174 BACTERIOLOGY FOR NURSES 



found. A similar result is obtained when dead cultures are used. 

 Thus it is evident that while large numbers of the organisms can 

 produce a certain amount of inflammation they are unable to 

 multiply and spread in animal tissues. 



In human beings infection is usually a result of sexual inter- 

 course. Gonorrhea in men frequently results in prostatitis and 

 epididymitis ; in women vaginitis and endocervicitis, or spreading 

 by direct continuity of tissue, the Fallopian tubes, the ovaries, 

 or even the peritoneum may become involved. Sterility may 

 result as a consequence of a salpingitis which obstructs the 

 Fallopian tubes, or in man epididymitis may have a similar 

 result. 



The organisms penetrate the mucous membranes and passing 

 between the epithelial cells cause an inflammatory reaction in the 

 tissues below. Secretion increases and numbers of leukocytes 

 gather around the infected area. The infection may remain more 

 or less localized or the organisms may be carried through the 

 blood and lymph to more distant parts of the body. One of the 

 most serious and disabling complications is gonorrheal arthritis; 

 neuralgic affections, muscle atrophies, and neuritis often accom- 

 pany or follow a gonorrheal infection. 



In gonorrheal conjunctivitis microscopic examination of the 

 secretion generally reveals the identity of the invading organism. 

 As the condition becomes chronic the gonococci are less numerous 

 and a greater proportion of other organisms appear. Of all cases 

 of ophthalmia neonatorum about two thirds are caused by the 

 gonococcus. 



Immunity. After recovery from an infection immunity seems 

 to be very slight if indeed it exists. Gonococci may persist in 

 the genito-urinary secretions for years after apparent recovery 

 has taken place and may at any time cause an acute gonorrhea 

 in another person or even in the individual carrying them. There 

 is no limit to the time an individual may remain infected or may 

 infect others. 



A slightly bactericidal serum has been produced by animal 

 inoculations. A moderate degree of passive immunity is said to 



