SPECIAL FORMS OF CONJUNCTIVAL INFECTION 245 



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In Fig. 47 towards the upper part of the film there is a place which 

 has been heated too much ; the surrounding medium has retracted 

 and formed a broad clear space ; elsewhere the bacilli lie in a gelati- 

 nous stained medium, preventing the movement of the bacilli amongst 

 each other, and composed of their confluent capsules. 



The cultural characteristics - and the pathogenicity of the Diplo- 

 bacillus are also quite dif- 

 ferent ; it will only -grow 

 on blood-serum and 

 media containing human 

 fluids at blood tempera- 

 tures. It has no patho- 

 genicity for animals, 

 while the so-called ozsena 

 bacillus will grow in a 

 characteristic manner on 

 the ordinary media even 

 at the temperature of a 

 room, and will cause sup- 

 puration in rabbits. 



Pneumobacilli are also re- 

 ported to have occurred in 

 connexion with the eye as 

 follows : In forty cases of 

 dacryocystitis Gourfein found 

 the Pneumobacillus four 

 times. The intensity of the 

 symptoms varied ; there were 

 no changes in the nose ; 

 ozsena was not present. Cuenod, Uhthoff and Axenfeld, and Gerstenberger report 

 single similar cases. In the earlier literature there is a report by Sattler (1887), 

 the first record of this organism ; he twice isolated it from lacrymal-sac pus, and 

 proved its pathogenicity for the cornea of the rabbit. Experimental researches 

 into the working of this organism have been made by Mandry. and more fully by 

 Perles, the latter of whom, like Terson, on the basis of his results, ascribed a con- 

 siderable importance in eye pathology to the Pneumobacillus. Loeb found the 

 Pneumobacillus in keratomalacia infantum, and Etienne in a dacryocystitis with 

 an ulcus cornese serpens. 



Gourfein, Basso, Zur Nedden, Bupprecht, like Terson and Gabrielides, found the 

 Pneumobacillus in individual cases of hypopyon-keratitis. Gourfein, however, goes 

 too far when he ascribes to the Pneumobacillus a power of producing an ulcus serpens 

 equal to that of the Pneumococcus, and states that all the pyogenic organisms 

 produce the same clinical appearances in the cornea (cf. chapter on ' Keratitis '). 



The full records show that the Pneumobacillus has been found a few times in the 

 contents of chalazia (Priouzeau, Maklakow ; cf. section on ' Chalazion '). Wopfner 

 found it in the interior of the eye in metastatic ophthalmia resulting from pneu 

 monia ; Pergens found it in a metastatic.orbital abscess. 



FIG. 47. FRIEDLANDER'S PNEUMOBACILLUS, AGAR 

 CULTURE, FROM A CASE OF DACRYOCYSTITIS. 



The even separation of the bacilli is due to the mucous 

 material between (confluent capsules). Where the 

 heat has been excessive, clear spaces have been formed 

 by retraction. 



