[Reprint from The Microscope for July, 1888.] 
THE GONOCOCCUS.1 
V 
WILLIAM BUCKINGHAM CANFIELD, A. M., M. D. 
Lecturer on Normal Histology. University of Maryland, Baltimore. 
T NLIKE the bacillus tuberculosis, the gonococcus has never 
made that impression on the medical mind that it should, 
and this is probably because the means of detecting it are not so 
certain as in the case of the former, and also because the diagnosis 
of a gonoiThcea does not so much depend upon an examination of 
the products of a urethral inflammation as the diagnosis of pulmo- 
nary consumption depends on an examination of the sputa. In 
medico-legal circles the gonococcus has demanded some attention, 
and it has undoubtedly been 
of use in some cases of inter- 
est. Although several investi- 
gators had suspected its 
presence as a cause of gonor- 
rhoea, no one had done such 
exact work to detect it as 
Neisser,2 of Breslau. In 1879 
he made a communication to 
the " Centralblatt f. d. med. 
Wissenschaften," in which he described what he has named the 
"gonococcus," or specific micrococcus of gonorrhoea. 
Since this time many others have confirmed his work. In 35 
1 Read before the Baltimore Microscopical Society, April 16, 1888. 
3 A. Neisser: " Centralblatt f. d. med. Wissenschaft," 1879, No. 28. 2 
cases of gonorrhoea, 7 cases of purulent ophthalmia neonatorum, 2 
cases of blenorrhceal ophthalmia, he found the gonococcus. Weiss1 
found it in 32 cases of gonorrhoea. Bokai3 made cultivations and 
inoculated successfully several students who volunteered for the 
cause of science. The following have also confirmed Neisser's 
discovery: Aufrecht,3 Ehrlich,4 Gaffky, Rucker,6 Brieger, Sadtler, 
Leber, Haab,6 Hirschberg,1 Krause,1 Konigstein,8 Bockhart,9 and 
others. The three last carried on successfully a series of experi- 
ments in inoculations upon eyes. Ogden described organisms 
resembling those found in pus taken from other sources not supposed 
to be gonorrhoeal. This statement led Keyser10 to investigate still 
further, and his work, done with the care of a painstaking student, 
is probably the most valuable contribution on this subject next to 
that of Neisser's. Keyser examined 67 cases of gonorrhoea and 
several cases of purulent ophthalmia. Three cases of what was 
supposed to be simple urethritis were examined and no gonococci 
were found. 
The method of examination is very simple. A little of the pus 
is pressed between two cover glasses, which are then drawn apart. 
Then the glasses are allowed to dry, and are quickly passed through 
the Bunsen flame to coagulate the albumen and fix the pus. Then 
a few drops of the ordinary methylene blue or violet are allowed to 
cover the specimen for a few minutes and washed off. The 
specimen may at once be examined in water or glycerin, or it may 
be dried and mounted in balsam, which makes it more distinct. The 
gonococci are seen in pairs or fours, apparently in the pus cells, 
while the contour of the pus cells is seen to be very indistinct, due 
to the Abbe illuminator. Keyser says they are in the cell, and 
Neisser says they are on the cell. Of course, this is not easy to 
decide, but from my own experience in examining the gonococci and 
1 Dr. F. Weiss: 11 La Micro du Pus Blenorrhagique." These de Nancy, 1880, and 
Gazette Hebdom., November 12ch, 1880. Weiss: " Anales de Dermatol.," 1881. 
2 A. Bokai: "Ueber das Contagion der Acuter Blenorrhcese." " Centralblatt," 1880. 
No. 74. 
3 R. Aufrecht: " Pathologische Mitt." 
4 Ehrlich: "Ueber Methylen blau und s. Klin. Bacterioskopische Verwendung," 
" Zeitschr. f. Klin. Med. 1," pg. 70,1881. 
6 G. Ruecker: " Ueber Polyarthritis Gonorrhoica," Deutsche Med. Woch, 1880. 
6 O. Haab: "Kleinere Ophtalmologische Mitt.," Corres. f. Schweitzer Aertzte. O. 
Haab: " Der Mikrokokkus der Blenorrhoea Neonatorum." Festschrifft, Wiesbaden, 1881. 
7 Hirschberg and F. Krause: "Zur Pathologie der Anstechende Augenkrankheiten." 
Centralblatt f. pract. Augenheilkunde. 
8 Koenigstein: "Zur Prophylaxis der Bien. Neonatorum." Vortrag gehalten in d. k. 
k. Gesellsch. d. Aerzte in Wien. 
9 Bockhart: " Beitrag zur Aetiologie und Pathologie des Harnroehrestrippers." Sit- 
zungs Ber. d. Wurz., Phys, und Med. Gesellschaft, September, 1882. 
10 " Is Gonorrhoea a Bacteria Disease?" by N. A. S. Keyser, Md. Med. Journal, February 
15th, 1883. Langenbeck's " Arch. f. Chirurgie." 3 
the other micro-organism, I am inclined to think they are on the 
outside of the pus cell. 
The best way to confirm the discovery of a micro-organism is 
by cultivation and inoculation. This, of course, is not possible in 
every case of urethritis. Another way is by a process of staining 
which shall exclude every other micro-organism. Dr. Gabriel 
Roux,1 of Paris, says that if the preparation be first stained 
according to Gram,2 and then be examined, and then be decolorized 
with alcohol and examined again, the gonococci will be seen stained 
at the first examination, and will be unstained after decolorization 
with alcohol. Allen3 and Wendt heartily confirm this. So far, I 
have not been doubtful in examining them myself, but as I have 
only looked for the gonococci in cases where gonorrhoea was 
undoubtedly present, my experience is of little value. 
This discovery is of importance, in so far as it is one step 
nearer to our hope of classifying diseases in a scientific manner. 
Practically, it is of decided interest, as changing the mode of 
treatment, and thus cutting short the former length of the disease. 
It has also explained why some cases of apparently cured gonor- 
rhoea break out afresh from taking stimulants after all signs and 
symptoms of the disease had disappeared. 
1010 North Charles St., Baltimore. 
1 Le Concour's Medical, November 13th, 1886. 
2 Gram's method consists in staining first with methylene blue or violet, 
fixing the color with a solution of iodine in the iodide of potash, and then decolorizing with 
alcohol. 
3 "Journal of Cutaneous and Genito-Urinary Diseases," March, 1887.