Pathogenesis 429 



Weichselbaum endeavored to reproduce the original 

 cerebrospinal meningitis in animals by trephining and in- 

 jecting the cocci beneath the dura. In this manner he 

 inoculated three rabbits and three dogs. Two of the rabbit 

 injections failed, probably because the injected material 

 escaped at once from the wound. The third rabbit died, 

 and showed marked congestion of the membranes of the 

 brain and a minute softened and hemorrhagic area. In 

 these the cocci were found by culture to be abundant. 

 The three dogs all died with congestion and pus-formation 

 in the membranes and areas of softening in the brain sub- 

 stance. The cocci were recovered from two of the dogs, 

 but the lesions of the third animal, which lived twelve days, 

 contained none. 



Flexner* found that in large doses the coccus was always 

 capable of killing small guinea-pigs and mice when injected 

 intraperitoneally. To achieve this, however, the organisms 

 should be suspended in sheep-serum water, not in salt 

 solution, which is an active poison to the coccus. 



Bettencourt and Franca f tried to infect monkeys by 

 trephining, by injecting into the spinal canal, and by rubbing 

 the cocci upon the nasal mucous membranes, but without 

 success. Von Lingelsheim and Leuchs| and Flexner were 

 more successful. Flexner 's method was to introduce a hypo- 

 dermic needle into the spinal canal, wait until a few drops of 

 cerebrospinal fluid had escaped, and then inject the culture. 

 When thus introduced at a low level of the spinal canal, the 

 diplococci distribute themselves through the meninges in a 

 few hours and excite an acute meningitis, the exudate of 

 which accumulates chiefly in the lower spinal meninges and 

 the meninges of the base of the brain. The inflammation 

 extends, in monkeys, into the membranes covering the 

 olfactory lobes and along the dura mater into the ethmoid 

 plate and nasal mucosa. 



The nasal mucous membrane is found in many instances 

 to be inflamed and beset with hemorrhages. Smear prepara- 

 tions from the nasal mucosa show many polymorphonuclear 

 leukocytes containing the cocci in a degenerated form. The 

 cocci were not cultivated from the nasal exudates. 



* Loc cit. 



t "Zeitschr. f. Hyg. u. Infekt.," XL,VI, p. 463. 



J "Klin. Jahrbuch," 1906, xv, p. 489. 



Loc. cit. 



