Report on epidemic cerebro-spinal meningitis in India / by C.J. Robertson-Milne.

  • Robertson-Milne, C.J.
Date:
1906
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Licence: In copyright

Credit: Report on epidemic cerebro-spinal meningitis in India / by C.J. Robertson-Milne. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    I ( 15 ) commonly known as Cerebro-Spinal Fever and this is its appellation in the Nomenclature of diseases. This name has been objected to by Dr. Rutter Williamson (1) on the ground that cases exhibiting no pyrexia whatsoever have been observed and in his clinical study of the disease he cited two such instances from his own practice. These cases are unusual and anomalous. Cerebro-spinal fever is a good name for the disease. The -Germans have called the disease Nackenstarre or Genickkrampf. The former, which denotes a muscular cramp of the neck, is a good name from a popular point of view in that it emphasises a constant and painful • symptom : it is thus comparable to our name lock-jaw for tetanus Definition.—Epidemic Cerebro-Spinal Meningitis is an acute infec- tious disease associated most frequently with the presence of a particular microorganism, the diplococcus intracellularis, first identified by Weich- .selbaum in 1887. It is characterised by symptoms referable to a profound inflammatory infection of the central nervous system; there is generally pyrexia of an irregular type \ cutaneous eruptions of a petechial or herpetic form are not infrequently present, while extensions of the disease to the ear and the eye leading to disorganisation of these ■ organs are common complications. The disease is known to prevail sporadically as well as epidemically. The sporadic attacks are of great importance, as they doubt- less form the links between successive epidemics ; clinically they are apt to be overlooked, and confusion as to their exact nature will continue to exist until a complete bacteriological diagnosis of the exudate to be obtained by lumbar puncture becomes a matter of routine procedure. It seems very probable that the disease known as posterior basic meningitis in infants is but a sporadic form of the disease, for the organism isolated by Still (2) is almost identical in its biological characters with those of the diplococcus intracellularis. Mtiology.—Predisposing factors. Age.—Most of the recorded cases have occurred in children and young adults. Moore,(4) Williamson,(5) and Brown (6) have noted the disease among* children in India. It is a rare affection of persons over the age of forty, as is indicated in the following table:— Table V. . Age incidence of Cerebro-Spinal Fever. Authority. Under 40. Over 4a Percentage under 40, Councilman (7) 104 7 93% Lcichtenstern (8) 100 11 90°/o Indian Jails 83 28 74-7 °/0 Councilman states that infants under one year, although very liable
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