CHAPTER XLVI. 

 THE GONOCOCCUS. 



Introduction. 



Section I. Experimental infection, p. 635. 



1. Man, p. 635. 2. Animals, p. 635. 

 Section II. Morphology, p. 635. 



1. Microscopical appearance and staining reactions, p. 635. 2. Cultural charac- 

 teristics, p. 638. 

 Section III. Biological properties, p. 640. 



1. Vitality and virulence, p. 640. 2. Toxin, p. 640. 3. Serum therapy. Agglu- 

 tination. Vaccination, p. 641. 

 Section IV. Detection and isolation of the gonococcus, p. 642. 



THE Gonococcus is the infecting agent in gonorrhoea (Neisser). The organism 

 may be found in cases of gonorrhoea in the pus from the urethra 1 and the 

 vagina, and in the other lesions of the genital tract complicating gonorrhoea ; 

 for example, it can be recovered from Bartholin's glands, and from the 

 uterus, Fallopian tubes and peritoneum when these structures are affected. 

 The gonococcus leads in some cases to cystitis, to suppurative affections of 

 the kidneys, gonorrhceal proctitis, gonorrhceal ophthalmia and the purulent 

 ophthalmia of newborn children. 



It may pass into the blood stream and give rise to a true septicaemia (Hallier, 

 Krause). Glon and Schlagenhaufer, and others have recorded cases in which 

 the organism has been found in the lesions of gonorrhceal endocarditis, and 

 Petrone and Kammerer have found it in the pus of gonorrhceal arthritis. As 

 a rule, it rapidly disappears from and cannot be found in the exudation 

 accompanying gonorrhceal rheumatism because it remains limited to the 

 articular tissues in which it lives for a long time but it may be detected by 

 sowing cultures with the inflamed synovial membrane (Vaquez). Bressel 

 found it in a case of pneumonia supervening on the subsidence of an attack 

 of gonorrhoea. De Josselin and de Jong found the gonococcus in the cerebro- 

 spinal fluid of a young man suffering from cerebro -spinal meningitis following 

 an attack of gonorrhceal urethritis. 



During the first stage of an attack of gonorrhoea the gonococcus is as a rule present 

 in pure culture in the urethra. But before long other organisms the colon bacillus, 

 the organisms of suppuration, diplococci, and various organisms described by Bumm 



1 Inflammatory conditions of the urethra are sometimes seen which are not due to 

 the gonococcus (pseudo-gonorrhoea of Bockart) ; among these may be noted urethral 

 inflammations due to caustics, to the ordinary organisms of suppuration staphylococci 

 and streptococci (Bockart), to herpes, to the colon bacillus (Van der Bluyn, Haay, Besson), 

 to gout, rheumatism, syphilis, tuberculosis, etc. Urethral inflammations in dogs and 

 other animals are caused by organisms other than the gonococcus. 



