MICROCOCCUS INTRACELLULARIS MENINGITIDIS 91 



and protected from light, it may live on sheets and clothing, 

 from eighteen to twenty-four hours." 



This bacterium produces an intracellular or endotoxin, 

 which is as potent when injected into animals as a devitalized 

 mass as the living form itself, although the gonococcus has 

 very little effect upon laboratory experimental animals. 

 Some observers have been able, by injecting goats with coccus 

 poison or the germs themselves, to produce an antiserum 

 against the gonococcus, and therewith treat human cases 

 with some success. Vaccination with killed gonococci has 

 been found of some value in chronic stages, and by some 

 observers, in acute stages also. 



The bacteriological diagnosis is easily made by spreading 

 some of the pus upon glass slides, staining appropriately, and 

 examining under the microscope. In the chronic gonococcus 

 infection the discovery of the germ is extremely difficult. 

 For the diagnosis of obscure cases of vulvovaginitis Dr. 

 Norris recommends a washing with 1 to 5000 bichloride 

 solution in a pipette filled with a bulb. The chemical 

 removes the surface epithelium and cocci hidden in the depths 

 are drawn out. The fluid can be centrifugalized and the 

 sediment stained. 



MICROCOCCUS INTRACELLULARIS MENINGITIDIS. 



Meningitis, or inflammation of the membranes covering 

 the brain and spinal cord, may be caused by several bacteria, 

 such as streptococci, pneumococci, and influenza bacilli, 

 but we shall deal chiefly with epidemic cerebrospinal menin- 

 gitis or spotted fever. (The latter is a common term which 

 should be discarded for meningitis and confined to typhus 

 or jail fever.) Epidemic cerebrospinal meningitis is an acute 

 primary inflammation due to a coccus called the Micrococcus 

 or Diplococcus intracellularis meningitidis of Weichselbaum 

 or the meningitis coccus or meningococcus. The organism 

 probably gains access to the meninges by way of the nose, 



