. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. by impure sexual intercourse, anddue to the gonococcus of Neisser. Etiology.— This organism is a cofi^ee bean or biscuit shaped coccusoccurring free and in pairs as diplococci in the protoplasm of the leucocytes in gonorrhoeal inflammation. It ispresent in the pus of gonorrhoea^urethritis and conjunctivitis and theexudate of gonorrhoeal endocarditis andarthritis. In smears stained with alka-line methylene blue the organisms areusually intracellular. It is Gram nega-tive. This wide-s
. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. by impure sexual intercourse, anddue to the gonococcus of Neisser. Etiology.— This organism is a cofi^ee bean or biscuit shaped coccusoccurring free and in pairs as diplococci in the protoplasm of the leucocytes in gonorrhoeal inflammation. It ispresent in the pus of gonorrhoea^urethritis and conjunctivitis and theexudate of gonorrhoeal endocarditis andarthritis. In smears stained with alka-line methylene blue the organisms areusually intracellular. It is Gram nega-tive. This wide-spread venereal infec-tion is scarcely inferior in importanceto syphilis. In truth, when we takeinto consideration the facts that syphilisis much less virulent than formerly inits early and late constitutional effects,and that it gives rise to symptoms whichcompel the most ignorant and inex-perienced to seek professional advice at a period when it is still amenableto treatment, and that gonorrhoea, while retaining all its capacity forimmediate and late harmfulness, is too often regarded as a trifling local. Fig. 282.—Spread of pus containing gonococci. GONORRHCEA. 229 disorder, the very existoiicc of which nuiy 1)0 unsuspected l)y the fciiiulepatient, we may even question whether gonorrhoea is not the more seriousdisease of tlie two. The unmorrhtial iiitcction may limit itself to the mucous membraneof the genitalia—(1) the })rimary local infection; it may invade the genito-urinary organs by direct continuity of structure—(2) secondary localinfection; or finally, it may be swept into the blood stream and give riseto (3) eonstitutional infection. With reference to the spread of the infection in the genito-urinary tract,it is a question of extent. Every case in the male is at first an infection ofthe anterior nrethra. AYith reference to systemic effects, it is a question ofdegree; any case is liable to systemic disturbance, and malaise, feverishness,head and back pains, and
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectmedicine, bookyear192
