THE SERUM TREATMENT OF MENINGOCOCCUS MENINGITIS 801 



The influence of age upon mortality was early pointed out by Flexner. 

 The very high mortality in infants and in old persons is due to their 

 lowered vitality and enfeebled resistance. An additional factor in 

 young children is their greater tendency to develop extreme hydro- 

 cephalus and convulsions. 



TABLE 31. MORTALITY ACCORDING TO AGE 



The statistics show indubitably that the mortality of epidemic 

 meningitis can be greatly reduced by the administration of serum treat- 

 ment. While the ordinary type of epidemic meningitis responds best 

 to the specific treatment, the fulminant cases may also receive some 

 of the beneficial influence of the serum. To quote from what Flexner 

 wrote in 1909, and repeated in 1913: "In view of the various considera- 

 tions presented, the conclusions may be drawn that the antimeningitis 

 serum, when used by the subdural method of injection, in suitable doses 

 and at proper intervals, is capable of reducing the period of illness; of 

 preventing in large measure the chronic lesions and types of the infection, 

 of bringing about complete restoration of health, thus lessening the 

 serious, deforming, and permanent consequences of meningitis; and of 

 greatly diminishing the fatalities due to the disease." 



Prophylactic Immunization in Meningococcus Meningitis. In Chap- 

 ter XXIX mention has been made of the probable value of active im- 

 munization against epidemic meningitis by the subcutaneous injections 

 of three doses of a polyvalent meningococcus vaccine at intervals of a 

 week. Sophian and others have shown experimentally that opsonins, 

 bacteriolysins, agglutinins, and other antibodies are produced, and 

 while meningococcus meningitis is ordinarily but mildly infectious (about 

 5 per cent, of secondary cases in homes), the method is practically 

 devoid of danger and worthy of trial, especially for physicians, nurses, 

 and members of a household who are exposed to the infection over a 

 period of many weeks. 

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