CHAPTER VIII 

 GONORRHEA 



Micrococcus Gonorrhce^ (Neisser) 



General Characteristics. — A minute, biscuit-shaped, non-motile, non-sporo- 

 genous, non-liquefying, non-chromogenic, non-flagellate, aerobic,_ strictly para- 

 sitic coccus, not stained by Gram's method, cultivable upon special media, and 

 pathogenic for man only. 



All authorities now accept the "gonococcus" as the specific 

 cause of gonorrhea. It was first observed in the urethral and con- 

 junctival secretions of gonorrhea and purulent ophthalmia by 

 Neisser* in 1879. 



Bummt found other cocci closely resembling the gonococcus 

 in the inflamed urethra, and points out that neither its shape nor 

 its position in the cells can be regarded as characteristic, but that 

 failure to stain by Gram's method can alone enable us to say with 

 certainty that biscuit-shaped cocci found in urethral pus are 

 gonococci. 



Distribution. — The gonococcus is a purely parasitic pathogenic 

 organism. It can be found in the urethral discharges of gonorrhea 

 from the beginning until the end of the disease, and often for many 

 months and even years after recovery from it. After the period 

 of creamy pus has passed, its numbers are usually outweighed by 

 other pyogenic organisms. WertheimJ cultivated the gonococcus 

 from a case of chronic urethritis of two years' standing, and proved 

 its virulence by producing experimental gonorrhea in a human 

 being. The organisms are chiefly found within the pus-cells or 

 attached to the surface of epithelial cells, and should always be 

 sought for as diagnostic of gonorrhea, as purulent urethritis is some- 

 times caused by other organisms, as Bacillus coli communis! and 

 Staphylococcus pyogenes. 



Morphology. — The organisms occur in pairs. Each pair of young 

 cocci is composed of two spherical organisms, but as they grow older 

 the inner surfaces become flattened and separated from one another 

 by a narrow interval, so that they somewhat resemble a coffee- 

 bean. A pair of the cocci resembles the German biscuit, and is 

 described by the Germans as semmelformig. 



* "Centralbl. f. d. med. Wissenschaft," 1879, No. 28. 



t"Der Mikroorganismus der gonorrhoischen Schleimhauterkrankungen," 

 "Gonococcus Neisser," second edition, 1887. 



% "Archiv f. Gynakologie," 1892, Bd. XLii, Heft i. 



§ Van der Pluyn and Loag, " Centralbl. f . Bakt. u. Parasitenk.," Feb. 28, 189S, 

 Bd. xvn, Nos. 7, 8, p. 233. 



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