That infection with the gonococcus may extend by continuity of structure from the site of original inoculation has long been known, but it is only within comparatively recent times that the occurrence of dissemination through the blood stream has been recognized. The articular or synovial complication formerly designated gonorrheal rheumatism must be considered as having this latter origin, although it has not been established whether it is due to the invasion of gonococci or to the action of toxins elaborated by these. The endocarditis that has been observed and carefully studied in a number of instances has been shown to harbor the microorganism itself.
A number of disturbances referable to the nervous system have also been described in connection with gonorrhea, and various explanations for their occurrence have been offered. Thus, paraplegia with wasting of the affected muscles in association with gonorrhea has been attributed to reflex influences, to myelitis