CHAPTER III. 

 CEREBRO-SPINAL MENINGITIS. 



DIPLOCOCCUS INTRACELLULARIS MENINGITIDIS 

 (WEICHSELBAUM) . 



General Characteristics. A minute non-motile, non-flagellate, 

 non-sporogenous, non-chromogenic, non-liquefying, aerobic and op- 

 tionally anaerobic, pathogenic coccus, staining by ordinary methods, 

 but not by Gram's method. 



Acute cerebro-spinal meningitis may be secondary to 

 various more or less well-localized infections, when it depends 

 upon such micro-organisms as may be carried by accident 

 to the meninges. Among these may be mentioned pneumo- 

 cocci, staphylococci, streptococci, Bacillus influenzas, Ba- 

 cillus typhosus, Bacillus coli, Bacillus mallei, Bacillus pestis, 

 and others. 



In addition to these cases, however, there are numerous 

 cases of primary infection of the membranes, either sporadic 

 or epidemic in occurrence. Such constitute the disease known 

 as cerebro-spinal fever, epidemic cerebro-spinal meningitis, 

 or " spotted fever." It is a very dangerous febrile malady, 

 characterized by high temperature, an irregular exanthem, 

 early meningitis, a moderate degree of contagion, and a 

 high mortality. The cause of this infection is a specific 

 organisin known as the meningococcus , or Diplococcus intra- 

 cellularis meningitidis. 



As early as 1887 Weichselbaum* carefully described a 

 diplococcus found in six cases of cerebro-spinal meningitis 

 that may have been identical with one found by Leichten- 

 sternf in the purulent exudate of a case of meningitis. 

 Weichselbaum 's studies and description of this coccus seem 

 to have attracted but little attention at first, and references 

 to them are but brief in most of the text-books. The 

 prevailing opinion was that its occurrence in cerebro-spinal 

 meningitis was accidental, as inoculations into animals 

 showed its pathogenic power to be very limited. The careful 



* " Fortschritte der Med.," v, 18 and 19. 

 f "Deutsche med. Wochenschrift," 1885. 



