Toxic Products 435 



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 the pus and epithelial cells is a very simple 

 matter. The certain recognition of the micro-organisms 

 under other conditions is by no means an easy matter. 

 Thus, when gonorrhea becomes chronic and the cocci are 

 no longer taken up by the phagocytes, and so lose their 

 intracellular occurrence, 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 gono- 

 cocci are any longer present in his urethra or not. Again, 

 when the gonococcus-like organisms occur upon the conjunc- 

 tiva, in the pus taken from joints, from the valves of the 

 heart, or from 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 confu- 

 sion of the gonococcus, the pneumococcus, and Micrococcus 

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

 experiments 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. 



Toxic Products. The toxic metabolic products of the 

 gonococcus appear to be contained within the bodies of the 

 bacteria and disseminated but slightly throughout the 

 culture-media. Christmas,* Nicolaysen,f and Wasser- 

 mannj 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 c.c. would kill mice; others, of which i.o c.c. 



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



t "Centralbl. f. Bakt. u. Parasitenk.," 1897, Bd. xxn, Nos. 12 

 and 13, p. 305. 



I "Zeitschrift fiir Hygiene," 1898, and "Berliner klin. Wochen- 

 schrift," 1897, No. 32, p. 685. 



