The Birmingham age-herald., 1914-08-30
City Physician Writes of Malady Peculiar to Chil- dren, One Considered With Dread by All

No children's disease probably holds greater terror for parents than the dead ly malady known as cerebro-meningiti commonly called meningitis This is the subject treated by Dr. R. M Cunning ham, city health officer, in his health bulletin No. 14 issued yesterday. It is az follows:
 The word "meningitis' is familiar to most people. The meninges are the mem- branes that line the interior of the skull and canal in the back bone, and form a covering for the brain and spinal cord
 the narrow. Meningitis Is inflamma- tion of one or all of these membranes From the standpoint of causation, there are many varieties. Thus. the tubercle bacillus, the plague bacillus, the typhoid bacillus, the pneumococcus, the pus form ing cocci etc, may produce meningitis. It is not an infrequent complication of
 injury to the skull and spine through in- lection, and also results from disease of the bone behind the ear, of the nose, the throat, nasal cavities and erysipelas of the scalp. It may occur as com plication of many infectious diseases, the germs of these diseases being conveyed to the meninges through the blood yes sells or lymph channels Meningitis may be local or general; and duration acute. subacute or chronic. The products of the inflammation are serum, lymph. pus, etc.
 It destroys life by involvment of those brain centers that preside over the vital functions. It may cause paralysis of the motor, sensory or special sense nerves. Thus general or local paralysis, blindness, deafness, etc., may follow One of the Varieties
 Cerebro-spinal meningitis, the subject of this bulletin, is one of the varieties of meningitis. It differs in many re- spects from the other varieties. In the first place it is caused by definite, specific germ, the menIngococcus. These cocci are found as a rule in pairs, hence 1t is called a diplococcus. It is. generally speaking, found in the white blood cells that are in the cerebro- spinal fluid. Hence it's full name is diplococcus intracelularis meningitidis. It is also locally epidemic and is mildly contagious. 1t occurs, how | evep sporadically that is a case at l time, no other cases following. Tn this sense 1t is endemic in most all cities. It never becomes large epidemic. Where | it prevails epidemically, there are only a small percentage of the population at tackled, and is never national or world wide. It prevails mostly in fall and win ter. Children and young adults are most liable to be attacked. The other varieties of meningitis are never epidemic, pre- vail at all seasons, attack all ages, and are not contagious. Cerebro- spinal menin- gitis is always primary disease. depend ing ifs ha | others, as a rule, are secondary to and complications of many diseases, whose germ produces the meningitis also Rare- ly these germs may produce meningitis alone-for example the pneumococcus. The meningococcus is very frail germ and soon dies under ordinary conditions of nature. It may live, however, indefi- nitely in its carriers.
 Made of Transmission
 It is believed that the germs are dis charged from the body in the nose and throat secretions and that these find l lodgment in the nose and throat and reach the brain through the blood ves- sels or lymph channels. Hence the dis case is contagious Fortunately how ever, only a few who get the infection | in the nose and throat develop the dis ease. Unfortunately, however, while es- caping the disease. they harbor and re- | tdiis tnt Sciiis anu luuS DtCOIHe cdI- | riers of the disease. "The number of persons who become such carriers dur l ing an epidemic of meningitis is far l gi eater than the number of cases of actual meningitis. Perhaps 70 per cent of healthy persons exposed may harbor meningococci in the respiratory pas | saGes. ."-Rosenau. This does not obtain except during epidemics. At other times about 2 per cent are carriers. It fol- | lows, therefore, that many more per sons contract the disease from carriers than from patients with the disease. It seems then that some personal predis- position is necessary for the full de- velopment of the disease as such a large per cent of those coming in con- tact with the disease get infected no further than the nose and thoat (naso- pharynx).
 Early Diagnosis
 l This Is extremely important, not only from the standpoint of prevention. but also from treatment. All the varieties of meningitis have symptoms and signs more or less alike. While a diagnosis Of meningitis is usually easy, the differ entiation of the variety is difficult. if
 not impossible, by the symptoms and signs. There is method, however
 which. in the majority of cases. not