struction of the cornea. Where the course of the blennorrhœa is less acute, there is more chance that the process will be arrested and healing occur before the entire cornea is destroyed. Frequently there are in the cornea at the same time several such points of purulent infiltration, in which case the danger to the cornea is, of course, increased.
The suppurative process which occurs in the cornea during the course of an acute conjunctival blennorrhœa has this peculiarity, that the pus never sinks downward in the substance of the cornea, nor is hypopion ever formed. But, as in other suppurations of the cornea, iritis is a frequent complication.
In blennorrhœal conjunctivitis of the milder forms, small, circumscribed corneal infiltrations are most apt to occur, with perhaps extensive loss of epithelium and diffuse clouding of the corneal tissue thus exposed, and shallow ulcers with smooth, reflecting floors.
Blennorrhœa may occur idiopathically, or in consequence of some external hurtful cause, especially in cases where the conjunctiva was previously quite normal. But very severe cases not infrequently occur for which no cause can be with certainty determined. In the great majority of cases, however, the disease is acquired by infection with the purulent blennorrhœal secretion. The most frequent source is the blennorrhœal disease of the conjunctiva itself.
Among; the inoculated forms, the first to be mentioned is the blennorrhœa neonatorum. The circumstance that this affection occurs always within a few days, generally three or four, after birth, points very decidedly to an infection occurring either at that time or very soon after it. It is, however, by no means necessary that the mother should have had a virulent vaginal blennorrhœa. It is probable that any muco-purulent secretion which during delivery accidentally gets into the conjunctival sac, is sufficient to produce this condition. It is possible that some days later, through carelessness, an infection may be caused by the lochial discharges. Frequently only one eye is at first affected; still, it is seldom possible to protect the second from infection by the first. The intensity with which blennorrhœa neonatorum occurs, varies greatly, probably on account of differences in the infecting secretion. Accordingly, the symptoms presented by the swelling of the
