I00 BACTERIOLOGICAL DIAGNOSIS. 
the Fallopian tubes (causing pyosalpinx), to the mouths 
of the tubes (causing local adhesive peritonitis, which 
probably results in sterility), or to the: peritoneum, 
where it may cause general peritonitis. 
The gonococcus may escape into the blood from any 
of these lesions, and the results of this occurrence are 
arthritis, ulcerative endocarditis and meningitis; the 
two latter are rare. 
The search for the gonococcus may have to be made 
(1) in urethral pus from either sex, (2) in pus from the 
cervix uteri, (3) in pus from the conjunctiva, (4) in pus 
from the meninges, tubes, peritoneum, or other region, 
whether removed by operative measures or at a post- 
mortem examination, (5) in the blood, or (6) in the 
urine. It is to be noticed that the gonococcus rarely, 
if ever, attacks the vagina, 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 gono- 
coccus does not grow readily on artificial media. The 
organism has well marked morphological characters, 
and the deductions drawn from these characters need 
only be corroborated in cases of generalised 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 bacterio- 
logist 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 to a 
laboratory. 
