280 Cerebro-spinal Meningitis 



Councilman, and Mallory and Wright* (embracing fifty-five 

 cases in which the cocci were found by culture or by micro- 

 scopic examination in thirty-eight) have, however, shown 

 the presence of the diplococcus of Weichselbaum in so large 

 a number of cases that its importance has correspondingly 

 increased. 



The distribution of Diplococcus intracellularis in nature 

 is as yet unknown. It has been found in cerebro-spinal 

 meningitis by those who have looked for it, twice has been 

 found in the nose in coryza by Scherer, has been found in 

 the conjunctiva by Carl Frankel f and Axenfeld,J and in 

 the purulent discharges of rhinitis and otitis by Jager. It 

 occurs in above 50 per cent, of the cases of cerebro-spinal 

 meningitis, but fails satisfactorily to fulfil the requirements 

 of the laws of specificity. 



Morphology. The micro-organism is a biscuit-shaped 

 diplococcus having a great resemblance to the gonococcus. 

 This resemblance is further increased by the fact that the 

 cocci are usually found inclosed in the protoplasm of the 

 leukocytes. Weichselbaum, by whom this was first ob- 

 served, found it constant in sections of the brain and its 

 membranes, though in the exudate of the disease a good 

 many free cocci may be observed. It was this peculiar 

 relationship to the cells that led Weichselbaum to name 

 the organism Diplococcus intracellularis. Many of the cocci 

 inclosed in the cells are apparently dead and degenerated, 

 as they stain badly and do not grow when the pus is trans- 

 ferred to culture media. 



Carl Frankel, in discussing the micro-organism, points 

 out that its morphologic peculiarities have much in common 

 with the.pneumococcus, so that the most refined methods 

 of differentiation should always precede a positive diag- 

 nosis. Its resemblance to the gonococcus should also be 

 kept in mind. 



Staining. The organism is easily stained with the 

 usual aqueous solutions of the anilin dyes. According to 

 Weichselbaum, Mallory, and Wright, it does not stain by 

 Gram's method. 



* "Amer. Jour. Med. Sci.," March, 1898, vol. cxv, No. 5. 

 t "Zeitschrift fur Hygiene," June 14, 1899. 



J Lubarsch and Oestertag, "Ergebnisse der allg. Path. u. path. 

 Anat.," in, S. 573. 



"Deutsche med. Wochenschrift," 1894, S. 407. 



