314 CLINICAL BACTERIOLOGY. 



able time gonococci are not always demonstrable in the 

 rather mucoid secretion then present, but that, neverthe- 

 less, the gonorrhea may persist and still be infective. The 

 gonococci are situated in the depth of the mucous mem- 

 brane, and the superficial secretion may be entirely free from 

 them. It is, therefore, advisable in doubtful cases to induce 

 irritation of the urethral mucous membrane (through the 

 use of beer, etc.), and thereby to stimulate the secretion. 

 Only when, after repeated examination and after previous 

 irritation, the secretion is found free from gonococci it 

 then generally still contains other cocci in abundance 

 may the gonorrhea be considered as terminated, and only a 

 catarrhal urethritis remains. 



Prophylaxis. Gonorrheal infection occurs almost ex- 

 clusively through sexual intercourse with those suffering 

 from the disease. It is a noteworthy fact that intercourse 

 with an individual suffering from gonorrhea does not neces- 

 sarily give rise to infection. It is, however, not necessary 

 to invoke a special predisposition to the disease for those 

 who are infected, and, on the other hand, a special immunity 

 for those who escape. The gonococcus must encounter a 

 lesion of the mucous membrane in order to gain lodgment 

 and to give rise to gonorrhea. When such a lesion is 

 wanting, infection may not take place, especially if the gon- 

 ococci taken up are soon removed mechanically by subse- 

 quent irrigation (perhaps through the urine in micturition). 

 Recovery from gonorrhea predisposes to repeated attack. 

 Rigid sanitary supervision of prostitutes alone is capable 

 of securing certain prophylaxis against gonorrhea. As a 

 prophylactic measure against blennorrhea of the new-born, 

 instillations of astringents into the conjunctivas are in gen- 

 eral employ. 



SYPHILIS. 



The exciting agent of syphilis is not yet known. Of 

 the numerous bacteria that have been found and to which 

 etiologic significance has been attached, the bacilli described 

 by Lustgarten seem worthy of mention. 



Lustgarten in 1884 found in syphilitic lesions and discharges 

 special bacilli that he demonstrated by means of the following 

 method of staining: Sections of tissue hardened in alcohol, or 

 cover-slip preparations made from discharges and passed but once 



