CHAPTER XXVII. 



THE GONOCOCCUS OR MICROCOCCUS GONORRHOEA THE 

 DUCREY BACILLUS OF SOFT CHANCRE. 



THE period at which gonorrhoea began to afflict man is unknown. 

 The earliest records make mention of it. Except for a period after the 

 fifteenth century it was generally recognized as a communicable dis- 

 ease and laws were made to control its spread. The differentiation 

 between the lighter forms of gonorrhoea and some other inflammations 

 of the mucous membranes was, however, almost impossible until the 

 discovery of the specific micro-organism by Neisser, in 1879. 



The organism was first observed in gonorrhceal discharges, and de- 

 scribed by him under the name of "gonococcus ;" but though several 

 attempted to discover a medium upon which it might be cultivated, 

 it was reserved for Bumrn, in 1885, to obtain it in pure culture upon 

 coagulated human-blood serum, and then after cultivating it for many 

 generations to prove its infective virulence by inoculation into man. 

 The researches of Neisser and Bumm established beyond doubt that 

 this organism is the specific cause of gonorrhoea in man. 



Microscopic Appearance. Micrococci, occurring mostly in the form 

 of diplococci. The bodies of the diplococci are elongated, and, as 

 shown in stained preparations, have an unstained division or inter- 

 space between two flattened surfaces facing one another, which give 

 them their characteristic " coffee-bean" or " kidney" shape. The 

 older cocci lengthen, then become constricted in their middle portion, 

 and finally divide, making new pairs (Fig. 111). The diameter of an 

 associated pair of cells varies according to their stage of development 

 from 0.8, to l.ftfjt in the long diameter average about 1.25," by 0.6^ 

 to 0.8/>- in the cross diameter. 



Intracellular Position of Gonococci. In gonorrhoea, during the earliest 

 stages before the discharge becomes purulent, the gonococci are found 

 mostly free in the serum or plastered upon the epithelium cells, 

 but later almost entirely in small, irregular groups in or upon the 

 pus cells, and always extranuclear. With the disappearance of the 

 pus formation more free gonococci appear. Discharge expressed 

 from the urethra usually contains more free organisms than the natural 

 flow. Gonococci are sometimes irregular in shape or granular in 

 appearance, involution forms, found particularly in older cultures and 

 in chronic urethritis of long standing. Single pus cells sometimes con- 

 tain as many as one hundred gonococci and seem to be almost bursting 

 and yet show but slight signs of injury. There is still discussion as to 

 whether the gonococci actively invade the pus cells or only are taken 



