A SECOND CASE OF GONORRHOEAL SEPTICAEMIA AND ULCERATIVE ENDOCARDITIS WITH OBSERVATIONS UPON THE CARDIAC COMPLICATIONS OF GONORRHOEA.

(1) An acute gonorrhoeal urethritis may be the starting point for a grave general septicaemia with all its possible complications. (2) These infections may be mixed or secondary, due to the entrance into the circulation of organisms other than the gonococcus, or they may be purely gonococcal in nature. (3) Endocarditis is an occasional complication of gonorrhoea. (4) This endocarditis may be transient, disappearing with but few apparent results, or it may leave the patient with a chronic valvular lesion, or it may pursue a rapidly fatal course with the symptoms of acute ulcerative endocarditis. (5) The endocarditis associated with gonorrhoea is commonly due to the direct action of the gonococcus, hut may be the result of a secondary or mixed infection. (6) Pericarditis may also occur as a complication of gonorrhoea, but it is less frequent than endocarditis. It may, as in the case of the latter, be the result either of a pure gonococcal or of a mixed infection. (7) Grave myocardial changes, necroses, purulent infiltration, embolic abscesses are common in the severe gonococcal septicaemias. (8) In instances of gonococcal septicaemia the diagnosis may, in some cases, be made during life by cultures taken from the circulating blood according to proper methods.