Vol. 60, 1909 - University of North Carolina at Chapel Hill

so THF. CHARLOTTE MEDICAL JOURNAL.
animals (horses, sheep, etc.) for the treat- encouraging. The mortality-, which withment
of streptococcus infections. But the out serum treatment varied from 50 to 85
results reported from the use of these serums per cent., has in a number of cases where
I'of which Maruiorek's is perliaps the best) the serum was used given a percentage of
have been very variable, and on the whole only 25 to .30. Holt considers that from
unsatisfactory. The protective power of being one of the diseases most to be dreadthe
serum is undoubtedly specific, but it ed, both on account of its high mortality
soon loses this power and often is practi- and its sequelae, often worse than death, it
cally useless six weeks after its preparation, seems probable that cerebro-spinal menin-
The same serum, moreover, does not confer gitis may become, like diphtheria, one most
immunity, apparently, to any other variety certainly controlled by preventive treatment,
of streptococcus than the one fiom which it The injections are administered by lumbar
was derived. This is a great hindrance to puncture, and the diagnosis is confirmed by
its u.se, for in cases where we want most to bacteriological examination of the fluid obuse
the serum, such as puerperal fever, tained from the spinal canal. This operasepticaemia,
ulcerative endocarditis, etc,, tion is easily performed and is attended
it is often difBcult to make a bacteriological with comparatively little danger. The sediagnosis
from the symptoms, and in over rum itself also appears to be harmless,
one-half of the cases even the bacteriologi- Typhoid Fever.—This disease, peculiar to
cal examination, carried out in the most human beings, is caused by i5ar////cj- i'j'///().T«.f,
thorough manner, will fail to detect the discovered independently by Eberth and
special variety of streptococcus causing the Koch in 1880. The mode of its infection
infection. is principally by way of the mouth and
The almost total abolition of child- stomach to the intestines, through the inbed
fever from our maternity hospitals gestion of infected milk and water, and
and from private practice, has been more rarely by eating raw oysters and clams
one of the most remarkable triumphs of or food contaminated by flies ana other inpreventive
medicine. In many institutions sects, or possibly by the inhalation or informerly
the mortality after child-birth was gestion of infected dust.
5 or 6 per cent., and sometimes, indeed, as In this, as in all infectious diseases, indihigh
as 10 per cent. ; today, owing to proper vidual susceptibility plays an important
antiseptic precautions, the mortality has role in the production of infection. There
been reduced to ,3 or 4 per cent., or even must be some disturbance of digestion, exless.
The recognition of the contagious- cesses in drinking, etc., or a general weakness
of puerperal fever was the most brll- ening of the powers of resistance of the inliant
work, perhaps, of Dr. Oliver Wendell dividual, caused by poor food, exposure to
Holmes, in 1843, although Semmelweiss, bad hygienic influences, overcrowding, and
a few years later, further corroborated the the like, as with soldiers and prisoners, for
fact. But the full realization of the causes instance, to bring about the conditions
of this disease was not reached until anti- favorable for the production of typhoid
septic methods had been put into practical fever,
use. After recovery from typhoid fever a con-
Cerebro- Spinal Meningitis.—This fatal siderable degree of immunity is present
epidemic disease is now known to be caused which lasts for years. This is not absolute,
by the meningococcus or diplococcus intra- as about 2 per cent, have a second attack,
cellularis meningitidis, discovered by Weich- but this attack is usually a mild one. Speselbaum
in 1887. The prevalence of the cific immunization against experimental
disease in winter and spring, a time favor- typhoid infection has been produced in
able to influenza and pneumonia, also sug- animals by the usual method of injecting
gests for this the respiratory tract as the at first small quantities of the living or dead
probable mode of infection. It is not bacilli and gradually increasing the dose,
known as yet why meningitis follows in The blood serum of animals thus immutisome
persons and not in others, from infec- ized has been found to possess bactericidal
tion of the mucous membranes. The diplo- and feeble antitoxic properties. These
coccus is often associated with the pneumo- characteristics have also been observed in
coccus and streptococcus pyogenes in mixed the blood serum of persons who are convainfections.
lescent from typhoid fever. An attempt
An antitoxic serum, prepared by Flexner has been made to utilize the tvphoid serum
and Jobling from the blood serum of im- for the cure of the disease in man; but almunized
animals by injections derived from though a number of individual observers
many strains of the meningococcus, has (
Chantemesse, especiallv) have reported
been recently used in the treatment of the good results, most consider that little or no
disease. According to the latest reports, benefit is derived from its use.
the results obtained would seem to be most The employment of vaccines from killed