216 THE INFECTIOUS DISEASES. 



rises. Wash off the stain with a twenty-per-cent solution of cupric sulphate. Dry and 

 mount in balsam. 



If the material containing the organisms already contain serum, the preliminary 

 mixing with this is unnecessary. Pneumococci in sputum which without the addition 

 of serum are often stained, with it not infrequently give better results. 



The method of Welch ' gives good results, but annoying precipitates often form. 

 After drying and fixing the specimen upon the cover-glass in the usual way, it is treated 

 with glacial acetic acid, which is at once drained off and replaced by anilin-gentian- 

 violet solution (p. 153), this being drained off and renewed several times until the acetic 

 acid is displaced. The specimen is now washed with a two-per-oent solution of sodium 

 chlorid, in which it may be covered and studied. The pneumoeoccus may be stained 

 in sections by Weigert's modification of Gram's method with preliminary contrast stain 

 (see p. 154). By this method the fibrin in pneumonic exudate is also stained. 



GONOB.RHO3A AND OTHER INFLAMMATORY LESIONS INDUCED BY 

 THE MICBOCOCCUS GONOBRHO3JE (GONOCOCCUS). 



The Micrococcus gonorrhoea (gonococcus) is most commonly found in 

 the exudate of gonorrhoeal inflammation of the mucous membranes, es- 

 pecially of the urethra. It may be free or enclosed in leucocytes or 

 other cells (Fig. 101), within or between the epithelial cells. The organ- 

 ism may be distributed from the seat of primary lesion, giving rise to 

 gonorrhceal arthritis, to malignant endocarditis, to exudative inflamma- 

 tion of the pleura, and to inflammatory processes in other parts of the 

 body.' 



The gonococcus may in the primary as well as in the secondary lesions 

 be associated with the "pyogeuic cocci," the colon bacilli, or other micro- 

 organisms. These associations have been observed in cases of pyaemia 

 following gonococcal infection. The gonococcus is usually most abun- 

 dant in the urethra during the acute stage of the inflammation. But 



long after the organisms have disap- 

 peared from the urethral discharge 



, ' * they may be present in small num- 



u / ,. , v , bers in the deeper portions of the ure- 



v "",., ' thra or in the prostatic secretions 



&>/** ,* 0ii whence under favoring conditions a 



^ v, *'" ' / v. '!, fresh infection may arise. In the 



"'' * tv ' ( " l female the inflammation, through the 



transportation of the gonococci, may 



/'." -'';, * <&?> ) extend to the vagina and uterus and 



\ f f \\ ..*"/ into the Fallopian tubes. The germs 



may enter the peritoneum, inducing 



FIG. 101 -MICROCOCCUS GOHORBHOC* IN CELLS. ^oAti^ inflammation. Hyperplasia 



SPECIMEN FROM THE URETHKA. and suppuration of lymph nodes near 



the inflammatory region may occur. 



Gonorrho3al conjunctivitis is similar in origin and character to the in- 

 flammation of the urethra. 



1 Welch, Johns Hopkins Hospital Bulletin, vol. iii., p. 128, 1892. 



2 Consult, for cases and bibliography, Young, " Welch Anniversary Contributions 

 to the Science of Medicine," p. 677, 1900; also, Elting, Albany Medical Aimals, March. 

 1900, BibK 



