SUPPURA TION. 269 



duces acids in the early days of its development, and 

 alkalies subsequently. He was unable to isolate any 

 toxin from the cultures. 



It is ordinarily presumed that gonorrhea cannot be 

 communicated to animals, but Turro asserts that the 

 gonococci when grown upon acid gelatin readily com- 

 municate urethritis to dogs, and that no Icesio continui is 

 necessary, the simple introduction of the organisms into 

 the meatus sufficing to produce the disease. 



The injection of gonococci into the subcutaneous tissue 

 does not produce abscess. 



There is no doubt that the gonococcus causes gonor- 

 rhea, as it has on several occasions been intentionally 

 inoculated into the human urethra with resulting typical 

 gonorrhea. It is constantly present in the disease, and 

 very frequently also in the sequelse — endometritis, salpin- 

 gitis, oophoritis, cystitis, peritonitis, arthritis, conjuncti- 

 vitis, endocarditis, etc. — and, so far as can at present be 

 determined, is never found under normal conditions. 



In the beginning of their activities the cocci grow in 

 the superficial epithelial cells, but soon penetrate between 

 the cells to the deeper layers, where they continue their 

 irritation as the superficial cells desquamate. Authorities 

 differ as to whether the gonococci can penetrate squamous 

 and columnar epithelium with equal facility. 



The periurethral abscesses that occur in the course of 

 gonorrhea are generally due to the Staphylococci aureus 

 and albus, not directly to the gonococcus. 



In certain of the remote secondary inflammations the 

 gonococci disappear after a time, and either the inflam- 

 mation subsides or is maintained by other bacteria. In 

 synovitis this does not seem to be true, and the inflam- 

 mation excited may last for months. 



As long as the gonococci persist the patient may spread 

 contagion. It must be pointed out that after apparent 

 recovery from the disease the cocci sometimes remain 

 latent in the urethra, and cause a relapse if the patient 

 partake of some substance, as alcohol, irritating to the 



