The Washington times., 1917-02-15
BRITISH ARECURING
SPINAL MENINGITIS
Army Surgeons Develop Serum
for Each OF Four Types
of Disease.
CARRIERS ARE DISCOVERED
Rapid Handling and Quick
Diagnosis Essential to Sue
cessfuI Treatment.

LONDON. Feb. 15.-One of the most
remarkable stories of the war, and es-
pecially interesting to. Americans in
view of last summers epidemic OF in
fantile paralysis, is the fight against
cerebro spinal meningitis which the
British army is making, with large
measure of success.
The fact was discovered that four
types of this dread spotted fever"
germ existed, and that each type must
betreated with particular serum. The
story of the attack then made on the
disease in home camps is told in re-
port just published by the medical re-
search committee 1t was feared
enormous toll would be taken, and at
once a base laboratory was equipped
by the royal army medical corps, and
thirty-seven district laboratories start
ed. An especially equipped travelling
laboratory was also put into commits
sion and special tests Of suspected
cases were begun.
II was discovered by so-called aE-
Glutination tests that the four types
of menigococci existed Until this
time the weapons to fight them had
consisted of a serum intended to de-
feat only one type. The reason for
2 the comparative failure of this serum
and the high mortality from this dis
ease began to be apparent.
Steps then were taken to identify
type .. type 3 and type of the men,
ingococcus. AS soon as defined speci-
mems of each type were procured they
-l,l rK-1a a
, anti-meningococcus serum. The sue
cess of the specific serum, however,
is dependent in no small degree on
early administration, which implies
early diagnosis.
Germ Found In Nose.
Investigation of the types went on
apace, and in each case the germ was
found not only in the fluid surround
ing the brain but in the nose of the
patient 1t was accepted that the dis
case began when the germ was able to
pass from the nose to the brain. The
question then arose, Can il be said
that if a patient has type 1 in his
nose he has type in his brain?"
Again. since the infection is direct
from patient TO patient. does the infec-
ton follow type /? Does the carrier
Of type l spread type l only?
Definite Conclusions Had.
1t was soon proved that:
The first case of cerebro spinal fever
yields only a single type Of menin-
gococcus from the cerebro spinal fluid:
that is, the case is always strictly of
one type or another.
The type found in the nose is al
ways the same type as in the brain.
Because the germ is always present
In the nose at the beginning Of the at
tack, in every case the disease is an
instance of the carrier becoming the
victim Of his own infection.
Finally, the type breeds true in
every case. The types are not inter
changeable, they are separate breeds,
as separate as white men, black men
yellow men.
On the heels of this knowledge
came the weapons forged to destroy
the meningococcus. First, there was
rapid administrative handling. When
ever a case was diagnosed the details
were ascertained at once: by tele-
phone if the case was in the London
area. Then the serum was admin
istered.
An example is furnished by an out
break which occurred in a large gar
rison in the spring of 1916. Captain
Armstrong examined a large section
of the whole garrison, in all 10000
men, the vast majority of whom had
not been in contact with the cases.
As a result provisional isolation was
made OF 40 men, of whom soon after
eighty-siX became. free OF organisms
All the remaining 324 had menin-
gococcuslike organisms. OF these POI
actually carried the specific menin-
EOcoccus. In no case did a man who
was found negative either develop
the disease or transmit it.
Carried Disease to Family.
Showing how the disease may be
transmitted the case OF Sapper B
may be cited. He came back from
France in April, 1916, complaining of
headache and pains in his back and
legs. Two days later one of his chill
dren was taken ill and removed with
symptoms of the disease. The next day
another child was removed to an iso-
lation hospital. where it died The
father was found to be carrier of
type . His sister was sent TO bring
home the first child, now recovered.
from the hospital, and the latter died
in twenty-fOUr hours. This child also
harbOred type 2
out Of thirty-three military cases
treated in the London district alone
last season with serum prepared under
the new method only three died. The
result is a marked contrast TO the 40 to
20 per cent mortality usually found be-
fore this serum was available
The treatment OF carriers is difficult.
but it has been found that inhalation
chambers charged with chloramine
yapor worn well in most cases Carriers
can thus be freed Of meningOcocci in a
short period. This treatment also
seems to benefit victims OF post-nasal
catarrh.
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