RELATIONS TO THE DISEASE. 193 



inoculated with the pus or other material in the same manner as 

 gelatine tubes for ordinary plates (vide p. 62). To each tube is added 

 an equal part of ordinary agar which has been thoroughly liquefied by 

 heating and allowed to cool also to 40 C. The mixture is then 

 thoroughly shaken up and quickly poured out on a plate or Petri's 

 dish and allowed to solidify, the plates being then incubated at a 

 temperature of 37 C. The colonies of the gonococcus are just 

 visible in twenty-four hours, and are seen both in the substance of the 

 medium and on the surface. The deep colonies when examined with 

 a lens are minute and slightly nodulated spheres, sometimes showing 

 little processes, whilst those on the surface are thin discs of larger 

 diameter with wavy margin and rather darker centre. In this way 

 the gonococcus may be separated from fluids which are contaminated 

 with a considerable number of other organisms. 



Relations to the Disease. The gonococcus is invari- 

 ably present in the urethral discharge in gonorrhoea, and 

 also in other parts of the genital tract when these are the 

 seat of true gonorrhceal infection. Its presence in these 

 different positions has been demonstrated not only by 

 microscopic examination but also by culture. From the 

 description of the conditions of growth in culture, it will be 

 seen that a life outside the body in natural conditions is 

 practically impossible a statement which corresponds with 

 the clinical fact that the disease is always transmitted 

 directly by contagion. Inoculations of pure cultures on 

 the urethra of lower animals, and even of apes, is followed 

 by no effect, but a similar statement can be made with 

 regard to inoculations of gonorrhceal pus itself. In fact, 

 hitherto it has been found impossible to reproduce the 

 disease by any means in the lower animals. On a consider- 

 able number of occasions inoculations of pure cultures 

 have been made on the human urethra, both of the male 

 and female, and the disease, with all its characteristic 

 symptoms, has resulted. (Such experiments have been 

 performed independently by Bumm, Steinschneider, Wer- 

 theim, 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. 



