4o8 Acute Contagious Conjunctivitis 



patch is noticeable; this is of a pearly color and possesses a glisten- 

 ing surface. By the formation of small concentric colonies the 

 growth extends for a short distance. At the end of the fourth or 

 fifth day the growth ceases to advance; it is never abundant. The 

 culture dies in from one to three weeks. 



Pathogenesis. — Both Weeks and Morax have tested the organ- 

 ism for pathogenic activity, and in every case in which pure cultures 

 of it were placed upon the human conjunctiva, typical attacks of 

 the acute conjunctivitis resulted. The organism fails to infect any 

 of the lower animals. 



Association. — Both Weeks and Morax found the organism in 

 intimate association with a larger club-shaped bacillus, which 

 was regarded as the pseudo-diphtheria bacillus. It seems to be of 

 no pathogenic significance. 



The Morax-Axenpeld Bacillus 



In 1896 Morax* found a new bacillus in certain cases of epidemic 

 subacute conjunctivitis. Immediately afterward Axenfeld* pre- 

 sented to a congress in Heidelberg cultures of the same bacillus that 

 he had isolated from 51 cases of what he called " Diplobacillen- 

 conjunctivitis" that occurred a few months before as an epidemic 

 in Marburg. De Schweinitz and Veasy,J Alt§ and others found 

 the same diplobacillus in America, and many others confirmed the 

 observations in various parts of Europe. It has also been found in 

 Egypt. There is no doubt, therefore, but that this is a widely dis- 

 tributed organism. Morax produced the disease by placing a pure 

 culture of the organism upon the human conjunctiva. He was 

 unable to infect any of the lower animals. 



In this subacute form of conjunctivitis there is very little secre- 

 tion, and to secure the micro-organism either for microscopic ex- 

 amination or for cultivation recourse must be had to minute flakes 

 of grayish mucus that collect upon the caruncle. 



Morphology. — The bacillus is small, commonly occurs in pairs 

 or chains. It measures approximately 2 m in length. It is not 

 motile, has no flagella, and forms no spores. It is somewhat pleo- 

 morphous. Involution forms soon appear in artificial cultures. 



Staining. — The organism stains by ordinary methods, but does 

 not stain by Gram's method. 



Cultivation. — The organism grows only upon alkaline blood- 

 serum or upon culture-media containing blood-serum. Morax 

 made his original observation by using Loffler's blood-serum mixture. 

 The colonies appear in twenty-four hours at 37°C. The blood- 



*"Ann. de I'lnst. Pasteur," June, 1896; "Ann. d'Oculist," Jan., 1897. 

 t "Heidelberg Congress," 1896; "Centralbl. f. Eakt.," etc., 1897, xxi. 

 j " Ophthalmological Record," 1899. 

 § "Amer, Jour, of Ophthalmology," 1898, p. 171. 



