DISTRIBUTION OF GONOCOCCUS 223 



established, and it is interesting to note how the conditions of 

 growth and the pathogenic effects of the organism agree with 

 the characters of the natural disease. 



Intraperitoneal injections of pure cultures of the gonococcus in white 

 mice produce a localised peritonitis with a small amount of suppuration, 

 the organisms being found in large numbers in the leucocytes (Wertheim). 

 They also penetrate the peritoneal lining and are found in the sub- 

 endothelial connective tissue, but they appear to have little power of 

 proliferation, they soon disappear, and the inflammatory condition does 

 not spread. Injection of pure cultures into the joints of rabbits, dogs, 

 and guinea-pigs causes an acute inflammation, which, however, soon 

 subsides, whilst the gonococci rapidly die out ; a practically similar 

 result is obtained when dead cultures are used. These experiments show 

 that while the organism, when present in" large numbers, can produce a 

 certain amount of inflammatory change in these animals, it has little or 

 no power of multiplying and spreading in their tissues. 



Toxin of the Gonococcus. De Christmas cultivated the gonococcus in 

 a mixture of one part of ascitic fluid and three parts of bouillon, and 

 has found that the fluid after twelve days' growth has toxic properties. 

 At this period all the organisms are dead ; such a fluid constitutes the 

 "toxin." The toxic substances are precipitated along with the proteids 

 by alcohol, and the precipitate after being desiccated possesses the toxic 

 action. In young rabbits injection of the toxin produces suppuration ; 

 this is well seen in the anterior chamber of the eye, where hypopyon 

 results. The most interesting point, however, is with regard to its 

 action on mucous surfaces ; for, while in the case of animals it produces 

 no effect, its introduction into the human urethra causes acute catarrh, 

 attended with purulent discharge. He found that no tolerance to the 

 toxin resulted after five successive injections at intervals. In a more 

 recent publication he points out that the toxin on intracerebral injec- 

 tion has marked effects ; he also claims to have produced an antitoxin. 

 He states that the toxin diffuses out in the culture medium, and does 

 not merely result from disintegration of the organisms. This has, how- 

 ever, been called in question by other investigators. 



Distribution in the Tissues. The gonococcus having been 

 thus shown to be the direct cause of the disease, some additional 

 facts may be given regarding its presence both in the primary 

 and secondary lesions. In the human urethra the gonococci 

 penetrate the mucous membrane, passing chiefly between the 

 epithelial cells, causing a loosening and desquamation of many 

 of the latter and inflammatory reaction in the tissues below, 

 attended with great increase of secretion. There occurs also 

 a gradually increasing emigration of leucocytes, which take up a 

 large number of the organisms. The organisms also penetrate 

 the subjacent connective tissue, and are especially found, along 

 with extensive leucocytic emigration around the lacunae. Here 

 also many are contained within leucocytes. Even, however, 

 when the gonococci have disappeared from the urethral dis- 

 charge, they may still be present in the deeper part of the 



