It may be advisable to examine the discharge immediately after menstruation. A cervical discharge is always increased immediately before, during, and after a menstrual period. This is probably the reason that men are more liable to contract gonorrhea at that time. This fact is so well known that there is a widespread popular belief that gonorrhea may be acquired from coitus, during a menstrual period, with a healthy woman. This is not true. A man cannot acquire gonorrhea from a woman unless she had been previously infected with the disease; otherwise a woman might develop gonorrhea in herself spontaneously, for her discharges come in contact with her own genito-urinary tract. The greater liability to infection at the time of menstruation is due to the fact that an existing pathological discharge is increased in amount; a subacute disease is rendered more active by the menstrual congestion; and gonococci, quiescent in the superficial cells, are more likely to be thrown off at this time. Gonorrhea of the cervix very often stops at the internal os. It may, however, extend to the body of the uterus and to the Fallopian tubes, as has already been described. The diagnosis of gonorrheal endometritis can be made only by microscopic examination of the discharge or of a strip of the endometrium removed with the curette. The gonorrheal discharge of the cervix may infect, secondarily, local areas of the vagina. The most usual position of secondary infection is the posterior vaginal fornix. A red eroded area, caused in this way, is often found. The prolonged contact of the pus produces a localized vaginal gonorrhea. Primary _vaginal gonorrhea_ is rare in the adult woman, in whom there is the usual resistant power of the epithelium. The mucous membrane of the vagina becomes tough from coitus and childbirth, and is usually impregnable to the gonococcus. Bumm has kept gonorrheal pus in contact with the vaginal wall for twelve hours without producing any inflammatory reaction. In girls and in young women, in whom the mucous membrane of the vagina is soft and hyperemic, vaginal gonorrhea is more likely to occur. Like gonorrhea in other parts, the disease may be acute or chronic. It may involve the whole vaginal tract or it may be restricted to local areas. The disease sometimes involves only the lower portion of the vagina, and is most severe on the posterior wall. In other cases it is limited to the posterior vaginal fornix, where it has a tendency to become localized and to persist. In the very early stage the mucous membrane is dry and red. It later becomes covered with a purulent or muco-purulent secretion of a milky color. If the disease is extensive, severe symptoms may be present. The woman will suffer with burning pain in the pelvis, the pain being increased by any movement.