CHAPTER IX. 



GONORRHCEA, SOFT SORE, SYPHILIS. 



GONORRHCEA. 



Introductory. — The micrococcus now known to be the cause 

 of gonorrhoea, and now called the gonococcus, was first described 

 by Neisser, who in 1879 gave an account of its microscopical 

 characters as seen in the pus of gonorrhceal affections, both of 

 the urethra and of the conjunctiva. He considered that this 

 organism was peculiar to the disease, and that its characters 

 were distinctive. Later it was successfully isolated and culti- 

 vated on solidified blood serum by Bumm and others. Its 

 characters have since been minutely studied, and by inoculations 

 of cultures on the human subject its causal relationship to the 

 disease has been conclusively established. 



The Gonococcus. — Microscopical Characters. — The organism 

 of gonorrhoea is a small micrococcus which usually is seen in the 

 diplococcus form, the adjacent margins of the two cocci being 

 flattened, or even slightly concave, so that between them there is 

 a small oval interval which does not stain. An appearance is 

 thus presented which has been compared to that of two beans 

 placed side by side (vide Fig. 85). When division takes place 

 in the two members of a diplococcus a tetrad is formed, which, 

 however, soon separates into two sets of diplococci — that is to 

 say, arrangement as diplococci is much commoner than as tetrads. 

 Cocci in process of degeneration are seen as spherical elements 

 of various size, some being considerably swollen. 



These organisms are found in large numbers in the pus of 

 acute gonorrhoea, both in the male and female, and for the most 

 part are contained within the leucocytes. In the earliest stage, 

 when the secretion is glairy, a considerable number are lying 

 free, or are adhering to the surface of desquamated epithelial 

 cells, but when it becomes purulent the large proportion within 



223 



