112 CLINICAL BACTERIOLOGY AND HEMATOLOGY 



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. 84), 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. 



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 

 proportion to its length, does not stain by Gram, and is fre- 

 quently intracellular, the cells then containing large numbers of 

 bacilli, though it may be necessary to search over a considerable 

 area of film before an affected cell is seen. It is advisable to 

 search for the organisms in a thionin or Lofifler's blue specimen, 

 as it will probably be more distinct than in the Gram specimen 

 counterstained with carbol thionin. 



If the two occurred in the same region, it would probably be 

 indistinguishable from the influenza bacillus ; they differ, how- 

 ever, in cultural characters. 



It causes the common self-limited variety of acute or chronic 

 conjunctivitis. There is no danger that the cornea may become 

 infected ; the disease is very contagious. 



The bacillus of Movax and Axenfeld (Plate IV., Fig. 3) causes the 

 dry conjunctivitis which occurs especially along the edges of the 

 eyelids and at the angles of the eye, and which does not tend to 

 cure in the absence of appropriate treatment. The secretion is 

 usually very scanty, and not purulent ; it is best collected from 

 the caruncle, and it may be necessary to use a capillary pipette 

 for the purpose. 



It is readily recognised as a rather large, broad bacillus, with 

 the sides parallel and the angles slightly rounded, and two bacilli 

 are often seen with their ends approximated together. It is most 



