244 BACTEEIOLOGY OF THE EYE 



found it frequently 20 times in 450 cases. No other author has 

 found this bacillus so frequently in the eye, and therefore Morax has 

 some doubts as to the correctness of the findings. 



Gourfein found the bacillus four times in pure culture in cases of new-born 

 catarrh. He described the cases as blennorrhoea of moderate severity ; at first they 

 had a superficial membrane. In every case both eyes were affected ; the cornea 

 and the lacrymal passages showed no change. Duration was from one to three 

 weeks ; in one case there was a recurrence. Gourfein also observed seven cases of 

 catarrhal conjunctivitis resembling Koch-Weeks catarrh, of which two had haemor- 

 rhages in the conjunctiva bulbi. He also saw twelve cases of subacute conjunctivitis, 

 which to some extent resembled diplobacillary conjunctivitis, but were not so 

 chronic. 



Gourfein emphasized the variability of the clinical picture. A case of pneumo- 

 bacillary conjunctivitis of great chronicity is recorded by Derby, and another by 

 Kreseritzki. 



Contact transference of this form of conjunctivitis has not been 

 recorded ; only sporadic cases have occurred ; epidemics are out of 

 the question. Neither have positive infections of the human con- 

 junctiva with pure cultures been made. In those cases, neverthe- 

 less, in which the Pneumobacilli or ozsena bacilli are plentiful in the 

 secretion they are probably the cause of the inflammation, and 

 certainly they do cause suppuration in the cornea and in wounds. 

 To what extent predisposing factors play a part in these cases we 

 cannot say. The conjunctivitis is certainly rare. 



The differential diagnosis is of interest in the demonstration of the 

 Morax-Axenfeld bacillus, which is similar in size and staining. The 

 double form is more constant in the Diplobacillus. The Pneumobacilli 

 vary very much in length ; they are single, and amongst them very 

 short, and also very long, individuals can be seen. The capsule is 

 very obvious in the Pneumobacilli, and at once presents a definite 

 point of differentiation, as in Gram-stained specimens of the Diplo- 

 bacillus it is not at all obvious, or is quite absent. 



The wide, clear spaces around the bacilli are not invariably cap- 

 sules, but are sometimes due to the fact that around these cap- 

 sulated bacilli the albuminous fluid retracts when too much heated. 

 When the film has been carefully heated, or is fixed without heat, 

 then the appearance is quite different. The capsule appears to be 

 lighter than the bacillus, but occasionally takes the colour more 

 intensely. Often chains or clusters of bacilli lie together in a 

 common, lightly-stained envelope. When deeply overstained, the 

 capsule may be so dark that the bacilli appear as thick, plump rods, 

 in each of which, as a matter of fact, a Bacterium is enclosed. 



On examining cultures, many of these appearances are presented. 



