Note upon a form of acute inflammation of the conjunctiva associated with pus cocci / by Sydney Stephenson.

  • Stephenson, Sydney, 1862-1923.
Date:
[1897]
Catalogue details

Licence: Public Domain Mark

Credit: Note upon a form of acute inflammation of the conjunctiva associated with pus cocci / by Sydney Stephenson. 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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    measles six months before coming under notice she had suffered no illness of any moment, and her eyes had been well in the interval. On examining the inflamed eye a considerable collection of yellowish-white dis- charge was seen in the lacus lacrymalis and the conjunc- tival sinuses. The lids were glossy and swollen, but not in the least tense ; the eyeball was reddened ; upon the upper and lower palpebral conjunctiva was a thin, greyish membrane, which could be readily detached, leaving the underlying tissues red and thick, with a slight tendency to bleed in a few scattered points. The cornea was bright and clear. The preauricular gland was not enlarged. The temperature of the patient was not raised; constitutional symptoms appeared to be absent. A few scabs were noticed upon the skin below the left lower eyelid. No discharge was present from the genitalia; there was no affection, as swelling or pain, of the joints. There was a negative history of sore- throat both as regards the child herself and those about her. The diagnosis seemed to lie between an acute inflammation of the conjunctiva due to (I) Klebs-Loffler bacilli; (2) gono- cocci; (3) Weeks's bacilli; (4) Fraenkel's pneumococci; or (5) pyococci. From a clinical standpoint diphtheritis appeared to be excluded, since the eyelids could be separated without difficulty, the false membrane was easily detachable, the cornea was intact, the preauricular gland was not involved, there were no diphtheritic patches about the skin of the face, and constitutional symptoms were absent. Against purulent ophthalmia due to gonococci were the negative facts that the lids were not tense, that the secretion was not pus-like, that cbemosis was not present, and, lastly, that discharge from the vulva or vagina was not present, as is apt to be the case among little girls. The unilateral character of the in- flammation, although rather suggestive of pneumococcus infection, could not be regarded as telling much in any direction. Diagnosis, therefore, appeared to be narrowed down to an inflammation produced by Weeks's bacilli of catarrhal ophthalmia, by pneumococci, or by pus-organisms. The probability was that the micro-parasites last-named lay at the root of the mischief. In order to determine this point a cover-glass preparation was made by lightly smearing a morsel of detached membrane over a glass slip, which was then stained in the usual way. The specimen, when examined with a one-twelfth oil immersion lens, showed merely a few scattered diplococci and cocci, lying upon and between the multinucleated and