MICROCOCCUS CITREUS CONGLOMERATE. 177 



time, even years, and yet retain its usual pathogenic power. 

 The purulent inflammation may have subsided entirely, and 

 the patient is apparently free from the disease, and yet it is 

 possible to find the gonococcus in the mucous secretions if 

 the membrane is irritated as previously described. A reap- 

 pearance of the gonorrhoeal discharge is not necessarily the 

 result of reinfection, but may be evidence of renewed activity 

 of the dormant germ. 



The gonococcus is a very virulent germ. Its toxin is 

 extremely toxic, and treatment must be thorough and con- 

 tinued for a long time to insure a complete cure. The 

 gonococcus is never the cause of abscess-formation. It is 

 said that the germ cannot penetrate membranes covered by 

 columnar epithelium. This belief is apparently confirmed 

 by the fact that urethral gonorrhoea is never met with in the 

 female, the female urethra being lined with columnar epithe- 

 lium. In gonorrhoea the entire vulva, including the urethral 

 papillae, is constantly bathed in pus, and yet the disease rarely 

 extends to the urethral canal. 



The characteristic biscuit shape, the position of the germ 

 within the cells, and its failure to stain with Gram, make a 

 positive diagnosis of it being the gonococcus justifiable. 



Micro co ecus Citreus Conglomeratus. 



This germ is found in the urethra and vagina in health as 

 well as in disease. It resembles the gonococcus in appear- 

 ance, but differs in culture. It can be cultivated easily on 

 all the ordinary culture-media, forming a solid yellow growth 

 on solid media. Gelatin is rapidly liquefied. It is stained 

 by Gram's method. 



Other organisms which resemble the gonococcus, and which 

 are also found in the vaginal and urethral secretions, are 

 Micrococcus subflavus, Diplocoecus albicam amplus, and Dip- 

 lococcus albicans tardissimus. They are all stained by Gram's 

 method, are not found within the cells, and rapidly liquefy 

 gelatin. They form luxuriant growths on all ordinary media. 

 We mention these various organisms for the purpose of em- 

 phasizing the importance of making an absolute diagnosis as 



12 Bact. 



