272 BACTEKIOLOGY OF THE EYE 



were without effect, as was also the transference of an excised follicle 

 into his own conjunctiva. Samperi found in the secretions of these 

 follicular cases, along with 8tapliylococci, very many 13ac. mesentcricus 

 and Bac. subtilis, which were also present in the dust from the horses ; 

 he therefore referred the disease to the action of this dust. The 

 Stapliylococci were only secondary to the presence of the follicles. 

 This was, of course, not an infectious disease. 



Beal made three inoculations with the secretions of an acute con- 

 junctivitis folliculosa, and only once obtained a slight follicular affec- 

 tion, which disappeared in a few days. He, nevertheless, considered 

 the disease contagious, on account of its rapid transference from one 

 eye to the other. The actual infection must, however, take place in 

 some other way. 



Benign infectious follicular affections of the conjunctiva do also 

 occur, and we are not sufficiently well acquainted with their cause. The 

 findings which Michel, Sattler, Basevi, Wilbrand, Saenger, and Staehlin 

 (Gram -positive cocci) report were only in a few of such epidemics. 

 The consideration of these findings has already been discussed. They 

 were the more acute epidemics in the course of which follicles had 

 formed. As I have already mentioned in the chapters on the organ- 

 isms in conjunctivitis, transient follicular formation has been observed 

 in infections with Diplobacilli, Pneumococci, and Streptococci. Among 

 the benign, chronic, and almost latent follicular epidemics with nega- 

 tive bacterial findings, there are cases which can be transferred by 

 inoculation, and which, therefore, can be infectious. I have proved 

 this on myself. I have had an excised follicle introduced into 

 my own conjunctiva, where, after a ten days incubation period, 

 a progressive follicular formation occurred; in about four weeks it 

 passed over to the other side, affecting the upper and the lower 

 fornices. The condition lasted for about eighteen months. A condi- 

 tion endemic in an orphan asylum was found to differ from trachoma 

 in that the cases always healed spontaneously, without leaving scars, 

 and without having produced in a single case any of the well-known 

 complications of trachoma. My own inoculated conjunctiva spon- 

 taneously returned to the normal without any changes. It is not 

 likely that in these cases an ' attenuated ' trachoma was present. 



Only the discovery of the cause of trachoma will bring certainty in 

 these investigations, and to this end we must use new culture methods, 

 as the finest of our present ones have completely failed. 



