154 CLINICAL BACTERIOLOGY AND HEMATOLOGY 



of poisoning. In uraemia there is often the additional advantage 

 of its aflfording a relief to some of the symptoms. Further details 

 are outside the scope of this work.] 



{d) Bacteriological . — The chief organisms which cause acute 

 meningitis are given in the following table, which is modified 

 from one given by Osier : 



Primary {i.e., not dependent on an obvious lesion elsewhere in the body). 



1. Cerebro-spinal fever — 



{a) Sporadic I „, . , ,, , ,. , 



(b) Enidemic f "'^•'^hselbauni s diplococcus, or meningococcus. 



2. Pneumococcic — 



{a) Pneumococcic infection of meninges alone, notde-' 

 pendent on disease of distant parts of the body, 



(b) Pneumococcic infection of meninges occurring as |.Pneumococcus. 



part of a general septicasmia without obvious 

 primary lesion. 



Secondary. 



A. To direct extension from local disease of the cranium, middle ear, fossae, 



spinal column, etc. 

 Pneumococcus. 

 Staphylococci. 

 Streptococci, etc. 



B. To septicasmic infection due to disease in a distant part of the body. 



(a) Pneumococcic — 



Secondary to pneumonia, endocarditis, etc. 

 Pneumococcus. 



(6) Pyogenic — 



Secondary to abscesses, etc., and occurring as a part of a general 

 infection. 



Staphylococci. 

 Streptococci, etc. 



(c) Gonorrhoeal — 



Secondary to gonorrhoea. 

 Gonococcus (rare). 



(d) Tuberculous^ — 



Secondary to tuberculosis of other regions. 

 Tubercle bacillus. 



(e) Miscellaneous — 



Secondary to typhoid fever. 



Typhoid bacillus (rare). 

 Secondary to influenza. 



Influenza bacillus (rare). 

 Secondary to anthrax, etc. 



Anthrax bacillus, etc. (rare). 



