528 BACTERIOLOGY. 



gonorrhoea in normal urethral mucous membranes by 

 inoculation of a pure culture on blood-serum in the 

 second generation; Wertheim, in the thirtieth; Kiefer, 

 in the sixth, and Heiman in the fifth generation. At 

 the same time the distinctive morphological, staining and 

 biological characters of the organism were carefully noted 

 and confirmed to be those of the gonococcus by these ob- 

 servers; the typical incubation and symptoms of the dis- 

 ease resulted in all cases in the subjects experimented on. 

 According to the observations of the most reliable 

 investigators and those most familiar with the various 

 forms of micrococci which are likely to be mistaken 

 for the gonococcus, affections due to this organism are 

 usually restricted to the mucous membranes of the 

 urethra, conjunctiva, bladder, cervix uteri, and rectum. 

 It rarely, if ever, produces a vaginitis in adults; but 

 occasionally a vulvo- vaginitis in young children. For- 

 merly the presence of gonococci could only be deter- 

 mined microscopically; but since the introduction of the 

 serum-agar the culture method has rendered the diag- 

 nosis of gonorrhoea much more reliable. This method 

 of investigation, moreover, has given valuable infor- 

 mation with regard to the nature of many infections 

 complicating or resulting from gonorrhoea, particularly 

 in affections of the uterus and joints, about which there 

 was heretofore considerable doubt, though the micro- 

 cocci often found in these organs were morphologically 

 identical with the gonococcus. It has now been shown 

 by the culture method that gonococci may occur in the 

 joints in gonorrhoeal arthritis, in the Fallopian tubes in 

 salpingitis, and in ovarian abscesses; and Wertheim 

 asserts that he has found them in the infiltrated con- 

 nective tissue in parametritis. 



