SOFT SORE. 179 



sufficient for purposes of clinical diagnosis, and therefore of 

 great value; in the acute stage a diagnosis can thus be 

 made earlier than by any other method. The mistake of 

 confusing gonorrhoea with such .conditions as a urethral 

 chancre with urethritis, will also be avoided. Even in 

 chronic cases the typical picture is often well maintained, 

 and microscopic examination alone gives a definite positive 

 result. When other organisms are present, and especially 

 when the gonococci are few in number, it is difficult, and 

 in many cases impossible, to give a definite opinion, as 

 a few gonococci mixed with other organisms cannot be 

 recognised with certainty. This is often the condition in 

 chronic gonorrhoea in the female. Microscopic examina- 

 tion, therefore, though often giving positive results, will some- 

 times be inconclusive. Cultures alone supply the absolute 

 test, and when the organism is present in an apparent con- 

 dition of purity, Wertheim's medium or blood-ag 

 be used. If other organisms are present, we are 

 restricted to Wertheim's plate method. 



SOFT SORE. 



Within recent years a considerable amount of attention 

 has been directed to the bacteriology of this condition, 

 owing to the discovery of a somewhat characteristic bacillus 

 in the affected parts. This organism was first described 

 by Ducrey in 1889, who found it in the purulent discharge 

 from the ulcerated surface; and later, in 1892, Unna 

 described its appearance and distribution as seen in 

 sections through the sores. The statements of these 

 observers regarding the presence and characters of this 

 organism have been fully confirmed by other observers. 



Microscopical Characters. This organism occurs in the 

 form of minute oval rods measuring about 1.5^ in length, 

 and .5/z in thickness. It is found mixed with other 

 organisms in the purulent discharge from the surface, and 

 is chiefly arranged in small groups or in short chains. 



