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96
Case 3.— H. T., age 18, residing at 30 Wickersley Road.
I was asked by the Medical Attendant, on the 6th September,
to see this case with him. The patient was by occupation a
plumber's mate. I formed the opinion that the patient was
probably suffering from cerebro-spinal fever, and advised his;
removal to hospital. He was removed the same day to St.
Thomas' Hospital. On the 4th October, in reply to my
inquiries, I was informed that the case was regarded as one,
of cerebro-spinal fever, as on several occasions pus has
been present in the cerebro-spinal fluid, and an intracellular
diplococcus has been seen, though no culture had been up to
then obtained.
These were the only cases in which the results of bacteriological
examination gave positive results, and in two of them
the results must be considered in the absence of evidence of
cultivation inconclusive. With regard to the other cases,
although the clinical evidence pointed to the disease being:
suspiciously like cerebro-spinal fever, in some of these in
which a bacteriological examination was carried out, the
organism form was either the tubercle bacillus or the pneumococcus.
There can be little doubt that Case No. 2 was a
sporadic case of epidemic cerebro-spinal fever, as both the
bacteriological and post-mortem examinations confirmed the
clinical evidence of the disease.
A very considerable amount of research has taken place
into the occurrence of cerebro-spinal fever since the recent
epidemics in Belfast and Glasgow, which it is to be hoped
will result in increasing our knowledge of the exact nature of
the disease, more especially as regards its spread, and its
differential diagnosis from other forms of cerebro-spinal
meningitis, which clinically resemble it. That the disease
can occur in a dangerous epidemic form (e.g., the mortality
in the Glasgow outbreak was 72.1 per cent.) the experience
of these two large cities sufficiently testifies, and the publication
of the facts associated with the outbreaks will be awaited with
interest.