GONOOOCCUS INFECTION 555 



tance, is equal to, if not more serious, than syphilis. The gonococcus is 

 primarily infectious for the genital organs, but may also infect the 

 eye, and in its secondary manifestations cause disease of the prostate, 

 epidydimis and bladder of the male, of the fallopian tubes and ovaries 

 of the female. In both it may and often does cause sterility. Invad- 

 ing the blood stream, it may cause endocarditis, and not infrequently 

 an acute and .subacute arthritis which is characterized by its frequent 

 localization in single joints or the bursse about joints, and cause peri- 

 articular inflammation. It may, but rarely does attack other organs. 



A most important consideration is the difficulty of complete cure. 

 A male who has contracted gonorrhea may seem to be completely 

 cured, but if a posterior urethritis has occurred, the organisms may 

 remain viable and capable of infecting others for a great many years. 

 Individuals who, therefore, seem to have been cured for years, may 

 still cause infection upon marriage, a fact which is the most frequent 

 cause of gynecological lesions in women. It goes without saying that 

 even the most careful bacteriological examination of such individuals 

 may often fail to reveal the gonococci, even though they may be present. 



Infection with gonococcus is almost invariably by sexual contact, 

 though the organism may remain viable on wearing apparel, bed cloth- 

 ing, towels, hands, etc., for brief periods, especially if protected from 

 light and drying, and others may be infected in this way. The danger 

 of self-infection of eyes by people who are suffering from an acute dis- 

 charge is a frequent one, and physicians and nurses, especially, are liable 

 to such infection. 



Gonorrheal infection of the eye is one of the most serious infections 

 that can occur in this organ. Ophthalmia of the new born may be due 

 to other organisms, but is almost invariably caused by the gonococcus. 

 It is acquired by the child in the course of delivery, from the secretions 

 of the mother, and if not attended to, may lead to blindness. The 

 importance of this infection may be estimated from the following 

 figures quoted by Rosenau from Kerr, who states that in the United 

 States and Canada 23.9 per cent of 351 admissions to schools for the 

 blind in 1910 the blindness was the result of gonorrheal infection. 



Fortunately, the method introduced by Crede has, to a very large 

 extent, done away with this accident. Crede, many years ago, intro- 

 duced the method of instilling a 2 per cent silver nitrate solution into 

 the conjunctiva] sa.cs of every child at birth. Since his time oilier silver 

 salts have been in use, the most popular ones at the present time being 

 protargol, 5 per cent solution, and argyrol, 20 per cent solution, which 



