CONJUNCTIVA IN HEALTH AND DISEASE 127 
As the disease diminishes in severity the number of leucocytes containing bacilli, 
and the number or bacilli in the discharge, correspondingly diminish. 
At first no other organisms could be observed in microsopical preparations, 
and in cultures from very early cases, besides the Koch-Weeks bacillus and a lew 
colonies of the xerosis bacillus, no other organisms could be cultivated. 
As the disease became more advanced the adventitious organisms increased in 
number and variety ; the pyogenic cocci, and especially the staphylococcus aureus, 
became frequent inhabitants of the sac. 
As convalescence approached the enormous increase in the numbers of the 
xerosis bacillus was very remarkable. In the small amount of discharge at this period 
the bacillus was sometimes so abundant that films appeared to be made from a pure 
culture. 
Previous Work on the Subject of Infection by Koch-Weeks Bacillus 
The bacillus was first seen by Koch iS (1883) in the discharge from cases of 
acute catarrhal ophthalmia. He examined in Egypt fifty cases of ophthalmia in which 
he found two microbes ; the one, Neisser's gonococcus, associated with severe 
symptoms ; the other, a small slender bacillus associated with mild symptoms. He 
ascribed the propagation of the disease to flies which were often seen covering the faces 
of children. Cultural experiments were unsuccessful. 
In 1887 Kartulis described the bacillus in Egyptian ophthalmia and corrobora- 
ted Koch's observations. He describes the bacillus in pure culture and succeeded in 
producing the disease in man in one out of six inoculation experiments. The 
description of his cultures would apply to the cultural appearances of the xerosis 
bacillus, but it is not unlikely that, since the slender bacillus may sometimes be found 
growing in association with or in the neighbourhood of other organisms, in his 
successful inoculation the culture contained Koch-Weeks bacillus. 
In 1887 Weeks 45 published a memoir in New York on the results of his 
investigations on catarrhal ophthalmia. He found in all his cases a small slender 
bacillus but was unable to obtain pure cultures, a club-shaped organism being always 
associated with it. Inoculation of the discharge on animals gave a negative result, 
but he was able to reproduce the disease in man by employing the mixeci cultures. 
In 1895 Weeks 46 in a further communication stated that, in over a thousand 
cases of catarrhal ophthalmia examined by him, Koch- Weeks bacillus was a constant 
factor in producing the disease. 
Gromakowski' 8 in eighteen cases of acute conjunctivitis found a slender bacillus 
which he concluded had an etiological relationship with an acute, highly epidemic 
conjunctivitis. 
