SKIN AND CONJUNCTIVA 569 



p. 219) has been used in the chronic form of the disease by Bassett- 

 Smith l and others with some amount of success (dose 100 to 500 

 millions) 



An organism, the M. paramelitensis, has been found by Negre 

 and Raynaud in certain cases of undulant fever. In such cases, 

 the blood may not agglutinate the M. melitensis but does agglu- 

 tinate the M. 'paramelitensis. A case of this kind is recorded by 

 Bassett-Smith. 2 As regards treatment, yeast or yeast-products 

 have been found of service in the neuritis of the disease. Vaccines 

 (100 to 500 millions) should be given every five to seven days : they 

 are contra-indicated when the pyrexia is continuous or remittent. 



Micro-Organisms of the Skin and Mucous 

 Membranes 



Skin. In the normal clean skin micro-organisms are scattered 

 here and there in cracks of the horny layer and in crevices around 

 hairs and glands, but such skin is not swarming with microbes. 

 The S. pyogenes and M. pyogenes, var. aureus, albus, and citreus, 

 and the M. epidermidis (albus) of Welch, are the commonest (see 

 p. 229). Equally common on the skin and scalp is the scurf micro- 

 coccus isolated by Gordon (see Table, p. 230). Sarcinae, bacilli, 

 and moulds occur also. On the skin of the groin, scrotum, and 

 vulva the smegma bacillus occurs. From sweating feet various 

 organisms have been isolated, which on culture evolve a disagreeable 

 odour, among which is the Bacterium fetidum of Thin. 



Conjunctive. Some observers have stated that the conjunctiva 

 is generally sterile. A certain number of organisms are, however, 

 usually present, though they are not numerous, and if artificially 

 inoculated the excess is rapidly eliminated. The B. xerosis can 

 often be isolated. 



Randolph 3 states that the normal conjunctiva always contains 

 organisms, the commonest species being the Micrococcus epidermidis 

 (albus) of Welch. 



Lawson 4 found the normal conjunctiva to be sterile in 20 per cent, 

 of cases and pyogenic cocci to be rare, and, when present, non- 

 virulent. 



1 Journ. of Hygiene, vol. vii, 1907, p. 115. 



2 Journ. Trop. Hed. and Hygiene, February 15, 1913. 



3 Archives of OphthalmoL, vol. xxvi, 1897, p. 379. 



4 Trans. Jenner Inst. Prev. Med., vol. ii, p. 56 ; also Griffith, 

 Thompson Yates Lab. Rep., vol. iv. pt. i, 1901, p. 99. 



