THE SERUM TREATMENT OF MENINGOCOCCUS MENINGITIS 747 



According to Holt, in the New York epidemic of 1904-05, antedating the 

 use of serum, among 350 cases that recovered the duration in 3 per cent, 

 was one week or less, and in 50 per cent, five weeks or longer. Of 288 

 cases reported by Flexner and Jobling, the average duration of active 

 symptoms in those receiving serum was eleven days. Sophian, in an 

 experience of several hundred cases, reports that many acute cases were 

 relieved in five or six days and discharged as cured in two weeks. 



(6) Upon Complications. Next to its influence upon mortality, the 

 good effects of antimeningitic serum are apparent in that it lessens the 

 incidence and severity of the terrible complications of this disease. The 

 most severe and permanent sequels are those resulting from affections 

 of the internal ear and the essential structures of vision. A conservative 

 estimate of the incidence of the former among cases not receiving serum 

 treatment is 12 per cent. (Goffert), whereas Flexner's 1 analysis of 1300 

 cases treated with serum shows that deafness occurred in but 3.5 per 

 cent, of cases. At least from 12 to 24 per cent, of cases not receiving 

 serum treatment will develop more or less serious eye complications, 

 whereas Flexner's report shows that impairment of vision among serum- 

 treated cases occurred in about 0.9 per cent, of cases. The latter report 

 shows the occurrence of arthritis in but 0.9 per cent, of cases, whereas 

 among cases untreated with serum this is a frequent complication. 

 Whereas chronic meningitis is relatively common among cases treated 

 without serum, it is uncommon among those treated with serum. 



(c) Upon Mortality. The gross mortality among cases treated 

 without serum varies from 70 to 90 per cent.; among serum-treated 

 cases the mortality is about 30 per cent. For example, of 1294 cases 

 treated with serum prepared in the Rockefeller Institute, the general 

 mortality was 30.9 per cent. 



The importance of early diagnosis and prompt institution of serum 

 treatment is shown in the following table : 



TABLE 30. MORTALITY ACCORDING TO THE PERIOD OF INJECTION 



OF SERUM 





Jour. Exper. Med., 1913, xvii, 553. 



