THE GONOCOCCUS GROUP 305 



of infection with the gonococcus, and the mucosa of the rectum is 

 occasionally involved. Serous surfaces are rarely involved. Occa- 

 sionally a generalized invasion takes place frequently resulting in 

 septicemia with endocarditis. Ophthalmia neonatorum is a particu- 

 larly common infection of the newborn of infected mothers. The 

 conjunctive become contaminated with gonococci as the child passes 

 through the vagina. A large percentage of the blind have lost their 

 eyesight in this manner at birth. The instillation of silver prepara- 

 tions, required by law in many States, has greatly reduced this form 

 of infection. 



Immunity. Man exhibits little or no resistance to infection with 

 the gonococcus and the mucous membranes may actually be more 

 susceptible to reinfection than they were originally. 1 In the chronic 

 cases, where the organisms lie dormant for months, even years, the 

 tissues appear to be somewhat less suited for growth of the organisms, 

 but the patient can infect others even at this stage of the disease. 

 Various attempts to prepare sera for curative purposes have not been 

 generally successful, although Rogers 2 has reported cures in cases of 

 gonorrheal rheumatism and chronic gonorrheal urethritis by the 

 injection of the serum prepared by Torrey. 3 



Vaccines have been used with variable success. The injection of an 

 autogenous vaccine, containing from five to ten million gonococci 

 from a twenty-four-hour ascitic fluid agar culture, appears to give the 

 best clinical results. Probably the extremely rapid autolysis of the 

 gonococci plays a prominent part in the ineffectual attempts to induce 

 improvement by the use of vaccines. 4 



Bacteriological Diagnosis. (a) Microscopical. Pus from the urethra 

 of acute cases of gonorrhea should be dropped upon a cover glass or 

 slide and spread by gently pressing a second cover glass or slide 

 upon the first, then sliding them apart. By so doing the organisms 

 remain in the polymorphonuclear leukocytes and epithelial cells, a 

 very important diagnostic point. A Gram stain and a methylene- 

 blue stain should be made. The former reveals intracellular and 

 intercellular bean-shaped diplococci which are Gram-negative. Occa- 

 sionally leukocytes contain as many as twenty pairs of the cocci. 

 Dilute methylene blue 1 to 10 (Loffler's) usually stains gonococci 

 intensely; the remainder of the cellular elements are faintly colored. 

 The morphology of the organisms is clearly shown by this procedure. 



1 It is uncommon, however, to find auto eye infections from venereal lesions; even 

 in cases of gonorrheal vulvovaginitis the eyes are rarely infected with the gonococcus. 



2 Am. Jour. Med. Sc., 1906, xlvi, No. 4. 



a Ibid. 4 Lespinasse; Illinois Med. Jour., April, 1912. 



20 



