MICROCOCCUS GONORRHCEM. 167 



pus pushed aside forms septa, between which the colonies 

 develop. This is a very characteristic picture (10, vi). 



Streak Culture. Transparent gray deposit, perhaps 

 with a trace of dirty yellow, somewhat elevated especially 

 at the edge. It has an oily but not a moist gloss. It 

 gives the impression as of mucus upon the surface, thus 

 differing from the streak cultures of other delicately grow- 

 ing organisms, as the Strept. pyogenes or lanceolatus. 



Toxins. Upon nutrose-serum bouillon Wassermann obtained 

 vigorous cultures, which were still poisonous after being killed. The 

 gonotoxin from the bodies of gonococci is very resistant to heat and 

 alcohol, kills mice, produces a doughy infiltration in rabbits and mice, 

 which often ends in necrosis. With large doses systemic effects occur 

 (compare Nicolaysen, C. B. xxn, 305). Gonotoxin injected sub- 

 cutaneously was without effect in chronic gonorrhea in man. The 

 marked reaction following the injection did not become less upon re- 

 peating the injection. 



The gonotoxin explains the gonorrheal secretion. Also some points 

 in the history of chronic gonorrhea may be explained by the fact that 

 for a long time a few gonococci slowly multiply and die and keep up 

 a suppuration almost free of gonococci, but that they may increase 

 more actively after any injury, irritation, etc., of the tissue and an 

 acute exacerbation of the process, with abundant formation of toxin 

 and large numbers of gonococci, may develop. 



Also, the filtrate from cultures of gonococci in ascites bouillon was 

 irritating, according to Schaffer, producing a suppuration upon the 

 urethral mucous membrane (C. B. xxm, 708). 



Distribution. (a) Outside of the organism: Never, ex- 

 cept upon linen, towels, etc., soiled by those with the dis- 

 ease. 



(6) In healthy organism : Never. 



(e) In diseased organism. : In gonorrhea in the urethra 

 and prostate of men ; in the urethra, Bartholinian glands, 

 cervix uteri in women. Cause of vaginitis and urethritis 

 in young girls. 



Besides these, in isolated cases it causes endometritis, 

 metritis, salpingitis, oophoritis, peritonitis, proctitis, ves- 

 ical catarrh, and probably also epididymitis. Cause of 

 blennorrhea neonatorum, rarely of diphtheritic conjunc- 

 tivitis in children (C. Frankel); the gonococcus also 

 causes, in adults, severe conjunctivitis, rarely rhinitis and 

 otitis. The gonococcus is often recognized as the cause of 

 arthritis, and more rarely of pleuritis and malignant endo- 

 carditis, abscesses, parotitis, periostitis, andbursitis. Now 



