COCCACEiE AND THEIR PARASITIC RELATIONSHIPS 26 1 



complication. Secondary infection with staphylococci is common 

 in chronic gonorrhea. 



Specific diagnosis by finding gonococci usually presents no 

 difficulties in acute inflammations of the genital tract, in which 

 the characteristic groups of Gram-negative intracellular diplococci 

 are practically diagnostic. In chronic cases and in extra-genital 

 iriflammations the diagnosis presents greater difficulty. Both 

 microscopic and cultural examinations should be made and if 

 negative they should be repeated many times. Even repeated 

 failure to &a/i the gonococcus by these^ methods does not justify 

 the positive assertion that it is absent. Specific diagnosis by 

 the method of complement fijcation has been developed by Sch- 

 wartz and McNeill.^ The antigen is prepared from several cul- 

 ture strains of the gonococcus and in all other respects the test 

 is similar to the Wassermann test for syphilis. Iron«^ has em- 

 ployed a cutaneous test, using a glycerin extract of gonococci. 

 The technic is similar- to that of the von Pirguet test for 

 tuberculosis. 



The prevalence of gonorrhea throughout the civilized world 

 is much greater than has been popularly supposed. Erb, in a 

 study of 2000 males among private patients of the middle and better 

 classes, found a history of gonorrhea in 50 per cent. Many 

 other students of the disease disagree with Erb, regarding his 

 figures as much too low. The large mass of statistics obtained by 

 examination of recruits for war service in 19 17 and 1918 indicates 

 that approximately 2 per cent of men in the age period 21 to 31 

 years in the United States are afflicted with recognizable gonorrhea 

 at any one time. Among women in German obstetrical hospitals, 

 largely from the poorer class, gonorrhea is present in 10 to 30 per 

 cent. The danger to the eyes of the new-born infant is now over- 

 come by the use of silver nitrate in the eyes when they are first 

 cleansed. The general prevention and restriction of gonorrheal 

 infection is engaging more and more the serious attention of 



' Amer. Journ. med. Sciences, 1912, Vol. CXLIV, pp. 815-826. 

 ^Journ. Infec. Diseases, 1912, Vol. XI, pp. 77-93. 



