DISTRIBUTION OF GONOCOCCUS. 195 



great increase of secretion. There occurs also a gradually 

 increasing emigration of leucocytes which take up a large 

 number of the organisms. It is to be noted, however, that 

 though there is such an abundant phagocytosis, the cocci 

 within the leucocytes are usually quite healthy in appear- 

 ance, and the establishment of the phagocytosis is not 

 followed by a rapid cure of the disease. The organisms 

 also penetrate the subjacent connective tissue, and are 

 especially found along with extensive leucocytic emigration 

 around the lacunae. Here also many are contained within 

 leucocytes. They are constantly being carried to the 

 surface by leucocytes and discharged, but by multiplication 

 they are able to maintain their footing till such a time as 

 the disease comes naturally to an end. Even, however, 

 when the gonococci have disappeared from the urethral 

 discharge, they may still be present in the deeper part of 

 the mucous membrane of the urethra, possibly also in the 

 prostate, and may thus be capable of producing infection. 

 The prostatic secretion may sometimes be examined by 

 making pressure on the prostate from the rectum when the 

 patient has almost emptied his bladder, the secretion being 

 afterwards discharged along with the remaining urine. 

 (Foulerton). In acute gonorrhoea there is often a con- 

 siderable degree of inflammatory affection of the prostate 

 and vesiculae seminales, but whether these conditions are 

 due to the presence of gonococci in the affected parts we 

 have not at present the data for determining. A similar 

 statement also applies to the occurrence of orchids and also 

 of cystitis in the early stage of gonorrhoea. During the 

 more chronic stages other organisms appear in the urethra, 

 aid in maintaining the irritation, and may produce some of 

 the secondary results. The bacillus coli, the pyogenic 

 cocci, etc., are often present, and may extend along the 

 urethra to the bladder and set up cystitis, though in this 

 they may be aided by the passage of a catheter. It is then 

 also that buboes usually occur, often associated with the 

 presence of a small ulcer in the urethra. Though the 

 bacteriology of these cannot yet be said to be fully worked 



