Keniig's sign present. Tjinnbar piinctnio the same day and 20 c.c. ot anti-meningococcal serum injected intraspinally.
Fluid turbid. Very somnolent. Became comatose that evening, and died December 19th, 1915. (7rt.sc Q. — Admitted 28rd February, 191(5, from Kichmond. Headache, slight head rigidity, slight Brudzinski, slight Kernig, rational.
Temperature 100% pupils dilated, vomiting, lumbar puncture at Kichmond on 22nd February, 1916.
Lumbar puncture repeated on 24th, 25th and 20th, followed on each of these occasions by administration intrathecally of 30 c.c. of anti- meningococcal serum (Lister).
From the 26th there was steady improvement, and he was discharged to convalescent home on 10th April, 1916.
Case 3. — Admitted to Richmond Military Hospital, 12th March, igi6_on admission, temperature was 1026^ F. — complaining of intense headache with pains in all his limbs. Kernig's sign present. Only came up from Salisbury yesterday ; began to feel unwell the same evening.
Was placed in the isolation ward ; in a short time became quite maniacal, so much so that it was difficult to restrain him. He had the peculiar cry which I have mentioned before as ushering in the delirium.
The delirium merged into coma, and he succumbed at 2.10 p.m. the same day.
He was lumbar punctured at 1.15 p.m., and 80 c.c. anti-meningococcal serum was injected intraspinally.
Case 4. — Admitted from Wimbledon on 30th March, 1916. Pains all over, severe headache, head rigidity, Kernig's sign, photophobia. Temperature 100°.
Lumbar puncture with administration of Lister serum on 80th and 81st March and April 1st.
On April 1st. Vomiting, semi-conscious, incontinent.
On April 3rd. Great improvement, disappearance of all meningitic signs. May 8rd. Perfectly well, except that postnasal swab still positive ; meningococci present.
