70 STUDY AND IDENTIFICATION OF BACTERIA 



that the presence of meningococci in a person has a value as indicating the presence 

 of the virus, so that such examinations should continue, but they insist upon the 

 futility of means for eradicating meningococci from the nasopharynx by disin- 

 fecting 'solutions. 



For diagnosis, make smears and cultures from cerebrospinal fluid. 

 The sediment from the centrifuged material gives better results. In 

 tuberculosis the lymphocytes preponderate; in cerebrospinal meningitis 

 the polymorphonuclears. 



It has been stated that a point of difference between the phagocytosis with the 

 gonococci and the meningococci is that the meningococci invade and at times destroy 

 the nucleus of the polymorphonuclear, which is not true of gonococci. The appear- 

 ance of large phagocytic endothelial cells, often containing polymorphonuclears, in 



FIG. 1 6. Diplococctis intracdlularis meningitidis and pus cells. (Xiooo.) 



(Williams.} 



the centrifuged cerebrospinal fluid is a favorable prognostic sign. At times there 

 does not appear to be any relation between the number of phagocytic polymorpho- 

 nuclears and the severity of the case. 



Vincent has recommended a precipitin test for epidemic cerebrospinal meningitis 

 which has the advantages of being simple and more immediate than cultures and of 

 particular value in those cases when meningococci cannot be found in the smears or 

 in cultures from the cerebrospinal fluid. It is performed by adding i or 2 drops 

 of antimeningococcic serum to a tube of fresh cerebrospinal fluid which has been 

 clearecf by centrifugalization for ten to fifteen minutes. After adding the serum the 

 tube is placed in the incubator at S2C. for two to five hours together with a control 

 tube. The formation of a precipitate (turbidity) shows a positive test. 



Micrococcus Catarrhalis (Seifert, 1890). This organism has been 

 specially studied by Lord. It resembles the Meningococcus strikingly 

 and can only be differentiated by cultural procedures. It grows on 



