234 BACTERIOLOGY OF THE EYE 



A similar condition of affairs is present in many cases of follicular 

 catarrh. The coccus found by Michel, Sattler, Goldschmidt, Wilde- 

 brand, Saenger, and Staehlin in this condition often shows a number 

 of points of difference from the common coccus (which does not 

 liquefy gelatine). Samperi attributes to the Staphylococci an action 

 in the production of that form of conjunctivitis folliculosa which 

 occurs in people who work in a dusty atmosphere. It should be noted 

 that exactly the same organisms occur on the conjunctiva which is not 

 affected with follicles. 



Thus, Fig. IV., b, on Plate II. is drawn from the secretion of a post- 

 operative conjunctivitis, and shows how a transient and harmless 

 catarrh can occur a few days after a cataract operation, apparently 

 due to the mechanical and chemical irritation at the operation from 

 disinfection, etc. In these cases I have found such phagocytes con- 

 taining Diplococci in enormous numbers. On cultivation the common 

 white, non-liquefying Stapliylococcus, of variable but slight virulence, 

 was found ; it can therefore be concluded that, for such a catarrh at 

 any rate, these organisms have only a secondary importance. These 

 cocci have nothing to do with true trachoma ; the experiments of 

 Villards fail to demonstrate any such connexion. 



An acute catarrh often occurs in the course of a blepharitis, or an 

 eczema, especially the impetiginous variety ; in such cases large 

 numbers of the aureus 1 are often found, and under the circumstances 

 may well have a pathological significance. Poulard described this 

 staphylococcal conjunctivitis fully; it is non-contagious, as can be 

 inferred from its frequent unilateral occurrence, and occurs in persons 

 with a special disposition.' 2 It is not always possible to prove in these 

 cases that a pyogenic form is present. In some cases the number of 

 the cocci is so small that we should not be correct in attributing an 

 etiological significance to them. 



I have often noticed that we find Staphylococci in chronic conjunctiv- 

 itis, in ectropion of the lids or punctum, in cases of neglected catarrh, 

 and in cases of trachoma where the surrounding skin is very dirty. 

 The Staphylococci here have probably some action, just as they play 

 an important part in many forms of inflammation of the lids, 

 hordeola, and pustules. In these cases of blepharo-conjunctivitis the 

 Stapliylococcus aureus is the important one ; in the other cases the 

 organism which is found is the ordinary white coccus of the conjunc- 

 tiva and skin, which does not liquefy gelatine and has a very low 

 virulence. 



1 Often along with Streptococci. 2 Perhaps a low opsonic index. TEAXSLATOK. 



