A study of the aetiology and diagnosis in males
based on a series of 118 cases.
There are two types of non -gonococcal urethritis,
namely, primary and secondary.
Primary non-gonococcal urethritis may be described
as a urethritis arising independently of any
Synonymous terms are primary non -gonorrhoeal
urethritis, primary non -specific urethritis,
urethritis simplex, idiopathic urethritis, and
pseudo -gonorrhoea. The latter term is chiefly used
.to describe the more acute cases of primary non - specific urethritis.
Secondary non -gonococcal urethritis is a residual
urethritis after the original infecting organism,
the gonococcus, has apparently died out. This is a
relatively frequent type as in the majority of cases
of gonorrhoea, even within a few days of the
appearance of the discharge, secondary organisms may
be found in the purulent exudate. In 1930 the
'writer investigated a series of 155 cases of early
acute gonorrhoea attending the Venereal Diseases
Department of the Royal Infirmary, Edinburgh and
cultured secondary organisms from the urethral pus of
130 patients (83.5 per cent). By far the commonest
organism found was staphylococcus albus followed by
diphtheroids, streptococci, staphylococcus aureus,
and bacillus coli in that order of frequency.
In the majority of cases, then, gonorrhoea is a
;mixed infection from the earliest stages of the
disease. A probable explanation of this
phenomenon is that the organisms normally inhabiting,
the anterior urethra become virulent, and as the
disease spreads backwards to the posterior urethra
these potential pathogens travel with it.
Frequently secondary organisms gain a firm
foothold in the damaged mucous membrane and may
result in a continuance of the urethritis for a
considerable period after the gonococci have been