EPIDEMIC CEHEBKO-SPINAL MENINGITIS 75 



gococcus, a small coccus, occurring in pairs, which is 

 sometimes difficult to cultivate in artificial media. 



The disease is most common in children and young 

 adults, seldom appearing after thirty-five years of age. 



The death rate is very high, averaging 70 per cent, 

 but meningitis due to other bacteria is fatal in nearly 

 all cases. 



The portal of entry and mode of dissemination in 

 epidemic cerebrospinal meningitis are still doubtful 

 subjects. It is thought that the nasal cavity and the 

 middle ear are the avenues of entrance. 



The fact that the meningococcus has a very slight 

 resistance to drying would seem to indicate that 

 .the disease is spread by germ carriers, whether 

 convalescents, actual patients, or healthy persons. 

 Contact with fresh infective material, as might oc- 

 cur upon handkerchiefs, towels, dishes, thermom- 

 eters, bedding or hands, is also an avenue for the 

 spread of infection. 



An anti-meningitis serum obtained by the immu- 

 nization of horses has been used with very good 

 results. In one epidemic of meningitis the Flexner- 

 Jobling serum was used in forty-seven cases, with 

 thirty-four recoveries and thirteen deaths, a very 

 marked decrease in the average death rate of 70 per 

 cent. 



