Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 9 (7).djvu/18

 turbid, and shewed microscopically many gram-negative cocci extra- and intra-cellularly. An abundant growth was obtained, and the organism was proved by agglutination to be a Type IV. meningococcus. In all, twenty-nine contacts were examined. These consisted of nineteen men who had slept in the same hut at Roehampton for one night only ; the X.C.O. in charge of the hut; five men who had travelled in the same railway carriages as the [)atient, either from Larkhill to Waterloo or from Waterloo to Barnes ; one man who had slept in same hut at Larkhill; and three orderlies from Richmond Military Hospital. Three shewed suspicious cocci, which were submitted to the agglutination test. Two were positive, but only one of the same type as the case, and it is inter- esting to note that the one true contact was the man who slept in the same hut at Ijarkhill Camp. The other positive contact must be looked upon as an accidentally found carrier. See Table II. for results.

Case 4. — Pte. Y., E Regt., was admitted into Richmond Military Hospital on ^NFarch HOth, 1016, and was transferred to Fulham Military Hospital on the same day. He had spent the ])revious seven days in detention, and before that was on leave, and had slept for one night only in hut 44 at Wimbledon. He complained of intense headache and stiffness of the neck, and of pains practically all over the body more like those of acute rheumatism. His temperature was 102'' F., and he also vomited at times. Lumbar ]iuncture was performed and a clear fluid drawn off, which shewed, on examining the centrifugalised deposit, no cocci and few cells; and, in spite of many subsequent endeavours, it has been found impossible, to grow it — no organism could be grown. From his naso- pharynx, however, a suspicious organism was isolated, and proved, after agglutination, to be a meningococcus of Type II. The man was, therefore, regarded as a case; this is confirmed by the marked response to serum treatment. Twenty-three contacts were examined; of these, three shewed suspicious gram-negative cocci, which were raised for agglutination. One proved to be positive and of the same type, as the case.

Clinical Notes.

Case 1. — Admitted Richmond Military Hospital, 18th December, 1915, complaining of severe headache; vomiting. Temperature on admission, 1026 ;, pulse only 68.