THE SERUM TREATMENT OF PNEUMOCOCCUS MENINGITIS 751 



erties, and did not give rise to complement fixation in dilutions greater 

 than 1 : 100. 



Following the administration of serum, the cerebrospinal fluid tends 

 to clear up; the bacilli become fewer in number and are mostly ingested 

 by the phagocytes; the pus-cells become less numerous, and while the 

 bacilli may persist in the fluid for a longer period, they ultimately dis- 

 appear. 



Administration of Anti-influenza Serum. The Rockefeller Institute 

 has distributed serum throughout different parts of the country, and is 

 prepared to furnish it to physicians upon request. Physicians, and 

 especially pediatrists, should resort to lumbar puncture early in all sus- 

 pected cases of meningitis, for only in this manner may influenzal menin- 

 gitis be detected early enough to derive any possible benefit from serum treat- 

 ment. The serum should be injected directly into the spinal canal by the 

 gravity or syringe method in exactly the same manner and with the same 

 precautions as are observed in administering serum in the treatment of 

 epidemic meningitis. Since -the disease is usually accompanied by a 

 bacteremia, it is well to inject serum intravenously, although serum in- 

 jected intraspinally soon finds its way into the blood-stream. All data, 

 including the clinical history and the records of bacteriologic examina- 

 tions of cerebrospinal fluid and blood, the amounts of serum injected, 

 and the results obtained, should be sent to the Director of the Rocke- 

 feller Institute. 



THE SERUM TREATMENT OF PNEUMOCOCCUS MENINGITIS 



Meningitis is caused more frequently by the pneumococcus than by 

 the influenza bacillus. Its mortality is certainly no less than in influ- 

 enzal meningitis. 



The few instances in which antipneumococcic serum has been em- 

 ployed have not yielded results that inspire confidence in its employ- 

 ment alone. As will be emphasized later, in considering the serum 

 treatment of pneumonia, an antipneumococcus serum is at best active only 

 against the homologous organism or organisms, the types of which have been 

 employed in its preparation. Even when the homologous serum is used 

 in treating experimental pneumococcus meningitis in monkeys, the 

 fatal termination may be delayed, but is not prevented. For this 

 reason the outlook for its successful employment alone in human in- 

 fections is not encouraging. Recent investigations of Lamar 1 have 

 1 Jour. Exper. Med., 1911, i; ibid., 380; xiv, 256; 1912, xvi, 581. 



