SPECIAL FORMS OF CONJUNCTIVAL INFECTION 243 



with ozsena it is seldom found (Cuenod, Uhthoff and Axenfeld, 

 Gourfein) ; in these persons the Pneumococcns is the most important, 

 both in the conjunctival and in the corneal infections. 



The majority of the cases in which the ozsena bacillus has been 

 found upon the conjunctiva were patients who did not suffer from 

 ozaena. Lodato and Angelucci state that the relation of the ozsena 

 bacillus to the conjunctiva, claimed by Terson and Gabrielides, was 

 not present to the extent stated ; they were unable to find the bacilli 

 in the conjunctiva in cases where 

 it was present in the nose. 



As a pure conjunctivitis pro- 

 ducer, I have not yet met this 

 organism ; here and there I have 

 seen individual examples of its 

 rare occurrence on the conjunc- 

 tiva in other forms of catarrh, 

 and I have also found it freely 

 in the secretions of two cases 

 of chronic conjunctivitis with 

 simultaneous lacrymal trouble. 

 Fig. 46 shows the secretion of 

 one of the cases which Dr. Brons 

 examined in the Freiburg clinic. 

 The Pneumobacitti can be at once 

 recognized by their large and 

 distinct capsules ; at places 

 where the preparation is deeply 

 stained the capsules have also 

 taken on the dye. In this slide xerose bacilli, Pneumococci, and 

 influenza bacilli occur in extraordinary quantity. The preparation 

 from which the figure on Plate I. was drawn was sent me by Dr. Zur 

 Nedden, and it, along with Fig. 46, shows the variable appearance 

 of the bacilli ; it was obtained from a case of conjunctivitis with 

 lacrymal trouble. In this case the Pneumobacillus alone was present. 



Pure infections of the conjunctiva with the Pneumobacillus have 

 been freely recorded in the recent literature. Brayley and Eyre 

 found one in a case of pseudo-membranous conjunctivitis. Groenouw, 

 Kreseritzki, and von Ammon saw the same a few times in newly-born 

 infants ; Gonin, Zia, and Derby found it in scattered cases ; Hirota 

 found the practically identical Bacillus mucosus capsulatus rather more 

 frequently, and considered it as the cause of conjunctivitis ; Gourfein 



162 



Flu. 46. FRIEDLANDER'S PNEUMO- 

 BACILLUS, FROM A CASE OF 

 DACRYOCYSTITIS. 



Besides these, we have in a, B. xerosis ; in b, 

 B. influenzas; also Pneumococci (blue). The 

 capsules of the Pneumobacilli are clear in a, 

 red in b (over-stain with safranin). 



