236 GONOKRHCEA. 



ordinary vulvo-vaginal blenuorrhoea, which consecutively extended 

 to the uterus and Fallopian tubes, and terminated in pelvic and 

 diffuse peritonitis. It is possible that in this case a secondary 

 infection had taken place, as at the necropsy chain cocci were found 

 in the peritoneal cavity. 



THE GONOCOCCUS AND PURULENT OPHTHALMIA. Haab (Der 

 MicroGoscus der Btenorrhoea neonat., Wiesbaden, 1881) showed that 

 the microorganism found in gonorrhoeal pus and the secretion 

 of purulent ophthalmia are identical. He placed great stress on 

 the fact that according to his own observations the gonococcus is 

 always present in the secretions of purulent ophthalmia, and that 

 it is never found in the simple inflammatory or catarrhal form. 



Widmark ( u Bakteriologische Studien iiber purulente Conjuncti- 

 vitis und gonorrhceische Urethritis/' Hygoei, B. xlvi., 1884) exam- 

 ined twenty-four cases of purulent conjunctivitis in reference to the 

 existence of the gonococcus, using "Welander's method. In most of 

 the cases he found the microbe. The gonococcus was found free in 

 the secretions, the pus corpuscles, and the epithelial cells. He be- 

 lieves, with Welauder, that during the period of incubation the 

 microbes remain attached to the epithelial cells, and are reproduced 

 there, whence they later penetrate into the deeper tissues. After a 

 time they almost disappear in the secretions, without, at the same 

 time, any improvement taking place in the catarrhal condition. 

 From a practical standpoint these observations are important, as 

 they prove the importance of early treatment before the microbes 

 have passed beyond the reach of local applications of autimycotic 

 remedies. 



Among other prominent ophthalmologists, Sattler, Lebert, and 

 Hirschberg recognize the gonococcus of Neisser as the specific cause 

 of gonorrhoea and its identity with the coccus found in specific 

 purulent ophthalmia. 



THE GONOCOCCUS IN ABSCESSES. Opinions are divided in 

 reference to the pyogenic properties of the gonococcus. In infec- 

 tions of the mucous membrane its pus-producing property is well 

 known, but at present is not attributed to its direct effect on the 

 tissues, but to the action of ptomaines which it produces. A num- 

 ber of cases have been reported which appear to show that under 

 certain circumstances the microbe enters the circulation and is the 

 cause of metastatic abscesses, and on this account should be classed 

 with the pus-microbes. 



Horteloup relates the case of a man, twenty-seven years of age, 

 who had suffered from gonorrhoea for several mouths, in whom an 

 abscess formed in the clavicular region, which was incised, and in 

 the pus numerous gonococci were found. 



Schwarz (Sammlung klin. Vortrage, 1886, No. 279) asserts that 



