THE LACRYMAL APPARATUS 



281 



FIG. 53. SEGRETION FROM A CASE OF 

 DACRYOCYSTITIS WITH INFLUENZA BA- 

 CILLI (BED) AND XEROSIS (BLUE). 

 GRAM STAIN, x 1,000. 



we have mentioned, the Staphylococci are of very little importance in 

 the secretion from the sac, although they are often enough found there. 

 The indication for the use of 

 the ' staphylase ' of Doyen in 

 dacryocystitis, as recommended 

 by Darier and Berard, is there- 

 fore very limited. 



Still more rarely do we find 

 Bacterium coli in phlegmonous 

 dacryocystitis (Mircoli, Mazet, 

 Uhthoff, Groenouw, Rabino- 

 witsch). This organism may 

 have been the cause of the 

 abscesses, as when cultivated 

 the bacilli were very pyogenic. 

 Other organisms which have 

 been found are the Bacillus 

 pyocyaneus (Sattler, Jaulin), 

 and certain peculiar pyogenic 

 bacilli of variable form, not 

 exactly classified 1 (Sattler, Uhthoff, Mazet). A strain resembling 

 Proteus caused a hypopyon-keratitis in the cornea of the rabbit. 



The two photographs here 

 reproduced show a pyogenic 

 bacillus of peculiar form which 

 I grew from a case of a dacryo- 

 cystitis several years ago. 

 SarcincB and Actinoinyces albus 

 have been found. Griffiths re- 

 ports having found the Koch- 

 Weeks bacillus twice in cases of 

 chronic dacryocystitis (in such 

 cases we should be careful about 

 the differential diagnosis from 

 the influenza bacillus). 



In the glairy non- purulent 

 secretion the xerose bacillus is 

 often prominent (Fagge), and 

 may appear to be in pure 



1 The Bac. salivarius septicus, which caused infection in a cataract case of Von Ewetzky 

 and Berestrew, is identical with the Pncumococcus, not the Pyocyaneus, as Gabrielides 

 considered. 



FlG. 54. PUS FROM THE LACRYMAL SAC 

 CONTAINING PNEUMOCOCCI, PNEUMO- 

 BACILLI, INFLUENZA, AND XEROSE 

 BACILLI. 



