324 Hermann Michael Biggs 



1. Purulent or sero-purulent meningitis is always microbic 

 in origin. 



2. Many cases of cerebro-spinal meningitis do not differ 

 from cerebral meningitis except in the extent of pia affected. 

 The etiological factor may be the same. 



3. Cerebro-spinal meningitis is usually primary. 



4. Cerebral meningitis is usually secondary to some in- 

 fectious disease, and is only occasionally primary. 



5. When the disease is secondary the cause of the secondary 

 infection may be a different organism from that producing the 

 primary disease. 



6. The following organisms have been previously found in 

 the pial exudate in cerebral meningitis : 



a. The/>«^M;;«i?-i5a«7/«5 of Fraenkel. 



b. The Sti-eptococcus pyoge7ies. 



c. T\y& Bacilltis Typhosus oi Eberth. 



d. Th^ Staphylococcus pyogenes. 



e. The Pneumo-bacillus of Friedlander. 



f. The Bacillus of '"La Grippe.'' 



g. The Gonococcus. 



My observations add two more organisms : 

 i . The Bacillus anthracis. 

 j . The Bacillus coli comtnutiis. 



7. The pneumo-bacillus of Fraenkel is the most frequent 

 cause of cerebral meningitis. 



8. The latter organism is a not infrequent cause of primary 

 cerebral and cerebro-spinal meningitis, the lungs not being 

 involved. 



9. The cases of meningitis due to different organisms do not 

 show such constant differences from each other in the symp- 

 toms presented as to make possible the clinical differentiation 

 as to cause. 



10. The amount of the exudation bears no constant relation 

 to the severity of the symptoms. 



11. It is not possible to distinguish with certainty during 

 life, cases of acute cerebral hyperaemia with or without oedema 

 from cases of meningitis. 



5 West 58th St., 



New York City, 



Aug. II, 1893. 



