MENINGOCOCCUS MENINGITIS 237 



were continued into this period, serious symptoms have not been 

 observed. 



Results. So far as the results of the serum treatment upon the 

 course of the disease are concerned, we have sufficient evidence to 

 show that through its introduction, one of the most fatal diseases, 

 and one of the most dangerous in its late effects, even in cases where 

 recovery has occurred, has lost some at least of its terrors. As 

 regards its effect upon the mortality, much depends upon the time 

 at which it is instituted. Of 241 cases which had thus been injected 

 with the Flexner serum during the first three days of the malady, 

 only 25.3 per cent, died, while a delay of from one to four days 

 beyond this period increased the death rate to 27.8 per cent., and a 

 still further delay to 42.1 per cent. The general death rate of 712 

 treated cases was 31.4 per cent., as contrasted with the usual 

 mortality of from 53 to 90 per cent. By eliminating all those cases 

 where the patients were first seen in an already hopeless condition, 

 but injected nevertheless, Flexner calculated an average mortality 

 of 25.4 per cent. Similar results have been reached with the 

 sera prepared by Wassermann, Jochmann, and Dopter. The latter 

 claims an average mortality of only 16.47 per cent. (402 cases) for 

 his serum, as contrasted with one of 65 per cent, in untreated cases; 

 Schone one of 27 per cent, for Jochmann's serum (in a relatively 

 small number of cases) and Dopter one of 18.35 per cent. (158 cases) 

 for that of Wassermann. 



The immediate effect upon the malady is also quite favorable; 

 usually within twenty-four to forty-eight hours there is definite 

 improvement, as evidenced by a return to consciousness, disappear- 

 ance of delirium, diminution of the general hypersensibility , etc. 

 The duration of the disease is shortened to eight to twelve days, 

 as contrasted with five weeks or longer, which is the rule in fully 

 one-half of the cases that end in recovery, in the absence of serum 

 treatment. 



In conclusion it would seem that late effects of the malady are 

 only exceptionally observed; mental disorder, paralysis and blind- 

 ness in particular are only rarely seen. 



We may accordingly look with pride and satisfaction upon the 

 antimeningitis work as one of the brightest pages in the history 

 of serology. 



