RELATIONS TO THE DISEASE 263 



usually slight, on a meningococcus and vice versa \ this indicates 

 that there are some receptors common to the two organisms. 

 Arkwright finds that the complement-fixation test does not 

 supply a satisfactory distinction between gonococci and 

 meningococci. 



Eelations to the Disease. The gonococcus is invariably 

 present in the urethral discharge in gonorrhoea, and also in 

 other parts of the genital tract when these are the seat of true 

 gonorrhoeal infection. Its presence in these different positions 

 has been demonstrated not only by microscopical examination 

 but also by culture. From the description of the conditions of 

 growth in culture it will be seen that a life outside the body 

 in natural conditions is practically impossible a statement 

 which corresponds with the clinical fact that the disease is 

 always transmitted directly by contagion. Inoculations of pure 

 cultures on the urethra of lower animals, and even of apes, is 

 followed by no effect, but a similar statement can be made with 

 regard to inoculations of gonorrhceal pus itself. In fact, 

 hitherto it has been found impossible to reproduce the disease by 

 any means in the lower animals. On a considerable number of 

 occasions inoculations of pure cultures have been made on the 

 human urethra, both on the male and female, and the disease, 

 with all its characteristic symptoms, has resulted. (Such 

 experiments have been performed independently by Bumm, 

 Steinschneider, Wertheim, and others.) The causal relationship 

 of the organism to the disease has therefore been completely 

 established, and it is interesting to note how the conditions of 

 growth and the pathogenic effects of the organism agree with 

 the characters of the natural disease. 



Intraperitoneal injections of pure cultures of the gonococcus in white 

 mice produce a localised peritonitis with a small amount of suppuration, 

 the organisms being found in large numbers in the leucocytes (Wertheim). 

 They also penetrate the peritoneal lining and are found in the sub- 

 endothelial connective tissue, but they appear to have little power of 

 proliferation, they soon disappear, and the inflammatory condition does 

 not spread. Injection of pure cultures into the joints of rabbits, dogs, 

 and guinea-pigs causes an acute inflammation, which, however, soon 

 subsides, whilst the gonococci rapidly die out ; a practically similar 

 result is obtained when dead cultures are used. These experiments show 

 that while the organism, when present in large numbers, can produce a 

 certain amount of inflammatory change in these animals, it has little or 

 no power of multiplying and spreading in their tissues. 



Toxin of the Gonococcus. De Christmas has cultivated the gonococcus 

 in a mixture of one part of ascitic fluid and three parts of bouillon, and 

 has found that the fluid after twelve days' growth has toxic properties. 

 At this period all the organisms are dead ; such a fluid constitutes the 

 "toxin." The toxic substances are precipitated along with the proteins 



