ENDOGENOUS INFECTIONS 



365 



Localized inflammations in other organs (joints, kidneys, etc.) are 

 recognized as due to circulating poisons, and the gouty affections of 

 the eye are of chemical nature. 



From these examples of endogenous inflammation from the localiza- 

 tion of some definite poison we cannot draw any general conclusions 

 regarding other poisons. With regard to infectious diseases, and the 

 participation of the eyes in them, it is still more important to consider 

 each infection by itself. As to the circulating toxins of the septico- 

 pyaemic conditions, we only know that they will produce certain 



FIG. 78. BENIGN METASTATIC NODDLE IN THE RETINA. 

 GRAM-WEIGERT STAIN. 



In the centre a degenerated mass of Pncumococci surrounded by phagocytes. 



changes in the eye, the so-called retinitis septica (Roth), consisting in 

 haemorrhages and nodules of swollen ganglionated nerve-fibres and 

 fatty degenerated cells. 1 



Axenfeld and Goh have shown that hyaline and laminated throm- 

 boses may be formed in the vessels of the choroid and the retina. 2 



1 In exceptional cases of typhoid (Paul, A'. M. f. A., July, August, 1906) pure Atoxic 

 changes in the retina occur. In close association with these forms of septic retiiiitis are 

 the changes which occur in many of the severe forms of anaemia (pernicious, cancerous, 

 anchylostomiasis), where the blood is being destroyed and toxic material is present, and 

 also the changes which occur in diabetes, nephritis, etc. 



2 In rare cases, such as those which were examined by Goh and Yamaguchi, a diffuse 

 collection of lymphocytes occurs amongst the choroidal vessels without any deposition of 



