DISTRIBUTION IN THE TISSUES. 22/ 



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-endotheliai 

 connective tissue, but they appear to have little pow r er 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 part of ascitic fluid and three parts of bouillon, and has found 

 that the fluid after twelve days 1 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 proteids by alcohol, and the 

 precipitate after being desiccated possesses the toxic action. In young 

 rabbits injection of the toxin produces suppuration ; this is well seen in the 

 anterior chamber of the eye, where hypopyon results. The most interesting 

 point, however, is with regard to its action on mucous surfaces ; for, while 

 in the case of animals it produces no effect, its introduction into the human 

 urethra causes acute catarrh, attended with purulent discharge. He found 

 that no tolerance to the toxin resulted after five successive injections at 

 intervals. In a recent publication he points out that the toxin has marked 

 effects on intracerebral injection ; he also claims to have produced an anti- 

 toxin. He claims that the toxin diffuses out in the culture medium, and does 

 not merely result from disintegration of the organisms. This has, however, 

 been called in question by other investigators. 



Distribution in the Tissues. The gonococcus having been 

 thus shown to be the direct cause of the disease, some additional 

 facts may be given regarding its presence both in the primary 

 and secondary lesions. In the human urethra the gonococci 

 penetrate the mucous membrane, passing chiefly between the 

 epithelial cells, causing a loosening and desquamation of many 

 of the latter and inflammatory reaction in the tissues below, 

 attended with great increase of secretion. There occurs also 

 a gradually increasing emigration of leucocytes, which take up a 



