GONORRHEA. 313 



glycerin, 3^ per cent, agar, 0.5 per cent, sodium chlorid. 

 Wassermann has recommended the following culture-medium for 

 gonococci : To 15 cu. cm. of swine blood-serum, from 30 to 40 

 cu. cm. of water, from 2 to 3 cu. cm. of glycerin, and 0.8 gram 

 of nutrose are added, and all are thoroughly mixed and boiled for 

 fifteen minutes. It is best to repeat the boiling on the follow- 

 ing day. The fluid thus obtained is heated to a temperature of 

 between 50 C. (122 F.) and 60 C. (140 F.), and mixed 

 at the same temperature with 2 per cent, peptone-agar in equal 

 amount. 



Microscopically, the gonococci thus cultivated present exactly 

 the same appearances as those present in gonorrheal pus. The 

 organisms survive in the cultures for from four to six weeks. 

 They are exceedingly sensitive to drying, disinfectants, and 

 temperatures above 42 C. (107.6 F. ). 



The specific pathogenic significance of gonococci is 



demonstrated by the fact that pure cultures introduced into 

 the normal human urethra (of paralytics) give rise to true 

 gonorrhea. Animals do not acquire gonorrhea. 



Bacteriologic Diagnosis of Gonorrhea. Microscopic 

 examination of the urethral secretion is of the greatest 

 importance, and in doubtful cases almost indispensable. 

 With the suspected discharge (gonorrheal threads) dry 

 cover-slip preparations are made, passed three times through 

 the flame, and simply stained with an aqueous solution of 

 methylene-blue. The cocci and the nuclei of the pus-cells 

 are stained blue, the former more deeply than the latter. 

 The characteristic shape of the cocci (kidney-shaped or 

 biscuit-shaped), their position in the leukocytes, and their 

 failure to stain by Gram's method justify a positive diag- 

 nosis of gonorrhea. 



Double staining may be successfully effected if the prepa- 

 rations are first stained with an alcoholic solution of eosin 

 (the eosin being absorbed with bibulous paper), and then 

 subsequently treated with methylene-blue. Cocci and cell- 

 nuclei will then appear blue, the cell-bodies red. 



Cultivation of gonococci for diagnostic purposes is not 

 necessary. 



Although positive evidence of the presence of gono- 

 cocci in microscopic preparations renders the diagnosis of 

 gonorrhea certain, negative evidence from examination of 

 the urethral secretion must be accepted with caution. It 

 is known that when gonorrhea has existed for a consider- 



