Gonorrhea is one of the most common sexually transmitted diseases and is a purulent inflammatory disease of the genitourinary system caused by Neisseria gonorrhoeae (referred to as gonococcus). It is mainly transmitted through sexual intercourse. It infects the urethra, the endocervix, and can also invade the rectum, conjunctiva, and pharynx. In women, vestibulitis, endometritis, tubitis and pelvic inflammatory disease can occur; in men, epididymitis and prostatitis can occur, causing infertility or sterility. It can also be disseminated through bloodstream, causing bacteremia, arthritis, endocarditis, meningitis, hepatitis, etc. The clinical characteristics are stinging pain in the urethra and discharge of purulent discharge from the urethra. It is mainly transmitted through sexual intercourse, and a few can also be indirectly transmitted through contaminated clothing. This disease is called “poisonous gonorrhea” and “flower and willow poisonous gonorrhea” in Chinese medicine. The etiology of gonorrhea 1, epidemiology Gonorrhea is one of the high incidence of all STDs, all over the world, according to the U.S. CDC estimates. 1997, there are about 62 million patients infected with gonorrhea worldwide, 320,000 people in the United States, the annual incidence rate of 122/100,000, the incidence rate of economically backward developing countries is higher, such as the incidence rate of Kampala in Uganda, Africa in 1991 For example, in 1991, the incidence rate of Kampala in Uganda in Africa was 10,000/100,000, and that of Nairobi in Kenya was 7,000/100,000, and some Asian countries also have a high incidence rate. Statistics show that the incidence of gonorrhea is related to the sexual activity of the population, with a high incidence age of 15-29 years, higher in summer than in winter, and more men than women. In addition, the incidence is higher among the poor, educated and unmarried. The emergence and prevalence of drug-resistant strains of gonococci is one of the major causes of the spread of gonorrhea. Penicillinase-producing and chromosome-mediated penicillin-resistant gonococcal strains, chromosomal and plasmid-mediated tetracycline-resistant gonococcal strains have been isolated. In 1999, the National Center for STD Control reported: 63.18% penicillin-resistant strains, 39.52% tetracycline-resistant strains, 31.78% propofol, 0.6% ceftriaxone, and 0.54% spectacularin-resistant strains. 2, pathogenesis The pathogen of gonorrhea is Neisseria gonorrhoeae, also known as gonococcus or gonorrhea bicoccus. Neisseria gonorrhoeae is ovoid or round, often arranged in pairs, two bacteria contact surface flat or slightly concave, double kidney-shaped, the size of 0.6 × 0.8um, Gram stain negative. Neisseria gonorrhoeae is aerobic bacteria, suitable for growth in a warm, humid environment, the first isolation and culture, need to supply 5%-10% carbon dioxide, high nutritional requirements. The optimal temperature is 35-36 ℃, the optimal pH is 7.4, after 48 hours of incubation, the formation of moist, round, gray or translucent, smooth type colonies. Gonococci do not tolerate dry heat and cold, dry environment 1-2 hours to die, but in not completely dry conditions, such as attached to the clothing and bedding can survive 18-24 hours. The resistance of gonococcus to general disinfectants is very weak, such as 1:4000 silver nitrate solution, 1% carbolic acid, 0.1% silver nitrate, 1% silver protein, 1% mercury, etc. can be killed within 1-10 minutes. Gonococcus can decompose glucose, produce acid without gas, do not decompose other sugars, do not produce indole, do not reduce nitrate, the growth process can produce oxidase. Humans are the only natural host of gonococci. After gonococci invade the human body, they quickly adhere to the epithelium with the help of their hairs, secondary tract white of the outer membrane and IgA-degrading enzymes, and then are engulfed by columnar epithelial cells. Intracellular proliferation of gonococci leads to cell lysis, and then the bacteria are released into the submucosal space, causing submucosal infection. Through the synergistic effect of endotoxin lipopolysaccharide and complement, IgM, it causes multinucleated leukocyte infiltration, mucosal erythema, erosion, epithelial cell shedding, and the formation of typical purulent urethral discharge.