190 



GONORRHCEA, SOFT SORE, SYPHILIS. 



members of a diplococcus, a tetrad is formed, which, how- 

 ever, soon separates into two sets of diplococci that is to 



say, arrangement as 

 is much 

 than 



as 



I 



FIG. 54. Portion of film of gonorrhoeal 

 pus, showing the characteristic arrangement 

 of the gonococci within leucocytes. 



Stained with fuchsin. x 1000. 



diplococci 

 commoner 



tetrads. Cocci in 

 process of degenera- 

 tion are seen as 

 spherical elements of 

 various size, some 

 being considerably 

 swollen ; they lie 

 singly or in small 

 groups. 



These organisms 

 are found in large 

 numbers in the pus 

 of acute gonorrhoea, 

 both in the male and 

 female, and for the 

 most part are contained within the leucocytes. In the 

 earliest stage, when the secretion is glairy, a considerable 

 number are lying free, or are adhering to the surface of 

 desquamated epithelial cells, but when it becomes purulent 

 the large proportion within leucocytes is a very striking 

 feature. In the leucocytes they lie within the protoplasm, 

 especially superficially, and are often so numerous that the 

 leucocytes appear to be filled with them, and their nuclei 

 are obscured. As the disease becomes more chronic, the 

 gonococci gradually become diminished in number, though 

 even in long-standing cases they may still be found in con- 

 siderable numbers. They are also present in the purulent 

 secretion of gonorrhoeal conjunctivitis, also in various parts 

 of the female genital organs when these parts are the seat 

 of true gonorrhoeal infection, and they have been found in 

 some cases in the secondary infections of the joints in the 

 disease, as will be described below. 



Staining. The gonococcus stains readily and deeply 



