No specific microbe has been subjected to such furious opposition as this gonococcus, and for years the controversy continued, until in 1892 an Austrian physician, Wer theim, quieted all contention by cultivations of the gono-cocci in human blood serum and subsequent successful inoculations of the cultures into healthy male urethrse. Only since the discovery of this gonococcus has it been possible accurately to diagnose all the phases of gonorrhoea in women, and before that important event medical practitioners were quite unable to recognize a large number of such cases as are those to day who are not skilled in microscopy having nothing on which to base their opinions except certain inflammatory conditions in the genital area quite undistinguishable from other like conditions which were not gonorrhceal (e.g., the acrid discharges accompanying uterine fibroids, polypi, cancers, and catarrhal inflammatory conditions).
Furthermore, in addition to the inability to recognize the disease even when actively present, it was also unappreciated that gonorhoea in women was a most serious affection, and that its despoilments and ravages within herinternal sexual organs and peritoneal cavity were far more severe and fatal than those of syphilis.
Frequency of Gonorrhoea in Women. In long standing cases of gonorrhoea it is often impossible to distinguish gonococci in the discharges, and it may be that they can only be found in the pus and diseased tissues of the ovaries and Fallopian tubes after removal of these organs by surgical means. Hence we cannot rely solely on the gonococcus for diagnosis in all cases, but must also pay careful attention to the clinical, or bedside, data.
According to Taylor,1 on account of the greater licentiousness of men, there are approximately thirty cases of gonorrhoea among them to one case in women.
According to Noeggerath's conclusions eighty per cent of married women suffer from latent gonorrhoea. Saenger, of Leipsic, believes that one eighth of all women who suffer from diseases peculiar to their sex are infected with gonorrhoea; and Sigmund, director of the venereal clinic in Vienna, found that in seven hundred and fifty eight public women, sixty three per cent were gonorrhceal. German authorities impute twenty three to twenty eight per cent of all diseases of the internal sexual organs of women to gonorrhoea; English and American authorities place it at seventy per cent.
Pagenstecher,5 a pupil of Professor Saenger at the gynaecological clinic in Leipsic, says: "The result of our studies regarding the frequency of gonorrhoea in the female sex ia that, according to the mode of living and the morality of the various classes, it covers from twenty to sixty three
per cent, which is to say, that in good moral families every fifth woman has a gonorrhoea, and among the public women there are two out of three. These figures will surely appear too high, I know well; yet when we consider that at least seven out of ten young men have had a case of gonorrhoea, and that the most of them are never cured to the point that they can no more be infectious, we shall then understand how, after being married, they contaminate their wives, so that the latter, although virtuous, acquire the gonorrhoea, for who could give it to them except their husbands?"
Valentine, professor of genito-urinary diseases at the New York school of clinical medicine says:
"Noeggerath, of New York, fully thirty years ago, sounded the first note of alarm in this connection. On purely clinical grounds he attributed a vast proportion of death dealing diseases in women to gonorrhoea which the husbands had had years before. Noeggerath's assumption has been more than borne out by recent science."
These are the views of recognized authorities who cannot lightly be set aside as extremists. Gonorrhoea is a disease which lingers in men long after apparent cure, only to infect innocent wives, as well as helpless mistresses, and as Sinclair says:
"It is the neglected cases of gonorrhoea in the male those which become chronic which most frequently give rise to the infection of the female, even though they may have long ceased to show signs of activity".
However, whether the foregoing statements have been overdrawn or not, the medical profession has within recent years unanimously come to a realization of the fact that gonorrhoea is the principal cause of the so frequent sterility and disease of the sexual organs in women, and that the suffering and racial degradation from this cause is appalling.
Mode of Ckiset and Gravity of the Besult. In the genital organs of the female there is a greater extent of mucous membrane than in the male, and their functions are more active. Furthermore, there is in woman a direct communication between the sexual passages and the peritoneal cavity, which renders the consequences far more grave. In woman gonorrhoea not only tends to become chronic and to invade the internal sexual organs with destructive changes, but with each recurrence of menstruation there is also a likelihood of its renewed activity and further spread; and especially does danger threaten if she become pregnant the results not showing fully until some weeks after the full time labor or miscarriage.