104 BACTERIOLOGICAL DIAGNOSIS. 
its arrangement; during the height of an attack of 
-gonorrheea it is almost entirely intracellular, being 
contained within the polymorphonuclear leucocytes. 
Further, several pairs occur in each cell, and the great 
majority of cells are entirely devoid of cocci. 
If the organism which you find possesses these char- 
acteristics turn to the specimen which has been stained 
by Gram’s method and counter-stained by carbol- 
fuchsin (Plate I., fig. 6). In this all bacteria which 
retain Gram’s stain will be coloured violet, while organ- 
isms which do not retain it will be red. You must 
therefore search for groups of diplococci contained 
within the cells and possessing the above character- 
istics. They will not be so prominent as in the other 
specimen, for the cells, nuclei, &c., will be coloured red 
also, and the contrast is not so great. But if the case 
is one of gonorrhoea you will find them after a careful 
search. 
INTERPRETATION OF RESULTS. 
You are justified in considering a case to be one of 
gonorrheea if in films made from the pus :— 
1. Large kidney-shaped diplococci are present. 
2. These cocci occur within the pus cells, and at 
least four pairs (Foulerton) in each affected cell. 
3. The vast majority of cells are entirely free from 
cocci. 
4. The organisms in question do not stain by Gram’s 
method. This is an absolutely essential point. 
If cocci which answer to the above description, 
except that they are not enclosed within cells, the case 
may still be one of gonorrhoea. The gonococcus is 
