouye states that the unilateral is the more common. 



It is possible that the infectious material sometimes did not take 

 hold, being so rapidly washed away by the tears, or that a certain 

 amount of immunity was present, or that the damage was averted 

 in some other way e.g., by the tears making the nidus unsuitable. 

 The urethral secretion also, before reaching the conjunctiva, may 

 have been diluted (e.g., in water), cooled or dried, and thus have lost 

 some of its virulence. Piringer's experiments show clearly the well- 

 known variation of activity in definitely gonorrhoeal pus from the 

 urethra, when diluted or cooled. The infectious material in the 

 urethra is, of course, rubbed in with more vigour than in the con- 

 junctiva. In the case of newly-born babies, on the other hand (who 

 also have not yet developed a flow of tears), the susceptibility of the 

 conjunctiva is influenced by the mechanical squeezing and irritation 

 which it is subjected to in the act of parturition. 



The occurrence of non-gronorrhceal catarrh and blennorrhcea in 

 newly-born infants naturally varies very much. Soon after the dis- 

 covery of the Gonococcus of Neisser, the serial examinations of Kroner, 

 Widmark, Haab, Schmidt-Rimpler, and others, showed that the 

 Gonococcus was absent in many cases of blennorrhcea. 



The following are some of the statistical data : 



Kroner in 92 cases found the Gonococcus 63 times. 



Widmark in 103 cases found the Gonococcus 64 times. 



Chartres in 25 cases found the Gonococcus 11 times. 



Groenouw in 40 cases of blennorrhcea neonatorum found the Gonococcus 



14 times. 



Haupt in 62 cases found the Gonococcus 45 times. 

 Gonin in 30 cases of catarrh found the Gonococcus 24 times. 

 Morax and Druais in 60 cases of catarrh found the Gonococcus 24 times. 



As might have been expected, the relative frequency varied. 



Kopfstein in fifty-one severe cases only found the Gonococcus thirty 

 times. 



Since the other causes of conjunctivitis, the Gram-stain, and the 

 finer points of cultural diagnosis have been discovered, these 

 researches have been repeated, with the result that the Pneumococcus 

 (Morax, Gasparrini, Axenfeld, Gifford, von Ammon, and others), the 

 Koch-Weeks bacillus (Morax, Chartres, Gonin, Druais, McKee), the 

 titapliylococcns pyogenes aureus, when they are found in ophthalmia 



