The following is a precise means of diagnosing posterior urethritis: The ure thra is first washed with a 0.5- or 1-per cent. boric-acid solution, then a lh-per cent.-pyoktanin solution is injected and retained for five minutes in the canal, and finally the urethra is again washed with the boric-acid solution until the washings pass colorless. The patient then urinates, and if the urinary fila ments passed are found to be colored violet, it is an indication that they come from the anterior part of the urethra. If, on the contrary, they are colorless, they come from the posterior part. E. Lehrwald (Sem. MM., xviii, p. 15, 'OS).
Experiments with pure culture of the gonococcus obtained from a gleety dis charge of two years' standing gave fol lowing results: 1. Attempted reinfection of the original urethra with this culture always failed. 2. The culture, when transplanted to a coccus-free urethra, produced typical acute gonorrhoea. 3. Infection from this back again to the original urethra gave a fresh gonorrhoea, which, after a typical acute course of five or six weeks, again subsided to a chronic gleet. This most interesting experiment demonstrates that by passing an attenu ated gonococcus through another indi vidual—that is, through a fresh culture ground—it becomes again virulent to a urethra which was immune to it before. This explains how an apparently healthy man, if he have the gonococcus lurking anywhere in his urethral tract, may in fect his hitherto uninfected wife, and how he may be again infected from her. H. Brooks Wells (N. Y. Polycl., May 15, '98).
The earliest diagnostic symptom of urethral contraction is the appearance of shreds in a clear, or semiclear, urine. At first these shreds are almost impercep tible, but their presence is quite constant from the time of submucous involvement, and as the canal becomes smaller the shreds increase in size. No case of gon orrhoea should be discharged as cured until the morning urine is clear of debris, and the patient should be kept under ob servation for at least six months, that urinal shreds may be detected early should they appear. J. Henry Dowd (Phila. Med. Jour., Mar. 11, '99).
In boys the period of incubation, the general characteristics, and the history of the disease are not different from those manifestations in the adult. The incubation from one to seven (lays, the pain and burning sensations, frequent desire to micturatc, and other symp toms are as seen in the usual adult gonorrhceic. The discharge is usually
profuse, but the pain seems out of pro portion to the clinical picture presented. This hypersensitiveness is, however, co incident with contracted prepuce or meatus, which serve to dam back the secretions and, by preventing proper drainage of the urethral canal, cause re tention of inflammatory products.
Complications occur in young boys similar to those of adult patients, after the disease has lasted several days: posterior uretbritis, prostatitis, and epididymitis, etc. A. L. Wolbarst (N. Y. Med. Jour, July 6, 1901).
There is also a small class of cases designated "non-specific" because of the absence of the gonococcus. The usual causes assigned are: contact with irri tating vaginal secretions other than those of gonorrhoeal origin, the intro duction into the urethra of irritating liquids or foreign bodies causing inflam mation, etc. The symptoms of these cases begin as do those of true gonor rhoea, but usually run a much shorter and milder course.
In many cases of chronic urethritis one is unable to demonstrate the pres ence of the gonococcus; these cases are probably non-infectious. In any case the possibility of infection as compared to an acute urethritis is small. A urethritis due to an attenuated organism, and con sequently modified in intensity, may be contracted from a chronic urethritis.
Conversely: Several negative examina tions of the secretion from a chronic ure thritis do not prove its non-infectious ness. The infectiousness or non-infec tiousness of a chronic urethritis can only be determined by frequent and careful examinations of the secretion, and if these prove negative, by the non-appear ance of the gonococcus after the applica tion of Neisser's test (an acute urcthritis caused by saline nitrate injections). E. R. Owings (Johns Hopkins Hosp. Bull., Oct., '97).
The important diagnostic point for the gonococcus is its property of de eolorizing by Gram's method. The other points of morphology and posi tion inside the leneocytes are not neces sarily characteristic. In the application of the method of cover-glass examina tion combined with Gram's method of staining for the identification of the gonococcus, the most important precau tion is to smear the pus properly on the cover-glass. Usually it is too thick. The best preparations are those ob tained by scraping oir the pus from the cover-glass as much as possible with a platinum loop or knife-point, after it has been placed thereon.