THE GOXOCOCCUS OR MICROCOCCUS GONORRHCE& 



Though animal inoculations are thus followed by negative results, 

 the etiological relation of the gonococcus to human gonorrhoea has 

 been demonstrated beyond question by the infection of a number of 

 healthy men with the disease by the inoculation of pure cultures of 

 the micro-organism. 



TOXINS. In the gonococcus cells substances are present which are 

 toxic after heating and contact with alcohol. Injected in considerable 

 amounts into rabbits they cause infiltration and often necrosis. Applied 

 to the urethral mucous membrane there is produced an inflamma- 

 tion of short duration. In gonorrhoea the secretion is believed to be 

 due to these intracellular toxins. Repeated injections give no appre- 

 ciable immunity. The filtrate of recent gonococcus cultures contains 

 little or no appreciable toxin. The typical incubation and symptoms 

 of the disease resulted in all cases in the subjects experimented on. 



FIG. 113 



Colonies ot gonococci on pleuritic fluid agar. (Heiman.) 



Disease Conditions Excited by Gonococci. Affections due to this 

 organism are usually restricted to the mucous membranes of the 

 urethra, prostate, neck of bladder, cervix uteri, vagina, and conjunctiva. 

 The conjunctival, vaginal, and rectal mucous membranes are much 

 more sensitive in early childhood than in later life. Besides these tissues 

 it has been proven that many others may be infected, so that we now 

 know that to the gonococci are due many cases of endometritis, metritis, 

 salpingitis, oophoritis, peritonitis, proctitis, cystitis, epididymitis, and 

 arthritis. Abscesses of considerable size, periostitis, and otitis are occa- 

 sionally due to the gonococcus. 



Endocarditis and Septicaemia. Cases of gonococcus endocarditis and 

 septicaemia are not infrequent. Gonococcus septicaemia may occur in 

 connection with other localizations or alone. Nearly every year one 

 or two of these cases is met with in every general hospital. In a 

 considerable number of cases where gonococci are obtained from the 

 blood the patients recover. The fever is sometimes typhoid-like in 

 character. 



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