Toxic Products 413 



The gonococcus could be kept alive upon these media for two 

 months. 



Metabolic Products. — Laitinen found that the gonococcus pro- 

 duces acids in the early days of its development, and alkalies sub- 

 sequently. The a,cids are produced only in dextrose broth, no other 

 sugars being fermented. 



Vital Resistance.— Authorities agree that the gonococcus has very 

 slight power of heat endurance. Wertheim found the optimum 

 temperature of cultivation to be 39° to 40°C., and saw no harm 

 result from exposure to 42 °C. It is killed in a few minutes at 5s°C. 



Gonococci are very delicate organisms, unable to resist external 

 conditions. They cease to grow and soon die out if the temperature 

 becomes low. They die quickly if dried. They are extremely 

 susceptible to the action of germicides. 



In artificial culture the gonococcus soon dies, though cultures 

 from different sources differ considerably in this regard. As a 

 rule they survive but a few transplantations, though Young found 

 that one culture had been kept alive by students in his laboratory 

 for more than three months. 



Diagnosis. — ^The diagnosis of gonorrhea by finding the diplococci 

 in urethral pus and epithelial cells is a very simple matter. The 

 identification of the micro-organisms under other conditions is by 

 no means easy. Thus, when gonorrhea becomes chronic and the 

 cocci are no longer taken up by the phagocytes, one may be in 

 doubt whether Gram-negative diplococci found in a urethral 

 discharge are gonococci or not. A patient getting over gleet and 

 wanting to marry desires to know definitely whether gonococci are any 

 longer present in his urethra or not. Again, when the gonococcus- 

 like organisms occur upon the conjunctiva, in the pus taken from 

 joints, upon the valves of the heart, or in the Fallopian tubes, the 

 same difficulty is met. Probably the greatest perplexity arises when 

 the conjunctiva is called in question, for here there can come about 

 a confusion of the gonococcus, the pneumococcus, and Micrococcus 

 catarrhahs (q.v.) which only careful staining and culture experiments 

 can solve. The pneumococcus may be readily separated by its 

 Gram-positive staining, its lanceolate form and capsules, but it is 

 only by seeing that Micrococcus cafarrhalis grows readily and 

 luxuriantly upon all the laboratory media, and the gonococcus 

 with difficulty and very sparingly upon any media, that the diag- 

 nosis can be made. 



The complement fixation test is probably the court of final resort, 

 but is attended with such great technical difficulty that it can 

 scarcely be recommended at present. 



Toxic Products, — The toxic metabolic products of the gonococcus 

 appear to be contained within the bodies of the bacteria and dis- 

 seminated but slightly throughout the culture-media. Christmas,* 

 * "Ann. de I'lnst. Pasteur," 1897. 



