MICROCOCCUS GONORRHGZ. 529 
Worthy of special notice in this connection are the 
cases of endocarditis accompanying gonorrhcea, and some- 
times terminating fatally, when they are known as en- 
docarditis gonorrheica maligna. The question naturally 
arises in these cases whether it is the gonococcus or 
some other coccus or diplococcus which has infected 
the endocardium. Here, again, it is only by means of 
the culture method that this question can be settled 
definitely. Fligge draws attention to this matter, and 
states that but few cases have been recorded in which 
the information given as to the cause of the disease can 
be unhesitatingly accepted. Weichselbaum mentions 
a case of endocarditis accompanying gonorrhea which 
was shown by the culture method to be due to strepto- 
coccus infection, proving that so-called gonorrheal 
endocarditis may be a secondary infection, Other cases 
are recorded by Leyden, Hiss, Councilman, and Wilms 
which are said to have been most probably of gonor- 
rheeal origin; but in these only microscopical examina- — 
tions were made and no culture experiments, or only 
cultures on gelatin plates, etc., which were inadequate. 
Welch also reports a case of endocarditis with general 
septicemia following gonorrhea, in which he demon- 
strated the gonococcus in the blood of a living person 
in cover-glass and culture medium. No other patho- 
genic bacteria were found, 
Immunizing Serum. As animals are not infected by 
the gonococcus they are not very suitable for injections 
with the cultures for the purpose of producing an anti- 
toxic or bactericidal serum. Their insusceptibility pre- 
sents also an almost insurmountable obstacle to the 
testing of the blood of animals under treatment, so that 
although it may be possible to bring about an artificial 
34 j 
