MICROCOCCUS GONORRHCEA 95 



Instead of plates, Petri-dishes can be used. In twenty-four hours isolated 

 gonococci colonies appear. 1'he superficial colonies exhibit a dark 

 punctiform centre, from which a delicate,, finely granular coating 

 extends round about the colony ; the deeper colonies are greyish-white 

 in colour, and possess an uneven appearance, and in two to three days 

 acquire the shape of a blackberry. In re-inoculating from the colonies 

 they are found to consist of a shiny, tenacious, compact mass. 



Stroke Cultures on oblique solidified Blood Serum Agar are prepared as 

 follows : 1 part of fluid human blood serum at 40 C. is m&ed with 3 

 parts of melted agar-agar, also at 40 C., and placed in an oblique 

 position to solidify. The growth on this medium is luxuriant ; at first 

 isolated grey colonies appear, which later become moist, shiny, tenacious 

 slimy tufts, and from the margins a thin film-like coating extends. 



A good liquid medium is prepared by mixing 1 part of human blood 

 serum with 2 parts of peptone bouillon. In this medium the gonococcus 

 forms a membrane on the surface, while the medium itself remains 

 almost entirely clear. 



In preparing the culture media animal blood serum can be used 

 instead of human serum, although they do not grow so well, but never- 

 theless the gonococci grow very well on swine blood serum. 



Pathogenesis. Bumm made inoculations into the healthy urethra, 

 and in two cases, once with a third generation culture and once with 

 culture transferred for twenty successive generations, and in both cases 

 a typical gonorrhoea developed as the result of the inoculation. The 

 mucous membranes of man liable to gonorrhoeal infection are those of 

 the urethra, conjunctiva, the cervix uteri, and the vagina in children. 

 Inoculations of gonorrhoeal pus into the vagina or conjunctival sac of the 

 lower animals, dogs, rabbits, horses, apes, are without result. 



In Blenorrhcea neonatorum, according to Bumm, after infection the 

 presence of gonococci may be demonstrated in the superficial epithelial 

 cells of the mucous membrane and between them ; that they soon 

 penetrate to the deeper layers ; and that by the end of forty-eight hours 

 the entire epithelial layer is invaded by the diplococci, which penetrate 

 by way of the connecting material, ' Kitt substance,' between the cells. 

 They also multiply in the superficial layers of the connective tissue, and 

 give rise to an inflammatory reaction, which is shown by an abundant 

 escape of leucocytes from the capillary network. 



Bacteriological Diagnosis. The microscopical examination of 

 the urethral discharge is of the greatest importance. Cover-glass 

 specimens are prepared from the suspected discharge, air-dried, fixed 

 in the flame, and stained with a watery solution of methylene blue. 

 The cocci and nuclei of the pus cells are stained blue by 'this method, 

 the cocci more intensely than the nuclei. The characteristic form of 



