SUPPURATION AND SEPTIC DISEASES 137 



new-born is due to maternal infection (see Stephenson's 

 * Ophthalmia Neonatorum '). In the male infection may 

 produce epididymitis and prostatitis. The circulatory 

 system may be invaded and produce arthritis (see Murrell, 

 Medical Press, 1910, 87) or endocarditis. Infection may 

 also be transferred by the use of infected towels, sponges, 

 etc. Entrance of the pus into the eye may result in its 

 loss unless properly treated. 



Christmas, by growing the gonococcus in a medium 

 containing fluid rabbit's serum, obtained a feeble toxin, 

 with which he immunised rabbits, the serum of which 

 was feebly antitoxic. Vaccines are sometimes used. 



Microscopical Examination of Pus. In the female an 

 examination is best made directly after a menstrual 

 period, as in some cases, especially in chronic and sub- 

 acute conditions, the gonococci are then, and then only, 

 to be found. Films are prepared from the cervix uteri, 

 Bartholin's ducts, and Skene's tubules in the female, or 

 from the discharge as it exudes from the urethra in the 

 male. The films should be fixed by immersion in alcohol 

 and ether (equal parts) for fifteen minutes. Some films 

 are stained with Loffler's methylene blue, and the others 

 by Gram's method. In using the latter method for this 

 organism it is of the utmost importance that the technique 

 be most carefully and religiously observed. Bismarck 

 brown is a suitable counter-stain (Neisser's 6. stain, 

 acting for two minutes.) Identification of the organism 

 is only permissible when all the following characters are 

 shown. The organism must completely lose its stain 

 when treated by Gram's method, should have the coffee- 

 bean form, and occur in the pus cells. In the early stage 

 of infection the organisms may be found outside the cells. 

 Abundance of other organisms may lead to the gonococci 

 being missed, and in all cases a negative result should 

 be received with great caution. 



The characters described will usually suffice to dis- 

 tinguish the gonococcus, but in cases of importance 

 cultures should be made. Organisms similar to the 

 gonococcus are found in the genitals, but these grow on 

 gelatin, with liquefaction of the medium, and on nutrient 

 agar. Some of these urethral diplococci are Gram-positive, 

 and there is no doubt that they are sometimes responsible 

 for the urethritis or whatever form the infection takes 



