NOTES ON CONTAGIOUS OPHTHALMIA. 305 



This latter point is of importance as showing the necessity for isolation 

 of eases of acute conjunctivitis in the work of inspection for trachoma. 



(a) The Koch-Weeks bacillus. — This bacillus was first found in Egypt by 

 Koch in 1883, when lie was examining some sore eyes. The discovery was 

 confirmed by Kartulis of Alexandria. The organism was first cultivated by 

 Weeks in New York in 1890. It is somewhat allied to the influenza bacillus, 

 but differs culturally from it, in that the bacillus of influenza will not usually 

 grow characteristically except in blood media. The Koch-Weeks bacillus grows 

 best on serum-agar, but the growth is quite satisfactory also on nutrient-agar 

 at 37° C. and also on glycerin agar phis ascitic fluid. 



The colonies occur as transparent dots which tend to coalesce, but never 

 attain a large size. The bacillus is 1.5 to 2 /i in length and about 0.4 /j. in 

 thickness. It forms no spores, is nonmotile and is Gram-positive. Its power 

 of resistance is slight and therefore it seems probable that the dust-born spread 

 of this disease will not often occur. The contagion probably is transmitted 

 either directly by the hands, or indirectly by means of flies. In Egypt, the 

 common house fly is probably the usual channel of infection. In Singapore 1 

 have found a very small brownish-red fly, often in large numbers, on coolie ships. 

 I have sent home for identification specimens of this insect. 



That the Koch-Weeks bacillus is accountable for much or our Eastern 

 ophthalmia seems probable from the fact that it was encountered in 

 54.7 per cent of my series of cases. 



A second cause of catarrhal ophthalmia is a bacillus of which I can find 

 no reports or descriptions. It somewhat resembles the Koch-Weelcs 

 organism in appearance, but is slightly larger, varjdng from 2 to 2.5 /j. 

 in length. It is nonmotile and forms no spores. The main point of dif- 

 ference from the Koch-Weelcs organism is that it is Gram-positive. The 

 only cultures I have tried have been on nutrient agar where growth 

 occurred fairly readily as small, dotted colonies. 



Clinically, the effect of the organism much resembles that of the Koch- 

 Weeks bacillus, but Doctor Ealtray has remarked in several of his cases a 

 somewhat follicular type of conjunctivitis. I hope to undertake further 

 work on this organism, with animal inoculations and on various culture 

 media. That the bacillus is not uncommon may be concluded from the 

 fact that it was found in 14.6 per cent in my eye series. 



The third cause of catarrhal ophthalmia is the Morax-Axenfeld bacillus. 



This was first found by Morax in 1896, and independently by Axenfeld. It 

 is about 1 to 2 /i in length and frequently occurs in pairs. It grows readily in 

 Loeffler's blood serum which is liquefied in characteristic pits in sixteen to 

 twenty-four hours. No growth seems to occur on agar, gelatin or the other 

 common media. It is Gram-positive. 



The bacillus has been described from Europe, Africa, North America, and Asia. 



Only 4.4 per cent of the infections of my series were due to this bacillus, 

 so that it is probably not particularly common in southern China and 

 Malaya. Clinically, I have found this type of conjunctivitis fairly 



