HISTORY OF THE ORGANISM 



1479 



delicate, reminding one of D. crassus. Does not attack grape-sugar, levulose, 

 and maltose. 



He also considered the possibility of the spread of the disease by insects, 

 by dwellings, and by clothing, food, and water, and concluded that none of 

 these were effective agents in the propagation of the disease. 



In 1909 there appeared a most important work by Elser and Huntoon in 

 which they described most carefully the cultural, biochemical, and serum 

 reactions of the meningococcus and its allies, as well as its viability, and 

 especially its selective affinity for the cerebro-spinal fluid, a point little con- 

 sidered by the majority of investigators. They also considered the subject 

 of mixed infections, which was dealt with by Specht in the following year. 



In the same year Dopter described his Parameningococcus^ which was not 

 agglutinated by meningococcus serum (a fact confirmed by Gordon and Murray 

 in 191 5), but showed complement-fixation. Two years later he described 

 seven cases of cerebro-spinal meningitis as being due to this organism, and 

 in 1 91 4 used Castellani's saturation test to differentiate it from the meningo- 

 coccus. 



The, agglutination reactions of the meningococcus are unsatisfactory, as 

 may be gathered by a study of Elser and Huntoon's careful work, as well as 

 by the discordant results obtained by numerous observers. In 19 15 Hime 

 instituted a rapid method of preparation of a high-titre agglutinating serum 

 in rabbits, and Gordon and Murray investigated genuine strains of meningo- 

 cocci obtained from the cerebro-spinal fluid of cases, and found that by agglu- 

 tination tests and by Castellani's absorption method they could split up 

 thirty-two strains into the following groups: — 



(I.) With serum from No. i, 19 strains. 



(II.) With serum from No. 20, 8 strains. 



(III.) With serum from No. 28, 4 strains. 



(IV.) With serum from No. 32, i strain. 



They also distinguished by these sera Dopter's parameningococcus from all 

 the other groups, and they noted that one strain absorbed the specific agglu- 

 tinins from two groups; while out of ten carriers one belonged to Group (I.) 

 and five to Group (II.), while the others were not classified. 



In the same year Crowe attempted to meet the difficulties met with in the 

 agglutination tests by devising a simpler method. 



We have now given a rough sketch of the history of Weichselbaum's 

 organism, and we might well pause, as Crowe has done, and ask where do we 

 stand as regards its recognition. 



It is admitted on all sides that there is a close resemblance between the 

 gonococcus and the meningococcus, except as regards the human diseases 

 which they produce, and, indeed, many years ago it was suggested that the latter 

 might be the former adapted to the cerebro-spinal nervous system and the 

 naso-pharynx, but to-day it is admitted on all sides that they are separate, 

 mainly because of an experiment in which the meningococcus was found not 

 to cause gonorrhoea when injected into the human urethra. 



As regards the meningococcus, we can aptly quote Crowe, who, writing in 

 191 5, says: — 



' The present state of our knowledge so far as it bears on the carrier may 

 be summed up : — 



' No Gram-negative organism isolated from the naso-pharynx can be proved 

 to be a meningococcus. 



No Gram-negative organism which resembles even faintly a meningo- 

 coccus can be regarded with certainty as incapable of producing meningitis.' 



Hence we have not improved our position since the days of the meningo- 

 coccal controversy, but are actually in a position of greater uncertainty as to 

 the differentiation of Weichselbaum's Diplococcus intracellularis, and, this 

 being so, we will now briefly review our position as to the causal relationship 

 between this organism and epidemic cerebro-spinal meningitis. 



Indeed, this is exceedingly necessary at the present time, because, firstly, a 



