THE LACRYMAL APPARATUS 295 



do occur. I use the name Streptotkricea as the family name for the 

 ray fungi, to which group the various Actinomycetes' belong. In the 

 eleven cases already cultivated (Kastalsky, Axenfeld, Silberschmidt, 

 Dalen, Awerbach, Zur Nedden, Morax, Velhagen) a Streptothrix was 

 always present ; l the only exception is the case of Camias, in which a 

 Leptothrix is said to have been cultivated, though it did not corre- 

 spond to the generally accepted characteristics of that organism. It 

 appears probable that a Streptothrix is almost always present, as the 

 clinical appearances are very constant, and the microscopic examina- 

 tion of the filaments in the fresh concretions agree very well with 

 each other. Even if in some of the concretions the branching of 

 the filaments was not clearly seen, it must be remembered that 

 in some cases, definitely due to the Streptothrix (Silberschmidt, 

 Axenfeld, Dalen, Zur Nedden, and Morax), this branching was very 

 scanty. It appears questionable whether the Leptothrix occurs at all 

 frequently. 



According to Mertens (Zent. f. Bakt., 1901, xxix. 650), the 

 Actinomyces hominis seu bovis of Bostrom and that of Israel can be 

 transferred into each other ; it is doubtful how often they take part 

 in the formation of a canalicular concretion, although Awerbach's case 

 shows that an Actinomyces bovis can occur. So long as we have no 

 further information about its cultures and the above-named authors 

 agree in considering that anaerobic cultures will give the most infor- 

 mation and so long as various questions are still under discussion 

 regarding the Actinomyces, the question of the frequency of these 

 various Streptothricece must remain an open one. 



In using the name Streptothricea as a general term to include 

 various possibilities, I am following the lead of Kruse and others, and 

 I do it more readily as in the historical account this name was first 

 used. Von Petruschky' 2 and others reject this as a generic name, and 

 include among the Streptothricece those moulds which do not form 



1 The interesting nodular (drusenartig) 'concretions in the conjunctiva,' described by 

 Fuchs and Wintersteiner as of frequent occiirrence in the conjunctiva, at first give the 

 impression that they are fungus masses (Pilzdruscn), and certainly these yellow nodules in 

 the conjunctiva do have a certain resemblance macroscopically to actinomycosis. The 

 writers mentioned have proved that these are not parasitic, but are really concretions. 

 The same can be said of the case which Demicheri (Arch. d'Ophth., 1899, xix. 102, 2) 

 wrongly described as actinomycosis. The cases published as actinomycosis by de Vincentiis, 

 von Oemichen, and Magnani (quoted by Zur Xeddeu), on the other hand, record true cases 

 of actinomycosis of the conjunctiva. 



Actinomyces albus, which is occasionally found on the conjunctiva and in the lacrymal 

 sac (Cazalis, Ricchi, Gombert, Axenfeld), and which is so easily cultivated, has nothing to 

 do with these Streptothricccc, and Cazalis is in error in identifying it with the Streptothrix 

 Foersteri. 



- Of. Petruschky, ' Die pathogenen Trichomyceten, ' ' Handbuch von Kolle und Wasser- 

 mann,' 1903, Bd. 3. 



