94 LOCALIZED INFECTIONS OF PUS NATURE 



The turbidity is due to great numbers of pus cells. These 

 cells contain the cocci of meningitis, which are of the same 

 general size, shape, and arrangement as the gonococcus. 

 They are so like this coccus that one must be well versed 

 indeed to differentiate between the two without a knowledge 

 of the source of the specimen. The meningitis cocci show a 

 great variance in size and shape within the same specimen, 

 conditions not common with the gonococci. They also 

 stain differently, although both are decolorized in the Gram 

 method. As is the case with gonococcus they lie within the 

 protoplasm, but not in the nucleus. Given a turbid fluid 

 from a case suggestive of meningitis, it is possible to make a 

 diagnosis by finding these cocci because gonococci practically 

 never cause meningitis. The cocci may also be found in the 

 bleod. They develop agglutinins whereby an additional 

 assistance in diagnosis may be given. 



The cocci are grown with moderate ease on laboratory 

 media, especially if they contain blood serum or glucose. 

 They grow best in the presence of oxygen at 37.5 C. or 

 98 F., but die rapidly if not put on fresh food frequently. 



They are killed by heating to 50 C. or 122 F. for ten 

 minutes, by exposure to sunlight at once, and by almost all 

 disinfectants in appropriate strength in five minutes. 



It has been possible to produce a very effective antiserum 

 by injecting into horses suspensions of whole and disinte- 

 grated meningitis cocci. The antiserum is introduced into 

 the space between the cord and the meninges by lumbar 

 puncture, first withdrawing some of the spinal fluid to make 

 room for it. By this treatment, especially when instituted 

 early in the disease, a great deduction in the mortality, and 

 in the deformities so frequently following meningitis, has 

 been effected. Since certain cases exhibit septicemic char- 

 acters, the serum should, under such circumstances, also be 

 given into the blood stream. 



