1998 DISEASES OF THE ORGANS OF SPECIAL SENSE 



Mierococci and Conjunctivitis. 



The presence of Gram-negative micrococci may be due to infection from 

 the generative organs by the gonococcus, but it may also be due to infection 

 from the nasopharynx via the lachrymal ducts by the meningococcus and the 

 Micrococcus catarrhalis, which is merely a term for a group of Gram-negative 

 cocci. The Gram-negative cocci of the conjunctiva may be roughly separ- 

 ated from one another by cultivation in sugar media. 



Organism. Glucose. Maltose. 

 Gonococcus . . . . . . . . -t- - 



Meningococcus ...... } % 



Micrococcus catarrhalis . . . . - - 



Acid only, + ; acid and gas, % ; neither, - . 



Conjunctivitis Trachomatosa. 



Synonym. — Ophthalmia ^gyptiaca. , 

 This is exceedingly common in China, where 70 per cent, of the 

 ^children in Hong Kong are said to be infected. It is also common 

 in many other parts of the tropics, especially in India, Japan, and 

 South America; but it is also prevalent in North Africa, especially in 

 Egypt, in South Africa, in Southern Europe, and in Porto Rico. 

 It is an infectious disease, believed by many authorities to be due to 

 a chlamydozoon described by Halberstaedter and Prowazek. A 

 fungus — e.g., the Microsporon tfachomatosum — has been described 

 by Noiszewski, which is only distinguishable from Malassezia furfur 

 by the smallness of its conidia. With regard to the chlamydozoon, 

 it occurs in the cytoplasm of epithelial cells as fine granules, which 

 increase in size, and separate so as to enclose a cavity at first free 

 from granules, in which subsequently very minute granules appear. 



Probable etiology. — There is a growing suspicion that trachoma is essen- 

 tially a disease arising from chronic urethritis in men and chronic vaginitis in 

 women, because cell-inclusions of a chlamydozoan nature have been found by 

 several observers in the discharge from the urethra of men suffering from 

 gonorrhoea, while Castellani has found similar inclusions in a man in Colombo 

 who is believed never to have had gonorrhoea. Further, similar bodies have 

 been found in the vaginal discharge of women whose children have suffered 

 from the form of ophthalmia neonatorum in which no gonococci or strepto- 

 tjocci can be found. Further, Castellani has found similar bodies in a case 

 which may have been one of the rare acute inflammations of a pure trachoma 

 without granule formation, and which may have been induced in the acute 

 form because the woman in question was run down owing to the acute attack 

 of malaria from which she suffered. This case emphasizes the fact that these 

 bodies should be looked for in those so-called attacks of malarial conjunctivitis 

 which are found associated with attacks of malarial fever. Finally, Linder 

 has produced a chronic conjunctivitis by transferring the secretion of vagina 

 and urethra mentioned above to monkeys. This experimental conjunctivitis 

 was associated with the formation of granules clinically and anatomically 

 resembling the conjunctivitis trachomatosa of man. 



Method of Infection. — -The infection is carried by the hands, 

 towels, handkerchiefs, etc., from the sick to the healthy. There 

 is no evidence of aerial transmission. The agency of flies in the 

 transmission of eye disease has long been known — for example, 

 Budd, in 1862, considered it proven that they transmitted ophthal- 



