254 SPECIFIC MICRO-ORGANISMS 



found in all of them a very definite Gram-negative intracellular 

 diplococcus, the meningococcus. He obtained cultures but his 

 animal inoculatons all gave negative results. Jaeger in 1895 

 seems to have found a similar organism in fourteen cases of 

 epidemic meningitis and Huebner in 1896 apparently found it 

 in five cases. The cultural work of these authors seems to be 

 unreliable as their cultures were Gram-positive. More conclu- 

 sive confirmation of the relation of this organism to epidemic 

 meningitis was furnished by Councilman, Mallory and Wright 1 

 in 1898. 



The meningococcus is found in the bodies of patients suffering 

 from meningitis, occasionally on the nasal mucous membrane 

 of healthy persons and of cases of rhinitis, and very rarely in 

 other situations. In cerebrospinal meningitis the organism is 

 present in the cerebrospinal fluid, in the meninges, often on the 

 nasal and pharyngeal mucous membrane, sometimes in the 

 blood and on the conjunctivae, and rarely in the urethra, where 

 it may be mistaken for the gonococcus. It is usually found 

 without difficulty in the cerebrospinal fluid in the first few days 

 of the disease, but may be very difficult to find at a later stage. 



The organism is found for the most part inside polynuclear 

 leukocytes and in its form, size, arrangement and behavior to 

 the Gram-stain resembles very closely the gonococcus. The 

 outline of the cocci is often somewhat hazy, suggesting possible 

 disintegration, and this sometimes makes their recognition 

 somewhat difficult in microscopic preparations of cerebrospinal 

 fluid. Cultures are best made on ascitic-fluid agar or blood 

 agar, upon which small dew-drop colonies appear in 24 hours 

 at 37 C. The color of blood is unaltered by the growth. Cul- 

 tures may be obtained on Loffler's blood serum, although ascitic- 

 fluid agar is probably the best medium for continued culti- 

 vation. The meningococcus grows more luxuriantly than the 

 gonococcus, as a rule, and adapts itself more readily to growth 



1 Report of the Mass. Bd. of Health on Epidemic Cerebrospinal Meningitis, 

 etc., Boston, 1898. 



