CHAPTER VII 



CEREBRO -SPINAL MENINGITIS 



DiPLOcoccus Intracellularis Meningitidis 

 (Weichselbaum) 



Synonyms. — Meningococcus; Micrococcus meningitidis. 



General Characteristics. — A minute non-motile, non-flagellate, non-sporog- 

 enous, non-chromogenic, non-liquefying, aerobic, pathogenic coccus, staining 

 by ordinary methods, but not by Gram's method. 



Acute cerebro-spinal meningitis may be secondary to various 

 more or less well-localized infections when it depends upon such 

 micro-organisms as may be carried by accident to the meninges. 

 Among these may be mentioned pneumococci, staphylococci, strep- 

 tococci. Bacillus influenzae, B. typhosus, B. coli, B. mallei, B. pestis 

 and others. 



In addition to these, however, are numerous cases of seemingly 

 primary infection of the membranes, either sporadic or epidemic in 

 occurrence and constituting the disease known as cerebro-spinal 

 fever, epidemic cerebro-spinal meningitis, or " spotted fever." It is a 

 very dangerous febrile malady, characterized by sudden onset, high 

 temperature, an irregular exanthem, early meningitis with or without 

 coma, and a high mortality. The disease is transmissible, though 

 but slightly contagious, and is caused by the meningococcus, or 

 Diplococcus intracellularis meningitidis. This micro-organism seems 

 to have been first seen and described by Marchiafava and CelU* 

 and by Leichtenstern.f It was, however, confused with the pneu- 

 mococcus and not much attention was paid to it until WeichselbaumJ 

 reported that he had found it, isolated it and cultivated it from six 

 cases of epidemic cerebro-spinal meningitis. 



Later careful studies by Jager,§ Scherer,||- Councilman, and Mal- 

 lory and Wright** (embracing 55 cases, in which the cocci were 

 found by culture or by microscopic examination in 38), and of Flat- 

 ten,tt Schneider,tt Rieger,tt Schmidt,tt Goppert,tt Flugge,tt von 

 Lingelsheim,tt Besredka,tt Flexner§§ and others have shown the 



* " Gaz. degli Ospedali," 1884, vm. 



t "Deutsche med. Wochenschrift," 1885. 



X "Fortschritte der Med.," 1887, No. 18 and 19. 



§ "Zeitschrift fiir Hygiene," xrx, 2, 351. 



II "Centralbl. f. Bakt. u. Parasitenk.," 1895, xvii, 13 and 14. 

 ** "Amer. Jour. Med. Sci.," March, 1898, vol. cxv. No. 5. 

 tt " Klinisches Jahrbuch," 1906. 

 it "Annales de rinst. Pasteur," 1906, XX, 4. 

 §§ "Jour. Exp. Med.," 1906-07. 



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