General and dental pathology with special reference to etiology and pathologic anatomy; a treatise for students and practitioners . form of gonorrhea. Chronic gonorrhea is usually a direct continuation of an acuteattack, and characterized by a constant discharge of a thin,catarrhal exudate (gleet). Ulcerous lesions, or papillomatousthickenings of the mucosa are a frequent result of chronic gonor-rhea, or there may be hyperplasia of the submucosal connectivetissue with narrowing of the urethra (stricture). The most com-mon seat of stricture is the membranous urethra. 158 GENERAL PATHOLOGY The g
General and dental pathology with special reference to etiology and pathologic anatomy; a treatise for students and practitioners . form of gonorrhea. Chronic gonorrhea is usually a direct continuation of an acuteattack, and characterized by a constant discharge of a thin,catarrhal exudate (gleet). Ulcerous lesions, or papillomatousthickenings of the mucosa are a frequent result of chronic gonor-rhea, or there may be hyperplasia of the submucosal connectivetissue with narrowing of the urethra (stricture). The most com-mon seat of stricture is the membranous urethra. 158 GENERAL PATHOLOGY The gonotoxin is intracellular, and while slight amounts ofantibodies are produced, antisera are valueless, but vaccines maybe useful in chronic forms of the disease. While gonorrhea is usually contracted through sexual contact,the transmission of the disease by towels, bedding, and othercontaminated articles, particularly in institutions, is probablymore frequent that is generally recognized. Latent gonorrhealfoci, existing long periods of time after apparent cures havebeen effected, and capable of becoming acute and transmitting. Fig. 58.—Acute urethritis, showing purulent infiltration and gonococci in the cells andbetween the cells. (Birch-Hirschfeld.) the disease to others, are also more frequent than is generallybelieved. (Fig. 58.) Soft Chancre, or Chancroid Soft chancre, or chancroid, is an ulcer almost invariably foundon the external genitals, due to the B. of Ducrey. It is alwayscontracted through sexual contact, but is autoinocnlable, hencethere are usually more than one ulcer. The infection begins as ared papule, which later suppurates, forming a yellowish ulcerwith irregular infiltrated margins. Sometimes it becomes phage- PATHOLOGY OF [NFECTIOUS DISEASES 159 denic or serpiginous in character. The organisms travel alongthe lymphatic channels to the inguinal glands which also sup-purate as a rule. The disease is purely local—never systemicwhen uncomplicated. Mixed inf
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