i24 THOMPSON YATES LABORATORIES REPORT 
II. In these researches the Koch-Weeks bacillus has been found in four 
varieties of inflammation about the eye. 
(a) In acute ophthalmia. 
(^) In catarrhal ophthalmia. 
(Y) In catarrhal ophthalmia in which the upper lid is covered with small 
miliary granules (follicular catarrh) and also in a few cases 
associated with large granules. 
(d) In mucocele. 
Acute Ophthalmia caused by the Koch-Weeks Bacillus 
Although the Koch-Weeks bacillus is usually associated with muco-purulent 
catarrh, yet occasionally it produces a very acute inflammation which cannot clinically 
be distinguished from gonorrhoeal inflammation. 
Four of such cases have come under observation ; two of the cases, before a 
microscopical examination was made, were diagnosed as gonorrhoeal ophthalmia ; the 
other two were suspected to be due to infection by the gonococcus. 
The ages of the patients were seven months, twelve months, seven years, and 
thirty-four years, respectively. . The last named, a woman with a large family, had 
had a previous and similar attack a few months before (no history of discharge from 
the eyes in the family could be obtained). 
In the babies, both eyes were almost simultaneously affected ; in the older 
patients one eye alone was inflamed at first, but after a week or ten days, when the 
inflamed eye had approached the normal, the disease appeared in the other eye. 
Examination of the discharge, after films had been made in the usual way and 
stained with an aniline dye, showed enormous numbers of a short, slender bacillus. 
In all four cases by far the greater number of the bacilli seen in the film was 
enclosed by leucocytes. Many were scattered about in the fibrin and between the 
cells, but those inside leucocytes far outnumbered those outside. A few of the 
leucocytes might be seen containing one or two bacilli only, but usually if leucocytes 
contained any at all, they were found absolutely packed with them. 
It will be seen later that in less acute inflammations caused by the Koch- 
Weeks bacillus it was sometimes difficult to find a single leucocyte containing the 
bacillus. 
This organism, sometimes, and more correctly, called the bacillus conjunctivitis, 
is a very slender, short rod closely resembling the bacillus of mouse septicaemia. Its 
length varies somewhat, but in discharge it rarely exceeds 1*5 n in length. It is very 
frequently seen with a constriction in the middle forming two distinct elements, each 
element having a slightly oval shape ; the dividing line is sometimes difficult to make 
out. The bacillus never forms chains. 
