70 MEDICAL BACTERIOLOGY 



cases may be found in the spinal fluid and exudate upon the membranes. The 

 organisms are nearly all found within the pus cells, polynuclear leucocytes, 

 some of these cells are full of cocci. These coffee bean-shaped, Gram negative, 

 diplococci vary in size. Variations in size may be noted among those observed 

 in a single pus cell; on an average they are somewhat larger than gonococci. 



When spinal fluid is to be examined a strong needle about 6 inches long, 

 that will not break if bent, is thrust into the spinal canal between the third and 

 fourth lumbar vertebrae, about % inch to one side of the median line, while the 

 patient is lying on his side with thighs and head strongly flexed. 



When the fluid begins to drop or flow from the needle, it is collected in a 

 test-tube that will carry from 5 to 15 cc. 



Strict aseptic precautions must be observed throughout, and after the 

 needle has been withdrawn, the wound is painted with iodine and covered with 

 a sterile dressing, the patient remaining reclined and at rest, for at least 8 

 hours. 



SERUM THERAPY 



A bacteriolytic serum is employed in the treatment of this disease, the usual 

 method of administration being into the spinal canal. 



