Nervous and mental diseases / by Archibald Church and Frederick Peterson. With 338 illustrations.

  • Church, Archibald, 1861-1952
Date:
1903
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Licence: Public Domain Mark

Credit: Nervous and mental diseases / by Archibald Church and Frederick Peterson. With 338 illustrations. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    exact infection path is often problematical. Ortman pointed out the presence of coryza in a large proportion of the cases, and supposed that the infection reached the pial space through the lymph-channels of the nasal vault, which are continuous with those of the brain. In the epidemic form Scherer ^ again calls attention to the severe nasal catarrh at the commencement of the attack. Weigerts in eighteen cases found purulent nasal catarrh, and demonstrated Weichselbaum's diplococcus intracellularis meningitidis in the secretions. In fifty per- sons not sufFering from the disease he found this diplococcus in two in- stances and supposes that it is inhaled, taken up by the leukocytes, and by them carried into the lymph-spaces of the brain through the nasal vault. Flexner and Barker 2 emphasize the probability of the infection atrium being in the intestinal tract. The close relation of pneumonia to meningitis has for a long time pointed to the lungs as an invasion route. As a clinical fact, any infection at any near or remote point may induce meningeal inflammation by way of the vascular system. Bacteriologically, a case of acute meningitis may present one or many organisms. Those most frequently found alone are Weichselbaum's diplococcus, the pneumococcus, the streptococcus, the typhoid bacillus,^ and the bacillus coli. In association with them, and perhaps often as a secondary infection, are found the staphylococcus aureus and albus and various indeterminate streptococci and bacilli. The most common of all and the most significant are the pneumococcus and the diplococcus intra- cellularis. These microorganisms are found in the meningeal fluid, but may, as in a general pneumococcic infection, be widely distributed throughout the body. Lately the diplococcus of Weichselbaum has been demonstrated in the pus of arthritis, occurring in a case of menin- gitis, and also in the blood.^ Osier, in the Cavendish lectures for 1899, made the following practical classification : 1. Of cerebrospiual f (a) Sporadic. I Diplococcus intracellu- fever. 1 (6) Epidemic. J larls. I 2. Pneumococcic. \ -^leni.iges alone involved or in a general 1 pneumococcus. ^. i.. J. uouii.v/v,uv,^iv. -j^ pneumococcus infection. j 1. Tuberculous Bacillus tuberculosis. {(a) Secondary to pneumonia, endocardi- ~] tis, etc. .J. ■ . r y Pnenmococcus. {b) Secondary to disease or injury of cranium or its fossa. J I (a) Following local disease of cranium -l various forms of sta- 3. Pyogenic. j or a local infection elsewhere. I phviococci and strep- ■'^ I (6) Terminal infection m various f fococci L eliroiiic maladies. J r T i 1 • 1 ^ -a J- i,ii, ■ 1 Typhoid hacillns, influ- 4. Miscellaneous J ^ ^■^P'^^'^ fever influenza diphtheria, ^V bacillus, diph- acute infections. | frottcrdiSses^^^^'^' / ^jf^, ^etc^'^' ^^^ It will have been noticed that leptomeningitis is found in fre- quent association with the other infectious diseases. Cnrschmann has noted it in small-pox and scarlatina, both with and without purulent otitis. It is not rare after typhoid. It is common with pneumonia. All pyemias, whatever their source, have their recorded cases. Acute 1 Centralbl. f. Bakt. u. Parasitenkunde, April, 1895. 2 Am. Jour. Med. Sei., Feb., 1894. 3 Daddi, Lo Sperimentale, July, 1894. Ohlmacher, Jour. Am. Med. Assn., Aug. 28, 1897. ■*Gynn, Phila. Med. Jour., vol. ii, No. 24. ^tJ OQ = »H g •s ^ o tl ^ >H 15 H g g- >, b c3 H 1- ►J H H ■Xi D O < ~
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