PRELIMINARY REPORT ON OPHTHALMIA 131 
Acute discharge from trachomatous eyelids contains quantities of the slender bacillus ; they 
are also found enclosed in leucocytes. 
The other organisms are not increased to any great extent. 
Acute Ophthalmia 
A few cases have been examined. Whereas in muco-purulent ophthalmia the slender 
bacillus is invariably the causal agent, acute ophthalmia may be caused by different organisms. 
The gonococcus was chiefly the cause of acute conjunctivitis in infants. In older children and 
adults the pneumococcus was often found to be the cause of an acute ophthalmia. The Koch- 
Week's bacillus can excite an inflammation indistinguishable from gonorrhoeal inflammation. 
The organisms found in and cultivated from the eye discharges were of a numerous and 
varied description. 
All the common varieties of staphylococci were found. Staphylococcus aureus occurred 
most frequently, and was invariably found when there was any blepharitis. 
Staphylococcus albus occurred next in frequency, and was especially found in cases of 
trachoma. 
Biscuit-shaped cocci were cultivated in many instances ; they probably represent the 
trachom-cocci of Sati ler. 
Pure cultures of the zerosis bacillus were obtained in about 80 % of all the inflamed eyes 
examined ; it was in a large number of cases the only organism cultivated. It grew most readily 
on serum, and often liquefied this medium in the form of little pits. 
The bacillus lacunatuSy described by Eyre, was found to have a strongly liquefying action 
on serum : the liquefied serum contained grey and white masses, and was turbid with suspended 
growth. Microscopically, the cultures in the first instance were impure containing cocci, 
slender bacilli, and the bacillus lacunatus. This bacillus mainly occurred in pairs And measured 
1.5 ^ by 2 ^ in length by i /x in breadth. 
A colon bacillus was cultivated in 8 or 10 cases. It occurred in simple conjunctivitis, 
muco-purulent ophthalmia, and dacryo-cystitis. 
Cultivation on artificial media of the slender bacillus found in the discharge of muco- 
purulent catarrh and acute trachoma was very difficult. It does not grow on tiic ordinary 
laboratory media. A limited growth lias, however, been obtained on human blood agar and on 
serum. The growth, in one instance, consisted of a number of minute colonies aggregated 
together to form a small transparent irregular mass. Single colonies were small and circular, the 
margins slightly raised above the surface of the medium, and the centre rounded and elevated. 
Older colonies have a frilled margin. The bacillus was commonly found growing in the 
neighbourhood of xerosis or staphylococcus colonies. In cultures the bacillus occurs singly, in 
pairs, and in threads. There is usually a distinct interval between the elements, especially when 
the individuals forming a pair have a short oval shape. The longer bacilli form palisades. 
Staining reactions. — It stains well with fuschin, and poorly with methylene blue and dahlia ; 
the stain is not retained by Gram's method. 
