A Bacterial Study of Acute Meningitis 317 



In one the Diplococcus intracellularis meningitidis ; 

 In two cases a mixed infection. 



Some brief notes of the clinical histories and pathological 

 findings in the more interesting cases follow. 



CASES OF CEREBRAL LEPTO-MENINGITIS. 



Case I. — Acute Lepto Meningitis due to the Diplococcjis Intra- 

 cellularis Meningitidis. 



H. T., male, aet. 28, was found in a lodging house, and no 

 history could be obtained, excepting that he had been ill for 

 several days. On admission, he was stupid, gave his name 

 but would answer no other questions. There were twitchings 

 of the muscles of the face, and rigidity of the muscles of 

 arms and neck. This rigidity of the muscles appeared as if 

 it were partly voluntary, and the condition seemed cataleptic. 

 When the arms were raised they remained in the position in 

 which they were placed for some minutes. The reflexes 

 were increased and the skin hyperaesthetic. He would not 

 swallow any fluid, and spit it out when it was poured in his 

 mouth. His condition did not seem to be very serious, but 

 36 hours after his admission his pulse began to grow rapid, 

 his temperature rose to 103 F., the respiration increased in 

 frequency, and 12 hours later he died. 



Autopsy : — There was hyperaemia of all the abdominal and 

 thoracic organs, and the pia covering both the convexity and 

 the base of the brain contained an abundant fibrino-purulent 

 exudation. Cultures made from this exudate showed the 

 diplo-coccus intra-cellularis meningitidis of Weichselbaum. 



Case II. — Acute Lepto- Meningitis due to the Anthrax B acillus . 

 T. H. , wool-sorter, aet. 36. The hi.story shows that about 

 three days before admission to the hospital he noticed a 

 pimple on the left wrist ; this became vesicular, opened and a 

 very dark areola formed around it. His arm began to swell 

 rapidly, and became very dark in color and extremely pain- 

 ful. He had no chill and complained of no fever. During 

 this time he was treated at Bellevue Out Door Dept. with 



