IO4 BACTERIOLOGICAL DIAGNOSIS. 



its arrangement ; during the height of an attack of 

 gonorrhoea it is almost entirely intracellular, being 

 contained within the polymorphonuclear leucocytes. 

 Further, several pairs occur in each cell, and the great 

 majority of cells are entirely devoid of cocci. 



If the organism which you find possesses these char- 

 acteristics turn to the specimen which has been stained 

 by Gram's method and counter-stained by carbol- 

 fuchsin (Plate I., fig. 6). In this all bacteria which 

 retain Gram's stain will be coloured violet, while organ- 

 isms which do not retain it will be red. You must 

 therefore search for groups of diplococci contained 

 within the cells and possessing trie above character- 

 istics. They will not be so prominent as in the other 

 specimen, for the cells, nuclei, &c., will be coloured red 

 also, and the contrast is not so great. But if the case 

 is one of gonorrhoea you will find them after a careful 

 search. 



INTERPRETATION OF RESULTS. 



You are justified in considering a case to be one of 

 gonorrhoea if in films made from the pus : 



1. Large kidney-shaped diplococci are present. 



2. These cocci occur within the pus cells, and at 

 least four pairs (Foulerton) in each affected cell. 



3. The vast majority of cells are entirely free from 

 cocci. 



4. The organisms in question do not stain by Gram's 

 method. This is an absolutely essential point. 



If cocci which answer to the above description, 

 except that they are not enclosed within cells, the case 

 may still be one of gonorrhoea. The gonococcus is 



