130 CLINICAL BACTERIOLOGY AND HiEMATOLOGY 



The organisms most frequently found in inflammation of the 

 general surface of the mucous membrane of the nose are the 

 diphtheria bacillus, the influenza bacillus, the M. catarrhalis, 

 the pneumococcus, the pneumobacillus, and B. septus. These do 

 not call for further mention. In early cases of leprosy the bacilli 

 may be found in the nose, apparently before they are present 

 elsewhere in the body, and the diagnosis may be made from their 

 recognition. 



In suppuration of the antrum and other sinuses the bacteriology 

 is very variable. In disease of the antrum due to carious teeth 

 the B. fusiformis, mixed with numerous other organisms, may be 

 found. In other cases the commonest bacteria are pneumococci, 

 streptococci, staphylococci, and the M. catarrhalis, usually unmixed 

 in each case ; the subject, however, has not yet been sufficiently 

 investigated. 



THE CONJUNCTIVA 



The method of examination is very simple. A little pus is taken 

 with a platinum loop and films prepared. One of these is stained 

 with carbol thionin or Loffler's blue, and the other by Gram 

 followed by dilute carbol fuchsin. 



The most common causes of conjunctivitis are the gonococcus, 

 the pneumococcus, the Koch-Weeks bacillus, and the bacillus of 

 Morax and Axenfeld. In addition to these, certain other bacteria 

 must be briefly mentioned. 



The method for the recognition of the gonococcus need not be 

 further described (see p. 87), nor is it necessary to point out the 

 danger of this form of conjunctivitis, nor the fact that prompt 

 measures must be taken if the eye is to be saved. 



Other organisms somewhat resembling the gonococcus some- 

 times occur in the conjunctiva, but I have never seen or heard of 

 a case in which they were absolutely identical in appearance and 

 distribution, and present in numbers sufficient to lead to errors in 

 diagnosis. If any doubt should arise cultures must be made, but 

 do not wait for them before commencing treatment. 



The pneumococcus is not a common cause of conjunctivitis, and 

 when it occurs the prognosis with regard to the involvement of 

 the cornea is not serious. 



The bacillus of Koch and Weeks is extremely minute, and has 

 a close resemblance to the influenza bacillus. It is very thin in 



