Toxic Products 397 



able to demonstrate their presence upon washed clothing after six 

 months, and found that they still stained well. This may not mean 

 that the organisms were still alive. 



In artificial culture the gonococcus soon dies, though cultures 

 from different sources differ considerably in this regard. As a 

 rule they survive but a few transplantations, though Young found 

 that one culture had been kept alive by students in his laboratory 

 for more than three months. 



Diagnosis. The diagnosis of gonorrhea by finding the diplococci 

 in urethral pus and epithelial cells is a very simple matter. The 

 recognition of the micro-organisms under other conditions is by 

 no means easy. Thus, when gonorrhea becomes chronic and the 

 cocci are no longer taken up by the phagocytes, it raises a little 

 doubt whether Gram-negative cocci may be true gonococci or not, 

 yet it is at precisely this time when a patient getting over gleet and 

 wanting to marry desires to know definitely whether gonococci are 

 any longer present in his urethra or not. Again, when the gonococ- 

 cus-like organisms occur upon the conjunctiva, in the pus taken from 

 joints, upon the valves of the heart, or in the Fallopian tubes, the 

 same .difficulty is met. Probably the greatest perplexity arises 

 when the conjunctiva is called in question, for here there can come 

 about a confusion of the gonococcus, the pneumococcus, and Micro- 

 coccus catarrhalis (q.v.) which only careful staining and culture ex- 

 periments can solve. The pneumococcus may be readily separated 

 if its lanceolate form and capsules can be observed, but it is only 

 by seeing that Micrococcus catarrhalis grows readily and luxuriantly 

 upon all the laboratory media, and the gonococcus with difficulty 

 and very sparingly upon any media, that the diagnosis can be made 

 with certainty. 



The method of diagnosis by staining and looking for Gram- 

 negative diplococci in the cells is only a " rough and ready" one 

 and is not dependable. 



The method of complement fixation is probably the court of final 

 resort, but this test is attended with considerable technical difficulty. 



Toxic Products. The toxic metabolic products of the gonococcus 

 appear to be contained within the bodies of the bacteria and dis- 

 seminated but slightly throughout the culture-media. Christmas,* 

 Nicolaysen,f and Wassermann J have studied gonotoxin, and have all 

 found that it remains in the bodies of the bacteria. The toxin 

 seems to be quite stable and is not destroyed by temperatures fatal 

 to the cocci. Wassermann obtained some cultures of which o.i 

 cc. would kill mice; others, of which i.o cc. was required. The 

 poison can be precipitated with absolute alcohol. Small quantities 

 of the toxin introduced into the urethra cause suppuration at the 



* "Ann. de 1'Inst. Pasteur," 1897. 



t "Centralbl. f. Bakt. u. Parasitenk.," 1897, Bd. xxn, Nos. 12 and 13, p. 305. 

 t "Zeitschrift fur Hygiene," 1898, and "Berliner klin. Wochenschrift," 1897, 

 No. 32, p. 685. 



