RELATIONS TO THE DISEASE 259 



Relations to the Disease. — The gonococcus is invariably 

 present in the urethral discharge in gonorrhoea, and also in 

 other parts of the genital tract when these are the seat of true 

 gonorrhceal infection. Its presence in these different positions 

 has been demonstrated not only by microscopical examination 

 but also by culture. From the description of the conditions of 

 growth in culture it will be seen that a life outside the body in 

 natural conditions is practically impossible — a statement which 

 corresponds with the clinical fact that the disease is always 

 transmitted directly by contagion. Inoculations of pure cultures 

 on the urethra of lower animals, and even of apes, is followed 

 by no effect, but a similar statement can be made with regard 

 to inoculations of gonorrhceal pus itself. In fact, hitherto it has 

 been found impossible to reproduce the disease by any means in 

 the lower animals. On a considerable number of occasions 

 inoculations of pure cultures have been made on the human 

 urethra, both on the male and female, and the disease, with all 

 its characteristic symptoms, has resulted. (Such experiments 

 have been performed independently by Bumm, Steinschneider, 

 We'rtheim, and others.) The causal relationship of the organism 

 to ,the disease has therefore been completely established, and it 

 is interesting to note how the conditions of growth and the 

 pathogenic effects of the organism agree with the characters of 

 the natural disease. 



Intraperitoneal injections of pure cultures of the gonococcus in white 

 mice produce a localised peritonitis with a small amount of suppuration, 

 the organisms being found in large numbers in the leucocytes (Wertheim). 

 They also penetrate the peritoneal lining and are found in the sub- 

 endothelial connective tissue, but they appear to have little power of 

 proliferation, they soon disappear, and the inflammatory condition does 

 not spread. Injection of pure cultures into the joints of rabbits, dogs, 

 and guinea-pigs causes an acute inflammation, which, however, soon 

 subsides, whilst the gonococci rapidly die out ; a practically similar 

 result is obtained when dead cultures are used. These experiments show 

 that while the organism, when present in large numbers, can produce a 

 - certain amount of inflammatory change in these animals, it has little or 

 no power of multiplying and spreading in their tissues. 



Toxin of the Gonococcus. — De Christmas has cultivated the gonococcus 

 in a mixture of one part of ascitic fluid and three parts of bouillon, and 

 has found that the fluid after twelve days' growth has toxic properties. 

 At this period all the organisms are dead ; such a fluid constitutes the 

 "toxin." The toxic substances are precipitated along with the proteins 

 by alcohol, and the precipitate after being desiccated possesses the toxic 

 action. In young rabbits injection of the, toxin produces suppuration ; 

 this is well seen in the anterior chamber of the eye, where hypopyon 

 results. The most interesting point, however, is with regard to its 

 action on mucous surfaces ; for, while in the case of animals it produces 

 no effect, its introduction into the human urethra causes acute catarrh, 



