134 1'he Philippine Journal of Science nu 



Thus considerable evidence is adduced that specific cerebro- 

 spinal meningitis occurs in the Philippines. There is, how- 

 ever, no definite record of a case occurring in a Filipino in 

 which the organism has been isolated and studied culturally. 

 For this reason, it is considered to be worth while to report 

 the findings in the present case, in order that this disease may 

 be definitely added to the nosology of the Philippines. 



Dr. Eleanor J. Pond, in whose service the case occurred, has 

 furnished the clinical data. 



Gregorio Pacheco, a 6-year-old boy of Malolos, Bulacan Prov- 

 ince, was admitted to the Mary Johnston Hospital, Manila, 

 on September 6, 1912, with a history of having had fever on 

 September 2. On September 3, he had projectile vomiting. 

 On September 4, vomiting was absent; the patient was semi- 

 conscious, and he showed some retraction of the head. 



On admission to the hospital the patient was restless and 

 somewhat delirious. Opisthotonus was marked; Kernig's sign 

 and trismus were present; the temperature was 39°. 1 C. ; pulse, 

 125; and respiration, 33. On September 7, the restlessness 

 was greatly increased; the body was rigid; the jaws were stiff; 

 opisthotonus, Kernig's sign, trismus, and photophobia were 

 present; and touching the patient produced tremors. Fifteen 

 cubic centimeters of very turbid, cerebrospinal fluid were 

 removed by lumbar puncture. The patient improved rapidly 

 after this operation. On the following day, the muscles were 

 slightly relaxed, and on the second day he was even less uncom- 

 fortable, and took milk and ice by mouth. The blood picture 

 at this time was as follows: 



Hemoglobin 95 per cent. 



Erythrocytes 4,400,000 



Leucocytes 21,000 



Polynuclears 74 per cent. 



Small lymphocytes 15.5 per cent. 



Large lymphocytes 6.0 per cent. 



Transitionals 1.0 per cent. 



Large mononuclears 2.0 per cent. 



Eosinophils 0.5 per cent. 



Mast cells 1.0 per cent. 



An urinalysis made on September 10 was as follows: yellow, 

 acid, cloudy; specific gravity, 1.018; a trace of albumin; no 

 sugar; ammonium urates in abundance; mucus; no pus and 

 no casts. The temperature gradually subsiding became normal 

 on September 11, the tenth day of the disease and the fourth 

 day after lumbar puncture. On September 12 an offensive 



