A Contribution to the Study of Epidemic Cerebro-Spinal Meningitis.

The following observations are based on one hundred and thirty cases of epidemic cerebro-spinal meningitis, which occurred in New York and Hudson-Street Hospitals, between January, 1903, and April, 1905. In one hundred and nine cases Diplococcus intracellularis meningitidis of Weichselbaum was found in cultures or in cover-slip examinations of the spinal fluid. In sixteen (I6) no microorganisms were found, either microscopically or culturally. In five (5) the bacteriological diagnosis was not established during life, but the diplococcus meningitidis was isolated in pure culture at the autopsy. Cultures were made from the spinal fluid during life in one hundred and five cases, with positive results in eighty-six. In seven of these the organism could not be demonstrated in cover-slip preparations, but was obtained in cultures. With the exception of three, the diplococcus meningitidis was obtained in cultures in all the cases in which it could be demonstrated in coverslip examinations. In quite a number of cases, several examinations had to be made before the organism was found in cover-slip preparations of the spinal fluid. Cultures also had to be repeated frequently in many instances before positive results were obtained. In one case the spinal fluid was examined four (4) times, both by cultures and microscopically, before a positive result was obtained (in cultures only). Of the sixteen negative cases recorded twelve (I2) were examined but once; four (4) were examined twice. It is