CHAPTER VI. 



CEREBROSPINAL MENINGITIS. 



DIPLOCOCCUS INTRACELLULARIS MENINGITIDIS 

 (WEICHSELBAUM) . 



General Characteristics. A minute non-motile, non-flagellate, 

 non-sporogenous, non-chromogenic, non-liquefying, aerobic and op- 

 tionally anaerobic, pathogenic coccus, staining by ordinary methods, 

 but not by Gram's method. 



Acute cerebrospinal meningitis may be secondary to 

 various more or less well-localized infections when it depends 

 upon such micro-organisms as may be carried by accident 

 to the meninges. Among these may be mentioned pneumo- 

 cocci, staphylococci, streptococci, Bacillus influenzae, B. 

 typhosus, B. coli, B. mallei, B. pestis, and others. 



In addition to these cases, however, there are numerous 

 cases of primary infection of the membranes, either sporadic 

 or epidemic in occurrence. Such constitute the disease 

 known as cerebrospinal fever, epidemic cerebrospinal menin- 

 gitis, or " spotted fever." It is a very dangerous febrile 

 malady, characterized by high temperature, an irregular 

 exanthem, early meningitis, a moderate degree of contagion, 

 and a high mortality. The cause of this infection is a specific 

 organism known as the meningococcus, or Diplococcus intra- 

 cellularis meningitidis. 



As early as 1887 Weichselbaum* carefully described a 

 diplococcus found in 6 cases of cerebrospinal meningitis 

 that may have been identical with one found by L/eichten- 

 stern| in 1885 in the purulent exudate of a case of meningitis, 

 and with a coccus observed as early as 1884 by Celli and 

 Marchiafava. J Weichselbaum 's studies and description of 

 this coccus seem to have attracted but little attention at first, 

 and references to them are but brief in most of the text- 

 books. The prevailing opinion was that its occurrence in 



*"Fortschritte der Med.," x, 18 and 19. 

 t "Deutsche med. Wochenschrift," 1885. 

 t "Gazette degli Ospedali," 1884, vm. 

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