THE aONOCOCCUS GROUP 347 
Complemeut-fi.vation Reartinu. —jyiagnosh of gonococcus infection 
by the method of complement-fixation has been shown to be of con- 
siderable value, particularly in the more chronic cases, pro\'ided a 
homologous strain of the organism is used for the antigen. A mixed 
antigen composed of several strains is freciuently employed in prac- 
tice.^ Much additional work is required, however, to determine the 
limits of variability of the various strains of the organism before the 
method is placed upon a thoroughly satisfactory basis for routine 
work. In general, acute cases fail to give a positive reaction. When 
the infection has been severe, and the infection has spread upward 
in the genito-urinary tract, positive reactions are generally obtained.'^ 
Non-specific reactions are not commonly met with. In general, the 
more inaccessible foci in chronic infections ai)pear to be responsible 
for the p()siti^'e reactions. 
Shattuck and Whittemore^ have prepared concentrated polyvalent 
glycerin extracts and autolysates of gonococci to test the value of the 
skin reactions in gonococcus infections. The tests were made intra- 
dermally and by the von Pirquet method. Their results were un- 
satisfactory diagnostically. Watabiki^ has shown that a positive 
cutaneous reaction may be elicited in generalized infection with the 
gonococcus. Localized infections fail to react in a specific manner. 
The medico-legal aspects of gonorrheal infections make it incumbent 
upon the examiner to be very cautious in diagnosing the organism. 
Dissemination and Prophylaxis.— The common towel has in the past 
been responsible for many cases of gonorrheal ophthalmia, but laws 
forbidding its use have largely removed this danger. It is certain 
that ordinary care will prevent infection of the innocent with the 
organism. Ophthalmia neonatorum is prevented by the instillation 
of silver salts in the manner indicated above. 
Micrococcus Catarrhalis. — Historical. — Micrococcus catarrhalis 
appears to ha\'e been described first by Seifert^ and by Kirchner;'' the 
name first appears in Die Mikrodrganismen (Flugge), 3d edition, in 
189(), credited to R. Pfeiffer. 
Morphology. IVIicrococcus catarrhalis occurs typically as a diplo- 
coccus with the apposed surfaces of adjacent cocci flattened and 
somewhat elongated. It measures about 1 micron in diameter. 
Occasionally the organisms are arranged in tetrads, particularly in 
young, active cultures in artificial media; in older cultures a tendency 
toward short chain formation is frequently observed. Degenerated 
cocci occur in older cultures. In sputum, bronchial secretions and 
1 Lespinasse and Wolff: Illinois Med. Jour., January, 191.3. Torrey's ten strains 
should be used in preparing the gonococcus antigen. 
2 Thomas and Ivy: Arch. Int. Med., 1914, 13, 143. 
' Boston Med. and Surg. Jour., 1913, 169, 373. ^ Sei-I-Kwai. 
' Volkmann's Sammlung klinischer Vortrage, No. 240. 
« Ztschr. f. Hyg., 1890, 9, 528. 
