72 MEDICAL BACTERIOLOGY 



Resistance. The gonococcus is a delicate organism, in dried pus on linen 

 and other articles usually it dies in several hours, occasionally it survives for 

 several weeks. Freezing for a number of days eventually kills, but tempera- 

 tures between oC. and 37.5C. do not destroy it. Temperatures above 4oC. 

 are injurious; in a moist state exposure to 6oC. for 10 or 15 minutes kills. 

 Drying rapidly destroys gonococci; in a hot-air sterilizer they are killed at iooC. 

 in a few minutes. 



Chemical germicides in very high dilutions are rapidly destructive. 



The gonococcus is especially sensitive to salts of silver. 



Toxin. The gonococcus produces an intracellular toxin. 



Agglutinins are not found in the serum of most infected patients; they may 

 be produced by animal inoculation, but are not employed in diagnosis. 



Attempts to produce antigonococcus sera of therapeutic value have been 

 unsatisfactory. 



Vaccines are of little or no value in acute infections ; in subacute and chronic 

 infections they sometimes give brilliant results; the chief indication for their 

 administration is gonococcus arthritis. 



Pathogenesis. The gonococcus has a predilection for the mucous mem- 

 branes of the urethra. It is most commonly found as the cause of urethritis. 

 Gonorrhea is the most frequent of venereal diseases. The activity of this 

 organism is not limited to the urethra in all cases; it often passes further, at- 

 tacking the cord, testicles, bladder or kidneys, in the male, and the bladder, 

 vagina, cervix, uterus, tubes or ovaries in the female. Occasionally infection is 

 not localized in the genito-urinary tract, but passes to the blood stream and 

 causes endocarditis, often malignant; the gonococcus may be deposited in the 

 joints and cause arthritis; so-called gonorrheal rheumatism. Infection in 

 practically all such cases is the result of sexual intercourse with persons harbor- 

 ing the organism. 



An epidemic form of vaginitis caused by the gonococcus, not due to sexual 

 intercourse, is observed from time to time among female children in the wards of 

 hospitals. The mode of transmission in such cases is not known. 



The gonococcus is sometimes conveyed to the eye by the fingers or linen 

 soiled with urethral discharge or pus. It frequently gets into the eyes of 

 infants during their passage through the vagina at birth, when the mother 

 harbors the gonococcus. In the eye this organism produces a violent inflamma- 

 tion with profuse purulent exudate; not infrequently vision is impaired or totally 

 destroyed. 



The gonococcus may persist in the urethra or vagina long after manifesta- 

 tions of disease have ceased, when there is no pus, no discharge and when smears 

 and cultures made from the urethra show no gonococci. Under these condi- 

 tions the carrier, individual harboring the organism, may transmit infection 

 during sexual intercourse. 



The gonococcus does not infect any animal other than man, and does not 

 exist outside the human body except under experimental conditions. 



Diagnosis. In acute infections of the genito-urinary organs and the eye, 



