268 BACTERIOLOGY OF THE EYE 



into a pouch made in the ape's conjunctiva, or he injected subcon- 

 junctivally an emulsion of the trachomatous material. The inflam- 

 matory symptoms at first subsided, but from the second week onwards 

 a granular inflammation occurred, lasting a long time, and spreading 

 to the plica semilunaris and conjunctiva bulbi. He did not observe 

 cicatrization. 



We also know of many cases in which doctors have been infected 

 when treating cases (cf. the statistics of Wurdemann, Duprez, and 

 Poulard). I am personally aware of two such. The view brought 

 forward by Straub that generally it is only contagious for children 

 cannot be accepted, although infection in childhood is more common 

 than is commonly supposed. Ewetzky confirms this for Eussia, and 

 Miiller and Morax for Egypt. The disease presupposes the trans- 

 ference of the secretion, and therefore it may remain isolated in many 

 cases. The contagiousness also is not the same in all stages. In 

 many families living in close contact it is often found that in the 

 course of years only a few persons or, indeed, a single person are 

 affected, and that, too, when they are sleeping together in the same 

 bed. 



We cannot deny the influence of personal disposition. The severity 

 of the attacks also may vary in different epidemics, and in exceptional 

 cases trachoma will remain one-sided. The experiments of Germaix 

 are of considerable value ; especially interesting were his attempts, in 

 unilateral cases, to infect the healthy eye with the contents of the 

 follicles from the diseased one, either through rubbing in or subcu- 

 taneous injection. This was never successful ; there appeared to be 

 a unilateral immunity. Germaix has also repeatedly inoculated his 

 own conjunctiva with trachomatous secretion without result. Simi- 

 larly Back reports (Munch, med. Wochen., 1900, Bd. i., S. 256) that he 

 has often inoculated his own conjunctiva with trachomatous secre- 

 tion, in every instance without any result. Bach lays special 

 emphasis on the personal factor in predisposition, and considers that 

 it is especially due to the presence of scrofula, as was previously 

 claimed by Arlt, Panas, True, and others. (The complete literature 

 of this subject is to be found in the paper by Duprez.) It is certain 

 that such a condition does conduce to the infection, and can influence 

 the course of the disease. The racial predisposition, 1 considered so 

 important by Chibert and others, has not the great importance 

 attributed to it, and the statistics on which their views are based are 



1 On this question, see my review in the 'Ergebnisse,' Lubarsch and Ostertag, section 

 ' Bakterologie des Anges,' 1894-99. The literature is given there. 



