Mode of Infection 323 



The three dogs all died with congestion and pus-formation 

 in the membranes and areas of softening in the brain sub- 

 stance. The cocci were recovered from two of the dogs, 

 but the lesions of the third animal, which lived twelve days, 

 contained none. 



Flexner* found that in large doses the coccus was always 

 capable of killing small guinea-pigs and mice when injected 

 intraperitoneally. To achieve this, however, the organisms 

 should be suspended in sheep-serum-water, not in salt 

 solution, which is an active poison to the coccus. 



Bettencourt and Franca f tried to infect monkeys by 

 trephining, by injecting into the spinal canal, and by rubbing 

 the cocci upon the nasal mucous membranes, but without 

 success. Von Lingelsheim and LeuchsJ and Flexner were 

 more successful. Flexner's method was to introduce a hypo- 

 dermic needle into the spinal canal, wait until a few drops of 

 cerebro-spinal fluid had escaped, and then inject the culture. 

 When thus introduced at a low level of the spinal canal, the 

 diplococci distribute themselves through the meninges in a 

 few hours and excite an acute meningitis, the exudate of 

 which accumulates chiefly in the lower spinal meninges and 

 the meninges of the base of the brain. The inflammation 

 extends, in monkeys, into the membranes covering the 

 olfactory lobes and along the dura mater into the ethmoid 

 plate and nasal mucosa. 



The nasal mucous membrane is found in many instances 

 to be inflamed and beset with hemorrhages. Smear 

 preparations from the nasal mucosa show many polymor- 

 phonuclear leukocytes containing the cocci in a degenerated 

 form. The cocci were not cultivated from the nasal exudates. 



Mode of Infection. It is not known by what channels 

 infection with Diplococcus intracellularis meningitidis takes 

 place. Weichselbaum supposed it might enter by the nasal, 

 auditory, or other passages, especially the nose, where he 

 constantly found it, and the more recent studies of Goodwin 

 and Shollyll have shown the organisms to be of frequent 

 occurrence in the nasal cavities of meningitis patients as 

 well as occasionally in those associated with them. It thus 



* Loc. cit. 



f "Zeitschr. f. Hyg. u. Infekt.," 1904, XLVI, p. 463. 



t "Klin. Jahrbuch," 1906, xv, p. 489. 



Loc. cit. 



|| "Journal of Infectious Diseases," 1906, Supplement No. 2, p. 21. 



