SYPHILIS OF THE EYE 357 



Syphilis. 



Until the present syphilitic lesions of the eye (hard sore, secondary 

 and tertiary affections) have given no opportunity for their bacterio- 

 logical examination. If the Spirochceta pallida is confirmed as the 

 cause of syphilis, and the signification of the silver impregnation 

 method be established, the determination will be of enormous value to 

 the ophthalmologist. 



Zur Nedden and Puccioni found Spirochteta in the fluid drawn off 

 from the anterior chamber in acute iritis (Heidel. Congress, 1906, 

 and La Clin. Ocul, 1906, vii., p. 2682) ; and Stephenson (the 

 Ophthalmoscope, 1907, p. 143, ' The Cornea in Keratomalacia in 

 Syphilitic Children '), Stock, Peters, Eomer, Bab, and Stargardt, 

 have demonstrated the Spirochceta in the cornea of prematurely born 

 syphilitic children, using the silver method of Levaditi. 



According to Stargardt, the Spirocluehe are freely found in the 

 deeper layers of the cornea in syphilitic children. They are best seen 

 in tangential sections, in which they are often arranged in parallel or 

 crossed rows (with them wandering cells tend to invade the cornea). 

 In stillborn cases, such as that of Bab's, a post-mortem impregnation 

 from the amniotic fluid, or from the interior of the eye, was possible. 

 A deep ring infiltration in a syphilitic child examined by Pieis showed 

 no Spiroch&tG. Perhaps this keratitis was only a toxic reaction 

 caused by the amniotic fluid. 



Bertarelli (Zentralblatt, 1906, Beiheft, S. Ill) injected an emulsion 

 of a chancre into the anterior chamber of a rabbit, and in fourteen 

 days was able to demonstrate numbers of Spiroch<et<e by the silver 

 method. They lay between the normal and infiltrated portions of the 

 cornea. 



In the iris no SpirocJuette could be found. A pure corneal infection 

 (by a pocket) did not give a positive result. In a further paper 

 (Centr. f. Bakt., Orig., xviii., 1907, p. 448) Bertarelli states that the 

 virus can be transferred from one cornea to another, and that the 

 virulence rises. The inoculated virus produced syphilitic symptoms 

 in apes, and in the end was pathogenic for guinea-pigs. 



Scherber inoculated the rabbit's anterior chamber, and obtained a 

 deep inflammatory reaction in the cornea, resembling a keratitis 

 parenchymatosa. Small nodules had previously formed at the 

 pupillary margin of the iris (Wien. Klin. Woch., 1906, No. 24). These 

 results are open to the objection that the Spirocluetfe demonstrated 

 may only have been those originally injected. In the experiments of 



