SOFT SOUK 257 



a standard by which to be certain that the supposed gonococci 

 are really decolorised. Regarding the value of microscopic 

 examination alone, we may say that the presence of a large 

 number of micrococci in a urethral discharge having the 

 characters, position, and staining reactions described above, 

 is practically conclusive that the case is one of gonorrhea. 

 There is no other condition in which the sum-total of the 

 microscopical characters is present. We consider that it is 

 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 may give a definite positive result. When 

 other organisms are present, and especially when the gonococci 

 are few in number, it is difficult, and in some 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 

 examination, therefore, though often giving positive results, 

 will sometimes be inconclusive. As regards lesions in other 

 parts of the body, microsocopic examination alone is quite 

 insufficient ; it is practically impossible, for example, to 

 distinguish by this means the gonococcus from the diplococcus 

 intracellularis of meningitis. Cultures alone supply the test, 

 and the points above detailed are to be attended to. 



SOFT SOKK. 



Tin; bacillus of soft sore 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 state- 

 ments of these observers regarding the presence and characters 

 of this organism have been fully confirmed by other observers. 



Microscopical Characters. The organism occurs in the form 

 of minute oval rods measuring about 1*5 ft in length, and *5 ft 

 in thickness (Fig. 75). It is found mixed with other organisms 

 in the purulent discharge from the surface, and is chiefiy arranged 

 in small groups or in short chains. When studied in sections 

 through the ulcer, it is found in the superficial part of the floor, 

 but more deeply situated than other organisms, and may be 

 present in a state of purity amongst the leucocytic infiltration. 



