GONORRHCEA 85 



(6) in the urine. It is to be noticed that the gonococcus rarely, 

 if ever, attacks the vagina, except in young children, and that in 

 cases of vaginitis the cervical secretion should be examined. 



In the vast majority of cases cultural examinations are quite 

 unnecessary. This is fortunate, for the gonococcus does not grow 

 readily on artificial media. It requires for its cultivation the 

 presence of haemoglobin, and in practice the simplest method 

 (should cultures be required for any purpose) is to smear sterile 

 blood over the surface of an ordinary agar tube and inoculate that 

 with the material to be examined. To prepare these tubes, 

 sterilize the tip of the finger with carbolic lotion, washing oflf the 

 latter with alcohol or ether ; then prick the finger and squeeze 

 two or three drops of blood into the tube. It will run down the 

 medium and mix with the water of condensation at the bottom. 

 Put the tube in the incubator for twenty-four hours to see if it is 

 sterile. This will probably be the case, as the living leucocytes 

 and fresh serum are probably sufficient to kill the few stray 

 bacteria that may have entered. It is then ready for use, and at 

 the time of inoculation smear the blood over the surface of the 

 agar with the loop. The colonies are very small and translucent 

 (like those of the pneumococcus), and readily die out. The 

 organism has well-marked morphological characters, and the 

 deductions drawn from these characters need only be corroborated 

 in cases of generalized infection or of meningitis, in which the 

 results are to be published (as they should be), and must, therefore, 

 be proved beyond doubt. In such cases the services of a bacteri- 

 ologist should be called in if possible; or the material may be 

 collected in pipettes with the most careful precautions as to 

 asepsis, and forwarded at once. 



Method of Making the Films. 



The pus is to be spread out into thin films at the time at which 

 it is taken, and this is true whether the practitioner intends to 

 make the examination for himself or is about to send the material 

 to a bacteriologist. Gonorrhoeal pus should never be collected 

 on a piece of cotton-wool or enclosed in vaccine tubes. 



The films are to be made thus : Take two clean slides and 

 place two or three platinum loopfuls of the pus on the centre of 

 one of them ; sterilize the needle and lay it down. Now take the 

 other slide and apply its centre to the pus, and allow it to fall on to 



