282 BACTERIOLOGY OF THE EYE 



culture ; such a secretion is not necessarily infectious, though it is 

 not justifiable to consider all cases which are not purulent as harm- 

 less, as even in them pus-producers may be present. Cuenod found 

 the Pneumococcus eight times in ten cases with glairy secretion. In 

 the purulent cases these bacilli are quite subordinate to the pyogenic 

 ones mentioned. 



As has been already mentioned in the chapters on ' Influenza Con- 

 junctivitis ' and ' Trachoma,' the influenza bacilli are fairly often 

 found in the pus from the sac (the term being applied to those small, 

 short, Gram-negative rods which only grow on media containing 

 blood). These bacilli were certainly overlooked by the earlier 

 examiners. Since turning my attention to this point I have found 

 them very frequently. Brons has established their cultural identity 

 with the influenza bacillus (Pfeiffer). L. Miiller was the first to draw 

 our attention to these bacilli in the sac ; he has given up his original 

 view that they were a proof of ' trachoma of the sac.' I have found 

 them often enough without any suspicion of conjunctivitis granulosa. 

 Brons rightly draws attention to their frequency in Baden, which is 

 free from trachoma. 



A case of diphtheria of the lacrymal sac with diphtheria of the nose, but without 

 any such condition in the conjunctiva, has been reported by Feilchenfeld. 1 Behring's 

 serum rapidly cured it. There was no bacteriological examination. 



Darier's statement that he found the Gonococcus in the secretions of simple 

 catarrhal dacryocystitis, is not conclusive, as his records contain no differential 

 diagnosis from the other Gram-negative Diplococci. 



In the secretions of chronic sac affections I have occasionally found 

 Gram-negative Diplococci. The essential factors in deciding about 

 these organisms are given on p. 212 in the chapter on ' Gonorrhoea.' 



They were usually the Micr. catarrhalis. The conjunctiva is only 

 slightly affected by them. 



Veillon and Morax have found the anaerobic Bacillus funduliformis 

 along with Streptococci in a case of gangrenous pericystitis. This is 

 one of the putrefactive organisms which cause gangrene, and is related 

 to the angina bacillus of Vincent ; they also found another pyogenic 

 anaerobic bacillus. Besides these organisms we can also find casually 

 many varieties of saprophytes (the Bacillus mesentericus) and Sarcina, 

 Mazet also found non-pathogenic bacilli. 



The cases observed by Gallenga of rhinoscleroma of the sac are 

 very unusual, as are cases of glanders, such as that of Gourfein 

 (cf. section on ' The Lids,' p. 73). 



1 Zcnt.f. Aug., 1902, }>. f>. 



