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Gonorrhea is caused by the gonococcus, a minute, coffee-bean-shaped bacterium occurring in pairs. It is present in the vaginal discharge of infected women and in the urethral discharge of infected men.
In the case of men, when the gonococci have gained entrance into the urethra, there follows a period of variable length during which these bacteria are multiplying and burrowing within the mucous membrane lining the urethra. Usually in about three days there is a sensation of burning in the urethra and a more or less copious discharge of pale yellow pus. Microscopic examination of this pus usually shows gonococci, white blood cells and epithelial cells shed from the inflamed urethra. The infection has a tendency to progress along the course of the urethra. In many cases it involves in turn the prostate gland, the seminal vesicles and the testicles. All of these complications are serious. An infected prostate gland requires prolonged treatment. It is a focus of infection from which there may arise certain systemic illnesses including arthritis (rheumatism) and heart disease. In itself it is frequently painful. No case of gonorrhea can be cured while infection remains in the prostate, because every ejaculation of semen means reinfection of the urethra. Infection of the seminal vesicles is not less serious than an infected prostate. An infected testicle is an extremely painful thing and frequently causes long periods of disability. Even uncomplicated gonorrhea limited to the anterior urethra may cause an exceedingly painful type of arthritis. Rarely, it causes heart disease.