i34 THOMPSON YATES LABORATORIES REPORT 
conjunctiva was studded with pale pinkish elevations. The discharge in each case was 
not abundant, and when present appeared as one or two small pellicles in the upper 
and lower fornix conjunctivae. 
In the fifth case, where there was no discharge, one or two slender bacilli were 
seen in films of the lachrymal fluid. 
The sixth case of this series had large granules, and has been placed in the 
second sub-division. 
Cases 15 and 16 were complicated by the presence of B. lacunatus (Eyre) 
and the pneumo-coccus, and the inflammation was probably due to their presence. 
In one of them, one or two slender bacilli were detected in the discharge. 
In 17, 18, and 19, there was practically no discharge, and films were not made. 
The lour last cases had been for about a week under treatment, and the inflammatory 
process had been to some extent arrested, yet in the last case careful examination of 
a little discharge showed one or two slender bacilli. 
The organism that occurred most frequently was the xerosis bacillus. This 
bacillus is found so often in healthy and diseased conditions that it must be considered 
a regular inhabitant of the conjunctival sac. 
Its repeated occurrence in all forms of granular lids made it necessary to prove 
that it could have no action in causing the granular condition. 
With this object in view various experiments were performed on the con- 
junctiva of rabbits. 
1. A pure culture was emulsified in sterile broth, and about 0*25 c.c. in- 
oculated beneath the conjunctiva. On the next day the fluid was 
absorbed, and subsequently, with the exception of a little redness 
about the point of inoculation, there was no inflammatory mani- 
festation. 
2. Together with two loopfuls of the pure culture a little finely-powdered 
glass was rubbed gently over the conjunctiva : slightly momentary 
irritation ensued, which quickly subsided. In twenty-four hours 
the appearance was normal and there was no congestion. 
3. Every day for fourteen days one loopful of a one day old serum culture 
of the xerosis bacillus was gently smeared over the conjunctiva. 
On the next day after each inoculation the conjunctiva was normal, 
and at the end of fourteen days or subsequently there was no 
appearance of granules. 
Additional evidence against the probability of xerosis bacillus being in any way 
responsible for granular lids is gathered from its occurrence in all diseased states of 
the conjunctiva. In xerosis of the conjunctiva, in which it was first described by 
Kusch bert and Neisser, it is present in enormous numbers, and one small loopful 
of lachrymal fluid from the healthy conjunctiva has been found to contain over two 
hundred bacilli. 
