384 PATHOGENIC MICROORGANISMS 



destroys it in a short time. Incompletely dried, however, and pro- 

 tected from light (gonorrheal pus) it may live, on sheets and clothing, 

 for as long as eighteen to twenty-four hours. 1 



It is easily killed by most disinfectant solutions 2 in high dilution 

 and seems to be almost specifically sensitive to the various silver salts, 

 a fact of therapeutic importance. 



Pathogenicity. Gonorrheal infection occurs spontaneously only in 

 man. True gonorrheal urethritis has never been experimentally pro- 

 duced in animals. In human beings, apart from the infection in the 

 male and female genital tracts, and in the conjunctivas, the gonococcus 

 may produce cystitis, proctitis, and stomatitis. It may enter the cir- 

 culation, giving rise to septicemia, 3 to endocarditis and arthritis. Iso- 

 lated cases of gonorrheal periostitis and osteomyelitis have been re- 

 ported. 4 



The acute infections of the genito-urinary passages are often fol- 

 lowed by prolonged chronic infection, which, though quiescent, may for 

 many years be a source of social danger. In children, especially females, 

 the infection is not rare, and may assume epidemic characters, traveling 

 from bed to bed in institutions. Such hospital epidemics can be stopped 

 only by the most rigid isolation. It is advisable, in view of this danger, 

 to examine all female children applying for admission to a hospital, by 

 Vaginal smear and, if possible, to keep them in a receiving ward for 

 twenty-four hours in order that the examination may be repeated before 

 admission to the general wards. In the best-equipped institutions, fur- 

 thermore, separate thermometers, bed linen, and diapers are set aside 

 for each child in order to preclude any possibility of accidental transmis- 

 sion from cases which may have escaped detection by smear examination. 



While inoculation of animals has never resulted in active prolifera- 

 tion of the gonococcus upon the new host, local necrosis, suppuration, 

 and temporary systemic reactions have been produced by subcutaneous 

 and intraperitoneal inoculation. A toxin has been isolated by Niko- 

 laysen 5 by extraction from the bacterial bodies with distilled water or 

 sodium hydrate solutions. It was found to be resistant to a tempera- 

 ture of 120 and to remain potent after complete drying. The same 

 author found that the isolated toxin and dead cultures were fully as 

 toxic for animals as living cultures, 0.01 gram killing a white mouse. 



1 Heiman, Medical Record, 1896. 



2 Schaeffer und Steinschneider, Kong. Deut. Dermat. Gesells., Breslau, 1894. 



3 Review of cases of Gon. Septicemia, Faure-Beaulieu, Thesis, Paris, 1906. 



4 Vllmann, Wien, med. Presse, 1900, * Nikolaysen, Cent, f . Bakt., 1897. 



