MICROCOCCUS GONOREHCEjE. 529 



Worthy of special notice in this connection are the 

 cases of endocarditis accompanying gonorrhoea, and some- 

 times terminating fatally, when they are known as en- 

 docarditis gonorrhoeica maligna. The question naturally 

 arises in these cases whether it is the gonococcus or 

 some other coccus or diplococcus which has infected 

 the endocardium. Here, again, it is only by means of 

 the culture method that this question can be settled 

 definitely. Fliigge draws attention to this matter, and 

 states that but few cases have been recorded in which 

 the information given as to the cause of the disease can 

 be unhesitatingly accepted. Weichselbaum mentions 

 a case of endocarditis accompanying gonorrhoea which 

 was shown by the culture method to be due to strepto- 

 coccus infection, proving that so-called gonorrhoeal 

 endocarditis may be a secondary infection. Other cases 

 are recorded by Leyden, Hiss, Councilman, and Wilms 

 which are said to have been most probably of gonor- 

 rhoeal origin; but in these only microscopical examina- 

 tions were made and no culture experiments, or only 

 cultures on gelatin plates, etc., which were inadequate. 

 Welch also reports a case of endocarditis with general 

 septicaemia following gonorrhoea, in which he demon- 

 strated the gonococcus in the blood of a living person 

 in cover-glass and culture medium. No other patho- 

 genic bacteria were found. 



Immunizing Serum. As animals are not infected by 

 the gonococcus they are not very suitable for injections 

 with the cultures for the purpose of producing an anti- 

 toxic or bactericidal serum. Their insusceptibility pre- 

 sents also an almost insurmountable obstacle to the 

 testing of the blood of animals under treatment, so that 

 although it may be possible to bring about an artificial 



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