Licence: In copyright
Credit: Pneumococcus conjunctivitis / by Fred T. Tooke. Source: Wellcome Collection.
Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)
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![by the pueiunococcus; but Gifford and Junius have not been able to substantiate this optimistic view. Inoculation of the disease inl'o animals very seldom produces positive results and a reaction in rabbits has only occurred after scarification of the conjunctiva or after abrasion of the corneal epithelium. The results in man, however, as I have already stated, are very variable; the occurrence of epidemics with the demonstration of the pathogenic cocci is the best proof that the disease is one that is transmitted. Veasey and Gifford have produced the disease by installing a pure culture of the pneumococcus into the conjunctival sac. Gifford had no success at first with eerobic gi'owths but with anaerobic forms, conjunc- tivitis with flecks of secretion was present after an incubation of 34 hours. Halle observed the onset of the attack of conjunctivitis seven days after some discharge containing pneumococci had accidently found its way into the eye; on the other hand Axenfeld reports a series of eight cases, one a child, with negative findings. From the foregoing is deduced the fact that in addition to contact infection there is a dis- tinct individual susceptibility; one must also consider the possibility that some secretions do not possess the same power of producing as others. From this inference we can thus account for many isolated or sporadic cases where, in spite of conditions of profuse discharge, contagion does not occur. The fact that adults remain uninfected in many epidemics endorses this conclusion. That many foster the pneumococcus in a normal conjunctiva and tear sac where little or no reaction is present is admitted; and inflammation of the conjunctiva due to an increased virulence of this micro-organism or the diminution of the patient's powers of resistance, can readily account for the subsequent outbreak. The ordinary chill on taking cold is frequently the cause to Avhich is to be attributed such formation of inflammation. To what degree immunity to the pneumococcus can be produced in the conjunctiva, has not been as yet satisfactorily estimated. Gifford after inoculating himself successfully found the conjunctiva apparently immune one week later. During the early stages and heiglit of the attack pneumococci are generally found in large (juantities, ])articular!y in small particles of pus from the discharge; the bacteria may appear free or they may Ije in- tracellular. They vary from those exhaled from the lungs in that the capsule of the conjunctival forin is less distinct. When many round, short diplococci appear one is generally able to recognise numbers of a larger form as well; staining after Gram's procedure differentiates](https://iiif.wellcomecollection.org/image/b21639425_0009.jp2/full/800%2C/0/default.jpg)
