236 BACTERIOLOGY OF THE EYE 



be found, for the latter are generally merely ' associated organisms,' 

 which have no influence on the condition. 



The occurrence of Stapliylococci, with or without B. xerosis, in a smear 

 from a simple conjunctivitis is important in that it shows that we 

 have to deal with a non-contagious process, in which the Staphylococci 

 are at most of secondary importance ; or else with an infection of 

 some other nature, whose cause we have not yet discovered (e.</., 

 trachoma, follicular conjunctivitis, etc.), arid in which the Staphylo- 

 coccus is merely casual. 



According to my own researches and the records available, the 

 Staphylococcus hardly comes into question as the cause of epidemics. 

 We can make the general statement that the Staphylococcus on the 

 conjunctiva is not contagious (cf. p. 110). 



Bach found a very small Micrococcus in an epidemic of acute conjunctivitis ; its 

 inoculation on the conjunctiva of other persons reproduced the disease. This is 

 the only record of a positive inoculation of the human conjunctiva with any form 

 of Staphylococcus. No general deduction can be drawn from this record. On the 

 whole, it is not likely that the Sta2)hylococcus is a factor in the contagion of 

 epidemics. 



The contents of the secretion in stapliylococcal cases require further 

 consideration and illustration (see Plate II., Figs. V. and VI.). 



In considering the occurrence of Staphylococci upon the conjunctiva it is 

 necessary on all possible occasions to take the secretion which has not been in 

 contact with the lid margins or angles. In such situations a secondary contamina- 

 tion and a growth due to contact with the cocci of the skin very soen occurs. The 

 appearances cannot then be referred to the really important cocci in the conjunctival 

 secretion. If we leave aside such cases, then the ones with excess of Siapliylococci 

 in the secretion are considerably decreased in number. A few stray cocci of this 

 species in a conjunctival secretion are naturally of no etiological significance, as 

 such are found there normally and can multiply on the slightest provocation. 



The name Staphylococcus (i.e., a bunch of grapes) indicates the clustered 

 arrangement of the round cocci. This familiar appearance can usually be seen in 

 the pus from abscesses of the lids, hordeolum internum or externum (see Plate II., 

 Fig. F., a). It is obvious in pus from vitreous abscesses. In the conjunctival 

 secretion it is less frequent ; there we more often find irregular masses. The cocci 

 very often vary in size. In many cases phagocytes are numerous, and the cocci 

 may lie in them as well as free ; many of what appear at first to be round bodies 

 present on closer examination a partition line, so that we have beautiful ' coffee-bean 

 Diplococci.' 



The staining has a very great influence on the demonstration of this diplococcal 

 form. The dividing line is hardly visible in prepai'ations which are stained 

 intensely ; then the globular form seems very obvious, and the only one present. 



This is especially the case in many Grain- stained films, but it also occurs when 

 they are intensely stained with fuchsin. When only stained slightly and over- 

 staining is carefully avoided this coffee-bean form is always more obvious, and 

 may even be the only one present. This appearance is very striking in Loffler's 



