INFLUENZA. 563 



better the results. Hence, should the film prep- 

 aration of the first fluid obtained by spinal punc- 

 ture show Gram-negative diplococci, some of which 

 are within leucocytes, an injection should be made 

 immediately and without waiting for the results 

 of culture tests. Should the diagnosis be left in 

 doubt or the disease prove later to be of another 

 nature than epidemic meningitis, no harm will be 

 done by the injection of the antiserum. 



"Although the best results have thus far been 

 obtained where the antiserum has been injected 

 early in the disease, yet the serum should be used 

 in its later stages also until our knowledge gov- 

 erning the value of the serum becomes more pre- 

 cise. The indications at present are that it is 

 useless to employ the serum in the very late stages 

 of the disease in which chronic hydrocephalus is 

 already developed/' 



Flexner and Jobling conclude from an analysis value of 

 of a large number of reports of the use of anti- 

 meningitis serum, that the serum is of value in 

 reducing the period of illness and diminishing the 

 fatalities due to the disease. The figures of Dunn 

 show that in the Boston Children's Hospital, the 

 mortality before the use of the serum, from 69 to 

 80 per cent., was reduced to below 20 per cent, 

 after the use of the serum. 



VII. INFLUENZA. 



Influenza occurs sporadically and in epidemics 

 of greater or less proportions. Its extreme con- 

 tagiousness is shown by the striking rapidity with 

 which it spread over the whole civilized world in 

 the epidemic of 1889 and 1890, leaving behind it 

 a trail of lesser epidemics which have prevailed up 

 to the present time. 



