widely spread, striking at once a great many
persons who in no possible way could have come
in contact with each other. This is like the la
grippe epidemics, showing that avoidance of
those who are ill with the disease will not at all
prevent an attack of it.
In a very few instances in this two year epi-
demic of cerebrospinal meningitis, in Connecticut
and Vibramycin 50mg elsewhere, have cases of apparently direct
communicability been reported, and, as already
stated, no more frequently than will occur in ty-
phoid fever and pneumonia. The report of the
Children's Hospital, in Boston, of the admission
of no patients with this disease in eight years,
all treated in open wards, without a single case
originating in the hospital is to me absolutely
positive proof of its noninfectiousness. In all of
the above hospital cases the diplococcus intra-
cellularis was found, and the only precaution against
contagion was ordinary careful cleanliness of the
patient and the nurse's hands.
We have heard discussed the aetiology of Vibramycin Suspension the
disease. I will only refer to some recent Vibramycin Mg investi-
gations under the auspices of the German gov-
ernment. Twenty-nine autopsies on patients dead
of this disease were carefully made, twenty-two
were children under ten years of age, and seven
were adults. This report shows that the infec-
tion started in the pharyngeal tonsil, entered Order Vibramycin Online the
cranium through the Vibramycin Tablets sphenoid bone, travelling
along the vessels which run from the pharynx
into the sella turcica through the Vibramycin Indications sphenoid fora-
mina. The part of the brain first affected was the
hypophysis, or pituitary body. There was no
evidence in these twentj-nine autopsies of the
infection passing through the cribriform plate of
the ethmoid, and the infection seemed to travel by
l_ymph channels rather than by blood channels.
The bacteriological studies in these investiga-
tions show that the Vibramycin Syrup Vibramycin Hyclate meningococcus •(vas not nec-
essarily the only germ to produce the disease, and
the investigators state that " the real cause seems
to be as unknown as that Buy Vibramycin Online of scarlet fever." In
a recent bacteriological report in New York of
150 cases the pneumococcus Purchase Vibramycin Online infection of the brain
was found to be of much worse prognosis than
the meningococcus infection.
To briefly refer to the pathology of the dis- Vibramycin Doxycycline Hyclate
ease that is of interest to the clinician, it may
CoPYiiiGiiT, 1906, BY A. R. Elliott Pobhshino Co.
OSBORNE: CEREBROSPINAL MENINGITIS.
fitst be noted that during an acute Vibramycin For Acne attack the only
organs of the system involved are the brain and
spinal cord. All grades of Vibramycin Cost Vibramycin Antibiotic congestion, inflamma-
tion, Vibramycin Antibiotics and pus formation can occur on the surface
of these organs, and I am convinced that many
cases abort with only the primary first conges-
tion. The first symptoms will denote the part of
the brain or spinal cord first congested, and the
symptoms will of course denote the amount of
pressure exerted by the exudation. In my per-
sonal experience last winter Order Vibramycin there were many
more cases of spinal irritation and congestion
than of cerebral inflammation.
In typical advanced cases the brain is covered
by a thin, yellowish pus which lies over the pia
mater, and little petechial hemorrhages may be
found on the surface of the brain. Vibramycin Acne The rapidity
with which this exudate may form and cause pres-
sure symptoms is unfortunately known to us all.
This fulminating variety of cerebrospinal fever Generic Vibramycin
was, fortunately, in the last two years, in Con-
necticut, not very frequent.
The pus formation and even the simple exu- Buy Cheap Vibramycin
date may not be equally distributed ; one portion
of the exudate may be clear, and in another part
of the brain there may be pus deposits. The ven-
tricles of course are generally filled with exudate.
Although primarily the inflammation is limited
to the cerebrospinal system, there is no disease
that can have as many complications and sequelae
as cerebrospinal meningitis. Besides deafness,
blindness, neuritis, and paralysis, we may have
pneumonia, pleurisy, endocarditis, pericarditis,
nephritis, and arthritis. This disease is not a sep-
tica:mic process, and I believe we rarely or never
have metastic abscesses. Neither do the lymph
glands nor the spleen ordinarily enlarge.
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