A few prominent writers on the subject of gonorrhoea have written extensively on the subject of innocent infection. As far as my investigation has gone, especially in clinical work (which has been quite extensive), I have found innocent infection in a very limited number of cases. I have met with one or two cases in women whom I had good reason to believe were infected through servants who were in their employ, and who were suffering with the disease in the acute form. Two or three cases of the disease in virgins came to my notice in private practice. I recall two severe cases, of innocent infection that were quite deplorable; one a case of gonorrhoeal ophthalmia in a young school girl, fifteen years of age, contracted from a brother, who carelessly left an infected towel in the bathroom. She lost an eye three days after infection. The case came into my hands too late to save the organ. The other eye showed symptoms of the disease, but was arrested promptly to the use of Argentum nit. Im. The other case was that of a female child about three years of age, infected in some unknown way while under treatment in Cook County Hospital in 1996. There are many other cases on record of course, and doubtless many others that are not recorded.
These exceptional cases do not alter the fact that it is seldom contracted except by sexual congress, and no matter how persistently the patient may deny the fact, we, knowing what we do concerning infection, must either not accept his story as being true or else hold it for further testimony. Venereal patients are noted for their lying qualities and will refer the origin of their difficulties to a thousand and one improbable possibilities.
The infective field in this disease is so limited, that we could not expect it to be otherwise. We do great injustice, however, to those patients who give us a history of unknown source, without carefully going into the history of each case, as this disease that carries with it such a stigma, that great charity should be shown, and above all things justice, especially if the patient be a woman. We are all too hasty in forming a judgment in venereal diseases. Public bath-houses and public closet seats are to be avoided when possible, and when it becomes impossible, great care should be taken to protect the mucous surfaces of the sexual organs.
The subject of the gonococcus in this disease, has received careful attention. Physicians both of this country and Europe, have rivalled each other in their efforts to search for the mite, not only in the gonorrhoeal discharges, but also in all the morbid discharges. They have even carried their investigation to the gouty joint and have succeeded in finding the gonococcus there. Neisser of Breslau made the discovery in 1879 and made his followers all happy in the fact that they had discovered the cause of gonorrhoea.
We find these little microscopic representation of gonorrhoea arranged in pairs and in colonies of ten to twenty, attached as a rule to the pus corpuscle. Owing to their arrangement in pairs, they are classified as a diplococcus. We might briefly describe the method of preparation for the microscope. A small drop of the pus is spread evenly on a glass slide and then dipped in methyl blue, the superfluous coloring matter is washed off with a stream of cold water; they are then mounted with Canada Balsam. A twelfth-inch oil-immersion objective which will give good results. In old long-standing cases it is difficult to find them in the discharges, they are found more readily in the acute stages of the disease.
But we know that the real cause of gonorrhoea has not been found in this minute organism, for every family of diseases and especially specific diseases are accompanied by their own peculiar micro-organisms, just as they are by their own peculiar phenomena and symptomatology. They are not the cause but the effect, and it is not necessary to have a single gonococcus present in the drop of sycotic pus that conveys the contagion from one to another. We leave this phase of the subject, however, for the present, and ask you to carefully investigate the late researches of the great French scientist Beauchamp in his exhaustive study of micro-organisms.
Much has been said with reference to the immunity produced by having once had the disease, but I believe this is not true. I make this statement after having examined many cases, and after having closely followed the history of a goodly number of patients, who had suffered from more than one attack. Of course as long as there is any trace of the disease Sycosis in the system, it prevents another acute attack in many patients. But again I have seen acute attacks that showed all the symptoms of a fresh attack of gonorrhoea, that had still in their organism traces of chronic Sycosis. This is especially true in tubercular patients or those who showed that diathesis in some degree at least. All perfectly cured cases of gonorrhoea and Sycosis we say are very liable to take the disease the second time.