Part II 
In dealing with the bacteriology of the suppurative inflammations of the 
conjunctiva I shall not give a complete clinical account of each disease, as most of 
them are too well-known to need any detailed description. But where necessary for 
the clear understanding of the exact disease under consideration, a few points in the 
clinical history will be noted. 
A table of all the bacteria found in inflamed eyes has already been drawn up 
for comparison with those obtained from healthy eyes, and inoculation experiments 
have shown that the pyogenic cocci from inflamed eyes are, in a large proportion of 
cases, more virulent than the normal flora. 
It is extremely probable that many of the chronic inflammations of the eye, 
such as cicatricial trachoma and chronic conjunctivitis, are due solely to the continued 
action of those cocci which have become lodged in the hypertrophied folds of the 
conjunctiva. In many cases, also, the pyogenic cocci may contribute in some measure 
to the severity and continuance of an acute imflammatory process. 
The material was collected by means of a sterile cotton-wool swab and the 
platinum loop. In many cases the pus was taken from the upper fornix conjunctivae 
after the lid had been everted ; by this means a sample of pus was obtained free from 
any risk of contamination. 
The chief medium was again horse-serum, but in many cases the discharge was 
divided equally over serum, serum-agar, agar-agar, and broth. 
In all cases films of the discharge were made. When there was no discharge 
films were sometimes made of the lachrymal fluid ; the most careful examination of 
the film in the latter case often failed to show any organism with the exception 
occasionally of a bacillus presenting granular staining. 
Ophthalmia Caused by the Gonococcus 
I. Eight cases of gonorrhoeal ophthalmia have been examined. With the 
exception of one child three years old they were all cases of ophthalmia neonatorum. 
The gonococcus was observed in large numbers in every instance. 
The only point worth calling attention to in these cases was the absence of all 
other bacteria except the gonococcus in the early stages. Later, numerous and varied 
organisms could be cultivated. The conjunctiva, in the disorganized state resulting 
from the inflammation, appears to become a nidus for all bacteria which are deposited 
on it, and the hypertrophied folds of the mucous membrane provide an excellent soil 
for their growth and multiplication. 
