Abstract
Cerebro-spinal Fever is a specific infectious disease. •
The causative organism is the Diplococcus Intracellularis
of Tiech.salbaum, con :only known as the Meningococcus. •
This organism. is carried .in the throats of apparently
health- persons, who are known as "Carriers." •
An epidemic of Cerebro-spinal Fever is really an epidemic
of meningococcal "carriers ", with sporadic cases of the disease. •
The original site of the organism? in the body is the
posterior nasopharynx. From this local seat of infection
the meningococcus spreads, via the blood stream, to the
leptomeninges of the brain and cord. •
Infection of the meninges may not necessarily result from
infection by the meningococcus. In about 2 of cases the
initial septicaemia is so severe that the patient succumbs
before the lesions of the meninges have time to develop.
In these, the characteristic lesion is found to consist in
haemorrhagicinflammation of the adrenal glands, associated
with purpura. To combat the great fall in blood pressure
which results, intravenous or intramuscular injection of
adrenaline is useful, in order to restore the tone of the
peripheral circulation. •
The signs and symptoms of Cerebra-spinal Fever are due
to the combination of several factors, which are all present
to a varying degree in every case of the disease.
1. The general toxaemia, which is common to all infectious
diseases
2. The lesions of the Central Nervous System, and its
covering membranes.
3. The presence of certain products of degeneration of the
myelin of the nerve fibres, namely cholin and neurin. •
All these factors are present in any one case, the
varying pictures produced. depending on which. predominates. •
Cases of Cerebro-spinal Fever may be classified into
the following types : -
1. Fulminating Type.
2. Ordinary Acute Type.
3. Suppurative Type.
4. Abortive Cases.
5. Mild Cases.
6. Posterior Basic Meningitis. •
These types can. be distinguished. both Clinically and
Pathologically. •
Death may be due to either the severity of the infection
or to the establishment of Internal Hydrocephalus. •
Treatment with specific antisera holds out more hope
of success than any other line of treatment. •
Since the institution of this means of treatment, the
mortality rate of Cerebro-spinal Fever has fallen from
70%-90% to 30%-40%. The proportion of patients who
suffer from permanent and disabling complications has been
reduced by an even more remarkable extent.
