GONOCOCCUS 57 



cultures was 30.3. Cole obtained 30% of positive blood cultures. The blood was 

 taken into flasks of bouillon in dilution of 1-50. 



Diplococcus crassus. This is a Gram positive, kidney-shaped 

 diplococcus, which might be confused with the M. catarrhalis or the 

 meningococcus by ordinary staining methods. It is larger than the 

 meningococcus. 



In throat cultures I have isolated on several occasions a Gram positive diplococcus 

 which is at times biscuit-shaped, at times irregularly spherical. It possesses two 

 or three metachromatic granules, so that in a Neisser stain for diphtheria the appear- 

 ance of these granules may be confusing. 



Using Ponder's toluidin blue stain I have observed granule staining in organisms 

 of round or oval morphology which were suggestive of the ascospore staining of 

 yeasts. 



Gram Negative Cocci. It is important to bear in mind that there 

 are many cocci of varying shapes, which in cultures or in smears from 

 the throat, nose or faeces are Gram negative. These are not well classi- 

 fied or described. To distinguish the three important kidney-shaped 

 diplococci, it can be most easily accomplished by cultural methods, 

 using hydrocele agar (ascites or blood agar will answer), ordinary blood- 

 serum and plain agar. The gonococcus will only grow on the hydro- 

 cele agar; the meningococcus will grow on this, but likewise grows on 

 ordinary blood-serum. The M. catarrhalis will grow on plain agar as 

 well as on other media. 



Other Gram negative organisms of confusing morphology are M. 

 pharyngis siccus, the colonies of which show great crinkly dryness, and 

 M. pharyngis flavus. 



Gonococcus (Neisser, 1879). This organism is characteristically 

 a diplococcus, the separate cocci being plano-convex with their plane 

 surfaces apposed. (Biscuit shape, coffee-bean shape.) They are gen- 

 erally found grouped in masses of several pairs, most strikingly in pus 

 cells or epithelial cells, but also found extracellularly. Except in the 

 height of the disease, there is a great tendency for the organisms to show 

 involution forms, so that instead of biscuit-shaped diplococci we have 

 round, irregular and uneven cocci. It is therefore advisable in search- 

 ing smears from chronic gonorrhoea to continue the search of Gram- 

 stained specimens until some fairly typical diplococci are found. There 

 is nothing requiring greater discrimination than a diagnosis from such 

 a smear. At the commencement of a gonorrhoea the epithelial cells are 

 abundant and gonococci are found adhering to them or lying free. 



