MICROCOCCUS MENINGITIDIS 91 



and influenza bacilli, but we shall deal chiefly with 

 epidemic cerebrospinal meningitis or spotted fever. 

 (The latter is a common term which should be dis- 

 carded 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 menin- 

 gitidis of Weichselbaum or the meningitis coccus or 

 meningococcus. The organism probably enters the 

 spaces between the nervous organs and their bony 

 casement by way of the nose, whence it penetrates the 

 sieve-like plate at the top into the space beneath the 

 brain, and proceeds by extension. 



The other forms of meningitis, the pneumococcal for 

 instance, gains entrance by way of the blood or lymph, 

 directly through the skull-base or by an extension from 

 the middle ear, where suppuration may burrow through 

 the bone. 



The meningitis coccus may be found in the nose 

 and throat of patients, and indeed also in the nose and 

 throat of those attending them. 



The affection produces a thick, stringy, purulent 

 exudate in the spaces between the nervous system 

 and their coverings, the meninges, called the arachnoid 

 space. This exudate covers the brain and cord, and 

 fluid accompanying it distends the various cavities of 

 the spinal column and interior of the brain. The dis- 

 ease has a high mortality. It affects chiefly the young. 

 Its results or sequelae consist in blindness, deafness, 

 and paralyses of various kinds. Mentality may be 

 affected. 



In taking care of meningitis patients the chief 



