CHAPTER II. 



CEREBROSPINAL MENINGITIS. 

 Diplococcus Intracellulars Meningitidis. 



The acute sero-purulent form of inflammation of the 

 cerebral and spinal meninges not infrequently presents 

 itself as a complication of certain well-known infectious 

 processes, as croupous pneumonia, more rarely as a 

 primary sporadic or epidemic affection. The disease is 

 usually associated with one or the other of three micro- 

 organisms, the pneumococcus, the streptococcus, and 

 the Diplococcus intracellulars meningitidis of Weichsel- 

 baum. In more rare cases the staphylococci, the typhoid 

 bacillus, and other bacteria may present themselves. 



As early as 1887 Weichselbaum 1 found in six cases 

 which he studied a diplococcus that had not been suc- 

 cessfully cultivated, although it may have been identical 

 with one found by Leichtenstern 2 in the purulent exu- 

 date of a case of meningitis. Weichselbaum' s studies 

 and description of the coccus seem to have attracted but 

 little attention at first, and references to them are but 

 brief in most of the text-books. The common opinion 

 seemed to prevail that as its presence did not appear to 

 be essential to the occurrence of cerebrospinal menin- 

 gitis, as its inoculation into animals showed its path- 

 ogenic power to be limited, its importance was but 

 trivial. The careful studies of Joger, 3 Scherer, 4 Council- 

 man, and Mallory and Wright, 5 embracing a large num- 

 ber of cases, have shown the presence of the diplococcus 

 of Weichselbaum in so large a number that its import- 

 ance has become correspondingly great. 



1 Fortschritte der Med., v., 1 8 and 19. 

 * Deutsche med. Wochensckrift, 1885. 



3 Zeitschrift fur Hygiene, xix., 2, 351. 



4 Centralbt. f. Bakt. u. Parasitenk., xvii., 13 and 14. 



5 American Jour. Med. Sci., March, 1898, vol. cxv., No. 3. 

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