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JAMA. 1912;LVIII(13):925-929. doi:10.1001/jama.1912.04260030323008.
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Trachoma is a disease of the conjunctiva, in which there is a characteristic connective-tissue hyperplasia. It is marked by a proliferation of lymphoid cells. The follicles formed by this proliferation tend to degenerate and to become encapsulated by the newly formed connective tissue. As a result of this inflammatory process, newly formed blood-vessels penetrate these follicles. They become distended with fluid, push their way above the surface of the conjunctiva, finally becoming degenerate, break down, and the overlying conjunctiva is replaced by scar tissue, and thus, step by step, the entire conjunctiva becomes destroyed. As a result of this chronic inflammatory process, connective-tissue changes take place in the deeper structures of the lid, normal blood-vessels become obliterated, all glandular secretion is checked and there is produced a general atrophy of the lid.

It was a little more than a hundred years ago that the significance of this disease began to


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