130 THOMPSON YATES LABORATORIES REPORT 
Histology of Inflamed Conjunctiva in which there are a few Granules 
There is the same abundant leucocytic infiltration as in the acutely inflamed conjunctiva ; 
but the small round cells are chiefly aggregated in the tissues immediately beneath the epithelium, 
and around the Meibomian glands ; the areolar tissue is not so profusely infiltrated. At this stage 
a more distinct formation of the round cell masses is observed beneath the epithelium and in the 
loose subepithelial tissue. The masses are quite isolated, but do not possess any distinct capsule ; 
running around the cells, however, is a delicate reticulum of fibrous tissue. When the mass is 
situated beneath the epithelium it causes on the surface of the conjunctiva a projection, which 
consists of dense, deeply-staining fibrous tissue almost entirely denuded of epithelium, one or two 
columnar cells alone remaining. In one specimen this thickening at the conjunctival surface had 
not occurred and the mass of cells had apparently ruptured, the contents being partly discharged. 
Very few plasma cells could be observed. There was early formation of young connective tissue 
in some amount. 
Section through a Typical Granuloma 
Granules consist of small round cells enclosed by an incomplete capsule of bands of fibrous 
tissue, and a delicate reticulum of fibrous tissue around the cells. Bands of connective tissue also 
run through the mass. Around the granule there is very little leucocytic infiltration, and plasma 
cells are not so abundant. Slender bacilli were found in large amount in one instance. 
Examination of the Discharge from different cases of Ophthalmia 
MUCO-PURULENT OpHTHALMIA 
Method of Examination. — After the lid had been completely everted some of the discharge 
was taken from the fornix conjunctivas on the loop of a platinum wire, and cover-glass 
preparations were made in the usual way. By this method a sample of pus was obtained free 
from the risks of contamination incurred if taken from the margins of the lids, or from the internal 
canthus. The pus consisted of large numbers of poly- and uni-nuclear leucocytes, epithelium cells, 
strings of fibrin, and bacteria. The bacteria found are of several varieties, the one of most 
frequent occurrence was a short, slender bacillus, usually seen in pairs ; but also found singly and 
in short chains. These bacilli were seen not only outside the leucocytes but also massed together 
inside, and often entirely filling them ; other leucocytes had a smaller number, and some contained 
only one or two in their substance ; they were also seen in close association with epithelial cells. 
The bacilli were only found in leucocytes when the reaction of the tissues was great. In the more 
chronic cases the leucocytes did not contain them 
The bacillus occurred principally in a diplo-form, although it was often seen singly and in 
short chains. Its numbers were sometimes enormous, especially in the acuter forms of muco- 
purulent catarrh ; the numbers diminished as the acute symptoms subsided. A morphologically 
similar organism has been detected in normal nasal mucus. 
Granular Conjunctivitis 
When the discharge is scanty isolated examples of the slender bacillus are seen. Cocci, 
diplococci, and xerosis bacilli occur in small numbers. 
