RESPONSE OF PFEIFFER'S BACILLUS MENINGITIS TO SULPHAPYRIDINE

556

" XBD=2389 XBD=2501XHG=825 XBD=110 XBD=249 XBD=448 XBD=546 XBD=793 XBD=869 XBD=1007 XBD=1267 XBD=1571 XBD=1745 XBD=1990 XBD=2095 XBD=2187 XBD=2297 XHG=68 XHG=142 XHG=281 XHG=479 XHG=577 XHG=895YBD=227 XHG=1037 XHG=1334 XHG=1603 XHG=1778 XHG=2024 XHG=2125 XHG=2218 XHG=2332 XHG=2423 YBD=227 YBD=237 YBD=228 YBD=235 YBD=229 YBD=237 YBD=233 YBD=228 YBD=227 YBD=236 YHG=205>so YHG=196>there YHG=197>remains YHG=198>the YHG=198>possibility YHG=198>of YHG=198>using YHG=198>intrathecal YHG=202>temperature YHG=200>became YHG=200>subnormal, YHG=200>and YHG=199>she YHG=200>died YHG=202>ten YHG=200>days " XHG=1332 YBD=267 YHG=239>later. " XBD=1435 XBD=325 XHG=410 XBD=389 XBD=660 XBD=775 XBD=1145 XBD=1267 XHG=680 XHG=68 XHG=345 XHG=797 XHG=1159 YBD=273 YBD=267 YBD=275 YBD=268 YBD=275 YBD=267 YHG=236>complement YHG=237>in YHG=238>conjunction YHG=238>with YHG=237>chemotherapy. YHG=237>Com-

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XBD=1269 XBD=239 XBD=289 XBD=498 XBD=653 XBD=770 XBD=854 XBD=960 XBD=1056 XBD=1106 XHG=68 XHG=256 XHG=307 XHG=515 XHG=670 XHG=787 XHG=978 XHG=1073 XHG=1125 YBD=312 YBD=314 YBD=308 YBD=307 YBD=306 YBD=305 YBD=305 YBD=307 YBD=313 YHG=274>plement YHG=277>is YHG=277>normally YHG=277>absent YHG=277>from YHG=277>the YHG=276>CSF YHG=276>and YHG=277>is YHG=277>always XBD=1472XHG=873 XBD=1607 XBD=1702 XBD=1806 XBD=1840 XBD=1965 XBD=2052 XBD=2241 XBD=2336 XBD=2369 XBD=2499 XHG=1379 XHG=1498 XHG=1620 XHG=1718 XHG=1821 XHG=1854 XHG=1980 XHG=2067 XHG=2253 XHG=2349 XHG=2382 YBD=326 YBD=324 YBD=316 YBD=315 YBD=314 YBD=313 YBD=323 YHG=288>CASE YHG=288>2.-A YHG=289>boy, YHG=288>aged YHG=289>8 YHG=296>years, YHG=296>was YHG=287>admitted YHG=286>with YHG=295>a YHG=286>history XBD=207 XHG=862 XBD=274 XBD=502 XBD=742 XBD=838 XBD=895 XBD=1071 XBD=1138 XBD=1269 XHG=69 XHG=232 XHG=297 XHG=523 XHG=764 XHG=917 XHG=1096 XHG=1156 YBD=344 YBD=345 YBD=346 YBD=352 YBD=344 YBD=351 YBD=344 YBD=345 YHG=314>absent YHG=315>in YHG=315>influenzal YHG=316>meningitis YHG=315>but YHG=315>is YHG=315>present YHG=316>in YHG=315>other XBD=1374 XBD=1565 XBD=1664 XBD=1840 XBD=2104 XBD=2186 XBD=2308 XBD=2415 XBD=2498 XHG=1333 XHG=1397 XHG=1594 XHG=1692 XHG=1866 XHG=2131 XHG=2211 XHG=2335 XHG=2439 YBD=355 YBD=356 YBD=363 YBD=353 YBD=360 YBD=354 YHG=327>of YHG=327>lassitude YHG=328>and YHG=326>evening YHG=328>temperature YHG=326>for YHG=325>three YHG=324>days YHG=327>and XBD=185 XBD=248 XBD=443 XBD=704 XBD=787 XBD=1127 XBD=1269 XHG=65 XHG=203 XHG=260 XHG=460 XHG=804 XHG=1147 YBD=384 YBD=391 YBD=383 YBD=388 YBD=383 YHG=353>forms YHG=354>of YHG=355>purulent YHG=354>meningitis YHG=354>its YHG=353>administration, YHG=354>either XBD=1511XHG=736 XBD=1603 XBD=1798 XBD=1872 XBD=1958 XBD=2061 XBD=2349 XBD=2442 XBD=2497 XHG=1333 XHG=1533 XHG=1624 XHG=1818 XHG=1892 XHG=1979 XHG=2108 XHG=2373 XHG=2453 YBD=402 YBD=394 YBD=393 YBD=400 YBD=401 YBD=391 YBD=397 YHG=366>headache ; YHG=366>and YHG=366>vomiting YHG=366>for YHG=374>one YHG=365>day. YHG=365>Temperature YHG=363>101° YHG=363>F., XBD=179 XBD=246 XBD=364 XBD=698 XBD=842 XBD=907 XBD=979 XBD=1142 XBD=1267 XHG=68 XHG=202 XHG=267 XHG=388 XHG=722 XHG=865 XHG=1002 XHG=1165 YBD=422 YBD=424 YBD=423 YBD=429 YBD=421 YBD=422 YHG=392>alone YHG=402>or YHG=394>with YHG=394>chemotherapy, YHG=400>seems YHG=392>to YHG=392>be YHG=392>useless YHG=392>since XBD=1523XHG=930 XBD=1629 XBD=1885 XBD=1957 XBD=2059 XBD=2147 XBD=2317 XBD=2398 XBD=2499 XHG=1332 XHG=1545 XHG=1660 XHG=1904 XHG=2003 XHG=2076 XHG=2164 XHG=2333 XHG=2413 YBD=438 YBD=441 YBD=432 YBD=431 YBD=429 YBD=430 YHG=404>pulse-rate YHG=406>144 YHG=404>respirations YHG=404>28. YHG=402>He YHG=412>was YHG=402>irritable YHG=401>and YHG=403>semi; XBD=175 XHG=714 XBD=228 XBD=297 XBD=552 XBD=611 XBD=696 XBD=914 XBD=1070 XBD=1269 XHG=68 XHG=194 XHG=247 XHG=318 XHG=566 XHG=629 XHG=932 XHG=1093 YBD=461 YBD=463 YBD=462 YBD=461 YBD=460 YBD=468 YBD=467 YBD=467 YHG=430>there YHG=431>is YHG=441>no YHG=432>diminution YHG=432>in YHG=432>the YHG=429>mortality YHG=430>figures YHG=431>(Aleman XBD=1522 XBD=1723 XBD=1899 XBD=2002 XBD=2175 XBD=2278 XBD=2328 XBD=2500 XHG=1334 XHG=1570 XHG=1755 XHG=1931 XHG=2034 XHG=2208 XHG=2308 XHG=2358 YBD=472 YBD=480 YBD=471 YBD=479 YBD=468 YBD=469 YHG=446>comatose. YHG=443>Cervical YHG=443>rigidity YHG=451>was YHG=444>present YHG=441>and YHG=450>a YHG=440>bilateral XBD=193 XBD=286 XBD=400 XBD=505 XBD=574 XBD=685 XBD=816 XBD=888 XBD=1074 XBD=1213 XBD=1267 XHG=72 XHG=247 XHG=301 XHG=421 XHG=526 XHG=596 XHG=705 XHG=837 XHG=911 XHG=1096 XHG=1234 YBD=507 YBD=509 YBD=501 YBD=500 YBD=498 YBD=499 YBD=500 YBD=507 YBD=501 YHG=470>1940). YHG=472>It YHG=481>-may YHG=471>well YHG=471>be YHG=469>that YHG=469>when YHG=479>an YHG=469>efficient YHG=471>agent YHG=471>is XBD=1662 XBD=1766 XBD=1968 XBD=2157 XBD=2345 XBD=2380 XBD=2500 XHG=1332 XHG=1679 XHG=1813 XHG=1982 XHG=2173 XHG=2360 XHG=2395 YBD=520 YBD=519 YBD=511 YBD=518 YBD=507 YBD=508 YHG=482>positive YHG=483>sign. YHG=481>Lumbar YHG=484>puncture YHG=479>produced YHG=487>a YHG=480>turbid Kernig’s XBD=190 XBD=266 XBD=405 XBD=474 XBD=625 XBD=739 XBD=874 XBD=997 XBD=1111 XBD=1179 XBD=1267 XHG=68 XHG=214 XHG=290 XHG=430 XHG=494 XHG=647 XHG=764 XHG=1021 XHG=1136 XHG=1200 YBD=540 YBD=540 YBD=545 YBD=538 YBD=539 YBD=539 YHG=509>found YHG=510>its YHG=510>mode YHG=509>of YHG=509>action YHG=516>may YHG=508>differ YHG=509>from YHG=509>that YHG=510>of YHG=509>the XBD=1419XHG=896 XBD=1472 XBD=1520 XBD=1692 XBD=1747 XBD=1848 XBD=1930 XBD=2028 XBD=2085 XBD=2221 XBD=2306 XBD=2500 XHG=1331 XHG=1433 XHG=1499 XHG=1533 XHG=1708 XHG=1765 XHG=1866 XHG=1944 XHG=2045 XHG=2102 XHG=2238 XHG=2320 YBD=559 YBD=550 YBD=548 YBD=553 YBD=549 YBD=556 YHG=521>fluid YHG=524>at YHG=532>a YHG=530>pressure YHG=522>of YHG=531>over YHG=521>300 YHG=529>mm. YHG=521>of YHG=522>water, YHG=519>and YHG=518>containing XBD=393 XHG=707 XBD=537 XBD=580 XBD=695 XBD=886 XBD=1002 XBD=1144 XBD=1267 XHG=69 XHG=416 XHG=548 XHG=591 XHG=901 XHG=1015 XHG=1156 YBD=587 YBD=578 YBD=577 YBD=584 YBD=579 YBD=578 YHG=549>sulphonamides. YHG=548>There YHG=548>is YHG=556>some YHG=548>evidence YHG=548>that, YHG=548>unlike YHG=549>other XBD=1454 XBD=1546 XBD=1618 XBD=1754 XBD=1805 XBD=1925 XBD=1977 XBD=2021 XBD=2119 XBD=2367 XBD=2501 XHG=1336 XHG=1465 XHG=1556 XHG=1627 XHG=1766 XHG=1812 XHG=1936 XHG=1983 XHG=2029 XHG=2127 XHG=2379 YBD=595 YBD=590 YBD=598 YBD=588 YBD=596 YBD=594 YHG=562>12,900 YHG=561>cells YHG=571>per YHG=569>c.mm., YHG=561>of YHG=560>which YHG=561>90 YHG=559>% YHG=569>were YHG=558>polymorphs YHG=559>protein ; XBD=186 XBD=245 XBD=486 XBD=686 XBD=859 XBD=1090 XBD=1268 XHG=67 XHG=201 XHG=253 XHG=501 XHG=700 XHG=870 XHG=1104 YBD=618 YBD=618 YBD=623 YBD=615 YBD=617 YBD=625 YBD=618 YHG=588>forms YHG=589>of YHG=587>meningitis, YHG=585>Pfeiffer’s YHG=585>bacillus YHG=587>meningitis YHG=588>resolves XBD=1398 XBD=1485 XBD=1574 XBD=1762 XBD=1848 XBD=1935 XBD=2015 XBD=2097 XBD=2245 XBD=2319 XBD=2501 XHG=1334 XHG=1415 XHG=1503 XHG=1592 XHG=1785 XHG=1864 XHG=1952 XHG=2035 XHG=2120 XHG=2275 XHG=2339 YBD=628 YBD=629 YBD=636 YBD=627 YBD=631 YBD=625 YBD=626 YHG=601>240 YHG=601>and YHG=600>chlorides YHG=602>690 YHG=609>mg. YHG=607>per YHG=600>100 YHG=607>c.om. YHG=607>no YHG=597>reduction ; - when XHG=507 XBD=278 XBD=779 XHG=245 does-by YBD=655 YBD=661 YHG=627>it YHG=625>bacteriolysis. XBD=1373 XBD=1566 XBD=1765 XBD=1888 XBD=1977 XBD=2274 XBD=2406 XBD=2502 XHG=1332 XHG=1392 XHG=1590 XHG=1802 XHG=1911 XHG=2000 XHG=2296 XHG=2424 YBD=667 YBD=671 YBD=675 YBD=666 YBD=674 YBD=665 YHG=640>of YHG=639>Fehling’s YHG=639>solution YHG=648>very YHG=639>few YHG=636>gram-negative YHG=636>bacilli YHG=646>were ; XBD=1413 XHG=2471 XBD=1470 XBD=1552 XBD=1684 XBD=1827 XBD=1916 XBD=2073 XBD=2270 XBD=2310 XBD=2453 XBD=2508 XHG=1332 YBD=704 XHG=1433 XHG=1490 XHG=1573 XHG=1705 XHG=1850 XHG=1938 XHG=2093 XHG=2290 XHG=2329 YBD=712 YBD=706 YBD=705 YBD=713 YBD=711 YHG=687>seen YHG=678>in YHG=678>the YHG=678>direct YHG=687>smear, YHG=678>but YHG=677>culture YHG=676>produced YHG=685>a YHG=675>growth YHG=676>of SUMMARY

" XBD=2503 XBD=1502 XHG=2462 XBD=1700 XBD=1973 XBD=2253 XBD=2415 XHG=1332 YBD=743 XHG=1541 XHG=1746 XHG=2026 XHG=2293 YBD=745 YHG=724>an YBD=744 YBD=747 YHG=715>Pfeiffer’s: YHG=717>bacillus. YHG=716>Treatment YHG=716>intravenous YHG=715>saline;

XBD=154 XHG=910 XBD=293 XBD=366 XBD=436 XBD=568 XBD=640 XBD=881 XBD=983 XBD=1053 XBD=1267 XHG=118 XHG=180 XHG=321 XHG=389 XHG=465 XHG=596 XHG=662 XHG=1011 XHG=1081 YBD=782 YBD=783 YBD=791 YBD=784 YBD=785 YHG=754>A YHG=753>series YHG=752>of YHG=753>24 YHG=762>cases YHG=753>of YHG=753>meningitis YHG=755>due YHG=756>to YHG=754>Pfeiffer’s " XBD=2502 XBD=1479 XBD=1545 XBD=1773 XBD=1834 XBD=1902 XBD=2032 XBD=2127 XBD=2254 XBD=2325 XBD=2419 XHG=1332 XHG=1505 XHG=1676 XHG=1798 XHG=1861 XHG=1926 XHG=2056 XHG=2152 XHG=2277 XHG=2347 XHG=2440 YBD=792 YBD=793 YBD=784 YBD=791 YBD=790 YBD=783 YHG=765>average YHG=756>of YHG=756>pints YHG=757>in YHG=756>24 YHG=756>hours YHG=764>was YHG=755>given YHG=755>by YHG=754>drip YHG=755>and XBD=230 XHG=703 XBD=336 XBD=569 XBD=659 XBD=893 XBD=1266 XHG=70 XHG=272 XHG=379 XHG=614 XHG=934 YBD=823 YBD=822 YBD=823 YBD=830 YBD=831 YHG=793>bacillus YHG=802>are YHG=792>reported, YHG=793>20 YHG=793>receiving YHG=794>sulphanilamide, " XBD=2501 XBD=1598 XBD=1672 XBD=1796 XBD=1870 XBD=2028 XBD=2371 XBD=2442 XHG=1331 XHG=1624 XHG=1693 XHG=1821 XHG=1890 XHG=2075 XHG=2397 XHG=2462 YBD=832 YBD=823 YBD=821 YBD=831 YHG=795>supplemented YHG=795>by YHG=795>fluids YHG=796>by YHG=796>mouth. YHG=794>Sulphapyridine, YHG=794>1’5 YHG=803>g., XBD=384 XHG=889 XBD=453 XBD=792 XBD=863 XBD=913 XBD=1202 XBD=1273 XHG=70 XHG=410 XHG=480 XHG=821 XHG=940 XHG=1229 YBD=870 YBD=862 YBD=870 YBD=863 YBD=863 YBD=864 YHG=832>sulphapyridine YHG=841>or YHG=832>sulphathiazole, YHG=842>or YHG=842>a YHG=833>combination YHG=834>of " XBD=2501 XBD=1401 XBD=1519 XBD=1796 XBD=1847 XBD=1922 XBD=2043 XBD=2147 XBD=2320 XBD=2379 XBD=2460 XHG=1330 XHG=1416 XHG=1532 XHG=1810 XHG=1860 XHG=1936 XHG=2059 XHG=2163 XHG=2332 XHG=2393 XHG=2473 YBD=871 YBD=862 YBD=863 YBD=869 YBD=861 YBD=870 YHG=844>was YHG=835>given YHG=834>intravenously YHG=835>in YHG=834>the YHG=834>saline YHG=834>drip, YHG=833>followed YHG=833>by YHG=833>0-75 YHG=843>g. XBD=176 XHG=194 XBD=320 XHG=68 YBD=903 YBD=909 YHG=871>these YHG=872>drugs. " XBD=2501 XBD=1506 XBD=1674 XBD=1719 XBD=1832 XBD=1896 XBD=1959 XBD=2015 XBD=2078 XBD=2121 XBD=2243 XBD=2359 XHG=1332 XHG=1530 XHG=1697 XHG=1741 XHG=1857 XHG=1917 XHG=1983 XHG=2040 XHG=2104 XHG=2146 XHG=2289 XHG=2380 YBD=911 YBD=902 YBD=903 YBD=901 YBD=910 YHG=874>4-hourly, YHG=873>making YHG=883>a YHG=874>total YHG=874>of YHG=874>27 YHG=883>g. YHG=873>in YHG=875>7 YHG=873>days. YHG=873>The YHG=873>patient XBD=200 XHG=822 XBD=378 XBD=521 XBD=607 XBD=698 XBD=762 XBD=800 XBD=932 XBD=1031 XBD=1190 XBD=1268 XHG=121 XHG=220 XHG=399 XHG=541 XHG=628 XHG=719 XHG=779 XHG=953YBD=950 XHG=1055 XHG=1227 YBD=949 YBD=942 YBD=942 YBD=943YHG=921>years YHG=911>The YHG=910>fatality YHG=912>under YHG=912>the YHG=921>age YHG=912>of YHG=912>2 YHG=921>was YHG=912>100% ; YHG=913>in " XBD=2500 XBD=1515 XBD=1715 XBD=1803 XBD=1882 XBD=1993 XBD=2052 XBD=2265 XHG=1331 XHG=1532 XHG=1733 XHG=1820 XHG=1900 XHG=2012 XHG=2065 XHG=2283 YBD=950 YBD=942 YBD=951 YBD=941 YBD=949 YHG=914>gradually YHG=913>improved YHG=914>and YHG=914>the YHG=914>signs YHG=913>of YHG=912>meningitis YHG=912>disappeared. XBD=93 XBD=165 XBD=253 XBD=302 XBD=499 XBD=615 XBD=729 XBD=822 XBD=933 XBD=1173 XBD=1268 XHG=72 XHG=120 XHG=185 XHG=280 XHG=328 XHG=525 XHG=640 XHG=753 XHG=848 XHG=958 XHG=1201 YBD=981 YBD=989 YBD=982 YBD=987 YBD=982 YHG=952>3 YHG=952>of YHG=952>the YHG=952>4 YHG=951>children YHG=960>over YHG=952>that YHG=961>age YHG=952>who YHG=952>recovered, " XBD=2501 |>" XBD=1363 XBD=1511 XBD=1669 XBD=1872 XBD=1915 XBD=2024 XBD=2137 XBD=2218 XBD=2323 XBD=2564 XHG=1330 XHG=1383 XHG=1530 XHG=1688 XHG=1896 XHG=1937 XHG=2045 XHG=2156 XHG=2238 XHG=2343 XHG=2560 YBD=990 YBD=981 YBD=980 YBD=986 YBD=989 YBD=964 YHG=953>A YHG=953>second YHG=953>lumbar YHG=956>puncture, YHG=954>7 YHG=954>days YHG=953>after YHG=952>the YHG=952>first, YHG=952>produced YHG=960>’ " XBD=1202 XBD=251 XBD=332 XBD=417 XBD=533 XBD=651 XBD=740 XBD=796 XBD=877 XHG=70 XHG=266 XHG=347 XHG=431 XHG=547 XHG=668 XHG=755 XHG=893 YBD=1028 YBD=1022 YBD=1021 YBD=1028 YHG=1000>recovery YHG=991>did YHG=991>not YHG=1000>seem YHG=991>to YHG=992>due YHG=992>to YHG=991>the YHG=991>chemotherapy. be XBD=1352XHG=811 XBD=1549 XBD=1690 XBD=1793 XBD=1888 XBD=1940 XBD=1973 XBD=2142 XBD=2191 XBD=2242 XBD=2335 XBD=2383 XBD=2501 XHG=1330 XHG=1365 XHG=1562 XHG=1703 XHG=1803 XHG=1901 XHG=1952 XHG=1985 XHG=2152 XHG=2202 XHG=2253 XHG=2345 XHG=2389 YBD=1021 YBD=1029 YBD=1020 YBD=1019 YBD=1026 YHG=1001>a YHG=992>colourless YHG=992>almost YHG=992>clear YHG=992>fluid YHG=994>at YHG=1002>a YHG=1000>pressure YHG=992>of YHG=992>90 YHG=1001>mm. YHG=991>of YHG=995>water; " XBD=1580 XBD=1659 XBD=1803 XBD=2066 XBD=2195 XBD=2360 XBD=2415 XBD=2505 XHG=1332 XHG=1597 XHG=1676 XHG=1822 XHG=2087 XHG=2226 XHG=2376 XHG=2429 YBD=1059 YBD=1065 YBD=1068 YBD=1060 YBD=1069 YHG=1031>cell-count YHG=1040>per YHG=1040>c.mm., YHG=1031>lymphocytes YHG=1030>92% YHG=1030>protein YHG=1032>40 YHG=1032>mg.; 45 " XBD=1265 XBD=136 XHG=908 XBD=245 XBD=305 XBD=443 XBD=559 XBD=619 XBD=756 XBD=886 XBD=963 XBD=1038 XHG=116 XHG=158 XHG=266 XHG=327 XHG=465 XHG=584 XHG=643 XHG=778 XHG=983YBD=1074 XHG=1060 XHG=1203 YBD=1075 YBD=1084 YBD=1074 YBD=1083 YBD=1075 YHG=1046>I YHG=1046>wish YHG=1048>to YHG=1046>thank YHG=1046>Prof. YHG=1046>C. YHG=1047>Bruce YHG=1047>Perry YHG=1046>for YHG=1045>his YHG=1045>help;; YHG=1046>Dr. "" XBD=1165 XBD=1501 XBD=1588 XBD=1679 XBD=1764 XBD=1850 XBD=1995 XBD=2206 XBD=2375 XBD=2501 XHG=1330 XHG=1525 XHG=1610 XHG=1701 XHG=1788 XHG=1873 XHG=2031 XHG=2227 XHG=2393 YBD=1104 YBD=1107 YBD=1099 YBD=1109 YHG=1070>chlorides YHG=1071>695 YHG=1080>mg. YHG=1080>per YHG=1071>100 YHG=1080>c.cm. YHG=1069>Fehling’s YHG=1070>solution YHG=1071>poorly ; XBD=114 XBD=173 XBD=311 XBD=397 XBD=474 XBD=535 XBD=599 XBD=725 XBD=793 XBD=1012 XBD=1065 XBD=1189 XBD=1266 XHG=72 XHG=130 XHG=189 XHG=325 XHG=411 XHG=490 XHG=550 XHG=615 XHG=739 XHG=806 XHG=1026 XHG=1082 XHG=1204 YBD=1115 YBD=1115 YBD=1123 YBD=1114 YBD=1123 YBD=1113 YBD=1122 YBD=1114 YHG=1086>B. YHG=1086>A. YHG=1086>Peters YHG=1086>and YHG=1085>Dr. YHG=1086>R. YHG=1086>H. YHG=1085>Parry YHG=1087>for YHG=1086>permission YHG=1088>to YHG=1087>quote YHG=1086>the " XBD=1592 XBD=1813 XBD=1946 XBD=2125 XBD=2281 XBD=2395 XHG=1546 XHG=1622 XHG=1842 XHG=1990 XHG=2154 XHG=2325 XHG=2421 YBD=1146 YBD=1143 YBD=1139 YBD=1138 YBD=1140 YHG=1119>no YHG=1110>organisms YHG=1119>seen; YHG=1110>culture YHG=1110>sterile. YHG=1109>The YHG=1111>child " XBD=2502 XBD=168 XHG=879 XBD=281 XBD=401 XBD=537 XBD=748 XBD=856 XBD=941 XBD=1097 XBD=1267 XHG=72 XHG=189 XHG=303 XHG=424 XHG=559 XHG=786 XHG=964 XHG=1120 YBD=1154 YBD=1162 YBD=1153 YBD=1154 YBD=1154 YBD=1154 YHG=1135>cases YHG=1125>from YHG=1126>Ham YHG=1124>Green YHG=1125>Hospital; YHG=1126>and YHG=1124>Dr: YHG=1125>Martin YHG=1124>Skelton " XBD=344 XBD=1400XHG=209 XBD=1629 XBD=1752 XBD=1890 XBD=2003 XBD=2237 XBD=2443 XHG=1329 XHG=1426 XHG=1652 XHG=1777 XHG=1913 XHG=2027 XHG=2259 YBD=1186 YBD=1177 YBD=1178 YBD=1187 YBD=1179 YHG=1159>was YHG=1149>discharged YHG=1150>three YHG=1150>weeks YHG=1150>later YHG=1150>completely YHG=1150>recovered. " XBD=125 XBD=194 XHG=71 XHG=140 YBD=1193 YBD=1193 YBD=1194 YHG=1165>for YHG=1164>his YHG=1164>advice. " XBD=2502 XBD=1469 XHG=2415 XBD=1603 XBD=1696 XBD=1795 XBD=1971 XBD=2054 XBD=2240 XBD=2334 XBD=2404 XHG=1376 YBD=1242 XHG=1494 XHG=1613 XHG=1708 XHG=1859 XHG=1983 XHG=2065 XHG=2249 XHG=2343 YBD=1240 YBD=1241 YBD=1232 YBD=1233 YHG=1204>CASE YHG=1203>3.-A YHG=1204>boy, YHG=1204>aged YHG=1214>years, YHG=1213>was YHG=1204>admitted YHG=1204>with YHG=1213>one YHG=1205>day’s REFERENCES " XBD=2502 XBD=1466 XBD=1531 XBD=1734 XBD=1829 XBD=2039 XBD=2331 XBD=2433 XHG=1329 XHG=1491 XHG=1556 XHG=1758 XHG=1856 XHG=2087 XHG=2361 XHG=2456 YBD=1271 YBD=1272 YBD=1281 YBD=1273 YBD=1280 YHG=1243>history YHG=1244>of YHG=1243>headache YHG=1244>and YHG=1244>vomiting. YHG=1244>Temperature YHG=1244>104° YHG=1245>F., R. Med. J. Aleman, surg. (1940) 93, 25.

2-2t

reduced;

4t

" XBD=2214 XBD=2501 XBD=1521 XBD=1607 XBD=1700 XBD=1945 XBD=2020 XBD=2122 XHG=1329 XHG=1546 XHG=1628 XHG=1719 XHG=1966 XHG=2067 XHG=2142 XHG=2234 YBD=1310 YBD=1312 YBD=1311 YBD=1320 YHG=1283>pulse-rate YHG=1284>140 YHG=1283>and YHG=1283>respirations YHG=1284>30. YHG=1284>He YHG=1292>was Banks, H. S. i, 1334. YHG=1284>semi-comatose, (1938) Lancet, " XBD=2502 XBD=1493 XBD=1589 XBD=1701 XBD=1873 XBD=1987 XBD=2107 XBD=2420 XHG=2441 XHG=1331 XHG=1516 XHG=1614 XHG=1724 XHG=1899 XHG=2012 XHG=2131 YBD=1358 YBD=1356 YBD=1350 YBD=1351 YHG=1322>delirious YHG=1322>and YHG=1331>very YHG=1323>restless, YHG=1322>with YHG=1331>some YHG=1323>head-retraction YHG=1326>and Dowds, J. H. (1940) Ibid,YBD=1353 ii, 100.

" XBD=2338 XBD=2502 XBD=1436 XBD=1721 XBD=1867 XBD=1986 XBD=2131 XHG=1329 XHG=1468 XHG=1768 XHG=1899 XHG=2018 XHG=2179 XHG=2368 YBD=1390 YBD=1399 YBD=1389 YBD=1398 YBD=1391 YBD=1400 YHG=1362>much YHG=1361>photophobia. YHG=1361>Neck YHG=1370>very YHG=1362>rigid; YHG=1362>bilateral D. (1937) New Med. 216, 587. Fothergill, L. Engl. J.YHG=1364>positive — and Ward, H. K. YBD=1439 " XBD=2502 XBD=1493 XBD=1598 XBD=1702 XBD=1879 XBD=2153 XBD=2283 XHG=2324 XHG=1330 XHG=1522 XHG=1630 XHG=1729 XHG=1913 XHG=2185 YBD=1429 YBD=1437 YBD=1430 YBD=1438 YHG=1401>Kernig’s YHG=1402>sign YHG=1401>and YHG=1401>positive YHG=1401>Brudzinski’s YHG=1401>sign J. Dis. Child. 43, 873. ; (1932) Amer.YHG=1401>knee-jerks

M. (1941) Lancet, " XBD=2395 XBD=2502 XBD=1401 XBD=1647 XBD=1816 XBD=2009 XBD=2147 XBD=2295 Jacoby, N. XHG=2424 XHG=1330 XHG=1433 XHG=1680 XHG=1862 XHG=2039 XHG=2178 XHG=2327 YBD=1477 YBD=1468 YBD=1475 YBD=1469 YBD=1471 ii, 753. YHG=1442>discs YHG=1441>ankle-jerks YHG=1440>absent. YHG=1440>Plantar YHG=1440>reflex YHG=1441>flexor, YHG=1441>and C. and Selinger, M. A. (1940) J. Pediat. 17, Lindsay, 3. XHG=2421 W., Rice, E. YBD=1510 " XBD=2502 XBD=1477 XBD=1680 XBD=1885 XBD=2098 XBD=2153 XBD=2276 XBD=2391 XBD=2455 XHG=2484 XHG=1329 XHG=1524 XHG=1712 XHG=1919 XHG=2129 XHG=2187 XHG=2308 YBD=1517 YBD=1508 YBD=1509 YHG=1480>normal. YHG=1480>Lumbar YHG=1482>puncture YHG=1480>produced YHG=1489>a YHG=1480>clear YHG=1480>fluid YHG=1484>at YHG=1491>a 220.

" " " " " " "

XBD=2500 XBD=1488 XBD=1552 XBD=1655 XBD=1742 XBD=1851 XBD=1916 XBD=2067 XBD=2186 XBD=2273 XBD=2355 XHG=1328 YBD=1555 XHG=1512 XHG=1572 XHG=1678 XHG=1765 XHG=1875 XHG=1935 XHG=2105 XHG=2210 XHG=2296 XHG=2377 YBD=1557 YHG=1530>c.mm.; YBD=1547 YBD=1553 YBD=1548 YBD=1549 YBD=1558 YHG=1529>pressure YHG=1520>of YHG=1529>over YHG=1520>300 YHG=1529>mm. YHG=1519>of YHG=1523>water YHG=1519>cells YHG=1520>380 YHG=1529>per ; Mackenzie, J. C., Page, A. P. and Ward, E. M. (1940) Lancet, i, 785. XBD=1516 XBD=1806 XBD=1939 XBD=2032 XBD=2084 XBD=2209 XBD=2355 XBD=2502 XHG=1328 XHG=1531 XHG=1821 XHG=1952 XHG=2046 XHG=2100 XHG=2224 XHG=2384 YBD=1597 YBD=1587 YBD=1588 YBD=1594 YHG=1569>numerous YHG=1559>gram-negative YHG=1558>bacilli YHG=1569>seen YHG=1559>in YHG=1559>direct YHG=1568>smear YHG=1561>culture ; 751. Mutch, N. (1941) Ibid, ii,YBD=1589 XBD=1507 XBD=1542 XBD=1696 XBD=1845 XBD=1898 XBD=2079 XBD=2248 XBD=2501 XHG=1328 XHG=1520 XHG=1555 XHG=1710 XHG=1859 XHG=1908 XHG=2092 YBD=1637 YBD=1636 YBD=1628 YHG=1599>produced YHG=1609>a YHG=1600>profuse YHG=1600>growth YHG=1600>of YHG=1598>Pfeiffer’s YHG=1599>bacillus. YHG=1600>Treatment: E. J. (1934) J. Amer. W. and Appelbaum, Jackson, H.YBD=1629 Neal, J. B.,XHG=2294 med. Ass. XBD=1402 XBD=1530 XBD=1605 XBD=1779 XBD=2116 XBD=2162 XBD=2235 XBD=2330 XBD=2448 XBD=2500 XHG=1330 XHG=1426 XHG=1556 XHG=1629 XHG=1818 XHG=2147 XHG=2190 XHG=2260 XHG=2353 XHG=2468 102, 513. YBD=1668 YBD=1672 YHG=1643>at YBD=1666 YBD=1675 YBD=1667 YBD=1676 YHG=1639>free ; YHG=1638>fluids YHG=1639>by YHG=1639>mouth YHG=1638>sulphapyridine, YHG=1640>1 YHG=1648>g., YHG=1648>was YHG=1638>given and Caughey, J. E. (1939) Roche, E. H. Lancet, ii, 635. XBD=1426 XBD=1521 XBD=1629 XBD=1729 XBD=1784 XBD=1981 XBD=2102 XBD=2218 XBD=2309 XBD=2500 XHG=1330 XHG=1450 XHG=1542 XHG=1652 XHG=1751 XHG=1809 XHG=2028 XHG=2125 XHG=2239 XHG=2329 YBD=1711 YBD=1714 YBD=1715 YBD=1706 YBD=1707 YBD=1716 YHG=1687>once, YHG=1679>and YHG=1679>then YHG=1679>0-75 YHG=1687>g. YHG=1678>4-hourly. YHG=1678>The YHG=1678>child YHG=1687>was YHG=1679>extremely 596. Sakula, J. (1940) Ibid, i,YBD=1755 XBD=1470 XBD=1570 XBD=1657 XBD=1743 XBD=1896 XBD=2084 XBD=2170 XBD=2287 XBD=2499 XHG=1328 XHG=1484 XHG=1587 XHG=1673 XHG=1757 XHG=1910 XHG=2099 XHG=2185 XHG=2301 YBD=1745 YBD=1746 YBD=1754 YHG=1717>restless YHG=1721>next YHG=1718>day YHG=1718>and YHG=1718>lumbar YHG=1720>puncture YHG=1727>was YHG=1717>again YHG=1718>performed; E. (1937) Ibid, ii, 1430. Watson-Williams, XBD=1416 XBD=1552 XBD=1605 XBD=1643 XBD=1811 XBD=1862 XBD=1939 XBD=2039 XBD=2097 XBD=2239 XBD=2347 XBD=2437 XBD=2499 XHG=1329 XHG=1430 XHG=1568 XHG=1622 XHG=1652 XHG=1822 XHG=1878 XHG=1954 XHG=2057 XHG=2107 XHG=2264 XHG=2362 XHG=2449 YBD=1794 YHG=1766>per YBD=1785 YBD=1790 YBD=1786 YBD=1795 YHG=1757>fluid ; YHG=1757>turbid YHG=1760>at YHG=1766>a YHG=1766>pressure YHG=1758>of YHG=1758>150 YHG=1767>mm. YHG=1757>of YHG=1759>water YHG=1758>2500 YHG=1757>cells

" XBD=2498 XBD=1472 XHG=2333 XBD=1698 XBD=1839 XBD=1944 XBD=2005 XBD=2140 XBD=2287 XHG=1331 YBD=1826 XHG=1510 XHG=1722 XHG=1863 XHG=1968 XHG=2030 XHG=2165 YBD=1829 YHG=1796>The YBD=1824 YBD=1825 YHG=1806>c.mm. YHG=1805>numerous YHG=1797>bacilli YHG=1805>seen YHG=1797>in YHG=1797>direct YHG=1805>smear. discs ;

PFEIFFER’S RESPONSE BACILLUS " XBD=2406 XBD=2498 XBD=1472 XBD=1587 XBD=1793 XBD=1890 XBD=2133 XBD=2228 XHG=1329OF XHG=1501 XHG=1612 XHG=1820 XHG=1914 XHG=2157 XHG=2254 XHG=2432 YBD=1873 YBD=1864 YBD=1865 YHG=1837>became YHG=1845>very YHG=1837>engorged, YHG=1837>and YHG=1836>restlessness YHG=1836>and YHG=1836>delirium YHG=1845>con" XBD=2500 XBD=1454 XBD=1617 XBD=1667 XBD=1833 XBD=1999 XBD=2199 XBD=2297 XBD=2382 XHG=1329 YBD=1906 XHG=1482 XHG=1645 XHG=1696 XHG=1860 XHG=2025 XHG=2228 XHG=2323 XHG=2407 YBD=1913 YBD=1905 YBD=1914 YBD=1904 YHG=1876>tinued YHG=1876>despite YHG=1885>a YHG=1876>further YHG=1876>lumbar YHG=1878>puncture YHG=1876>and YHG=1876>the YHG=1875>intraTO SULPHAPYRIDINE MENINGITIS XBD=1507 XHG=2447 XBD=1702 XBD=1770 XBD=2094 XBD=2168 XHG=1330 YBD=1944 XHG=1533 XHG=1730 XHG=1792 XHG=2117 YBD=1954 YHG=1916>the YBD=1953 YHG=1916>muscular YHG=1916>injection YHG=1917>of YHG=1916>phenobarbitone YHG=1925>gr. " XBD=2500 XBD=2325 XBD=2426 XHG=2270 XHG=2351 YBD=1945 YHG=1917>He YHG=1915>died " XBD=1525 XBD=1426 XHG=1443 XHG=1332 YBD=1984 YBD=1992 YHG=1965>same YHG=1956>day. RAYMOND A. MOIR, M B LOND

" XBD=2500 XBD=1424 XBD=1602 XBD=1648 XBD=1766 XBD=1919 XBD=1985 XBD=2073 XBD=2168 XBD=2302 XBD=2404 XHG=1375 XHG=1449 XHG=1627 XHG=1673 XHG=1791 XHG=1945 XHG=2005 XHG=2097 XHG=2193 XHG=2326 XHG=2425 YBD=2033 YBD=2032 YBD=2024 YBD=2023 YHG=1995>At YHG=1998>autopsy YHG=2004>a YHG=1996>large YHG=1996>plaque YHG=1996>of YHG=2004>pus YHG=2004>was YHG=1994>found YHG=2003>over RESIDENT MEDICAL OFFICER AT YHG=1994>both KING’S COLLEGE HOSPITAL " XBD=2499 XBD=1483 XHG=2419 XBD=1757 XBD=1875 XBD=1997 XBD=2130 XBD=2240 XBD=2306 XBD=2392 XHG=1331 YBD=2062 XHG=1512 XHG=1789 XHG=1903 XHG=2027 XHG=2158 XHG=2269 XHG=2334 YBD=2072 YHG=2034>base. YBD=2071 YBD=2063 YHG=2034>cerebral YHG=2034>hemispheres, YHG=2044>very YHG=2035>little YHG=2034>being YHG=2043>seen YHG=2037>at YHG=2034>the XBD=169 XHG=818 XBD=296 XBD=365 XBD=456 XBD=714 XBD=794 XBD=885 XBD=1023 XBD=1092 XHG=120 XHG=198 XHG=320 XHG=389 XHG=486 XHG=743 XHG=910YBD=2100 XHG=1048 YBD=2101 YBD=2101 YBD=2101 YHG=2071>IN YHG=2071>view YHG=2070>of YHG=2071>the YHG=2070>discussions YHG=2080>on YHG=2070>the YHG=2070>effect YHG=2071>of sulpha" XBD=2501 XBD=1405 XBD=1524 XBD=1613 XBD=1736 XBD=1937 XBD=2065 XBD=2186 XBD=2300 XBD=2355 XHG=1331 XHG=1422 XHG=1542 XHG=1630 XHG=1754 XHG=1984 XHG=2086 XHG=2203 XHG=2318 XHG=2367 YBD=2111 YBD=2103 YBD=2102 YHG=2074>The YHG=2074>brain YHG=2083>was YHG=2075>much YHG=2075>engorged. YHG=2075>Two YHG=2073>small YHG=2083>areas YHG=2074>of YHG=2073>necrosis " XBD=1267 XBD=246 XBD=319 XBD=408 XBD=564 XBD=631 XBD=833 XBD=1012 XHG=70 XHG=268 XHG=340 XHG=433 XHG=587 XHG=854 XHG=1032 YBD=2149 YBD=2140 YBD=2141 YBD=2141 YBD=2148 YHG=2111>pyridine YHG=2119>on YHG=2111>the YHG=2119>course YHG=2110>of YHG=2110>Pfeiffer’s YHG=2110>bacillus YHG=2111>meningitis, XBD=1418XHG=647 XBD=1575 XBD=1627 XBD=1704 XBD=1817 XHG=1330 XHG=1434 XHG=1590 XHG=1642 XHG=1720 YBD=2151 YBD=2142 YBD=2143 YHG=2123>were YHG=2116>present YHG=2114>in YHG=2114>the YHG=2114>liver. " XBD=136 XBD=349 XBD=390 XBD=514 XBD=624 XBD=690 XBD=753 XHG=69 XHG=154 XHG=367 XHG=410 XHG=531 XHG=641 XHG=709 YBD=2181 YBD=2181 YBD=2188 YBD=2180 YHG=2151>the YHG=2150>following YHG=2151>4 YHG=2159>cases YHG=2159>may YHG=2150>be YHG=2150>of YHG=2150>interest. " XBD=937 XBD=1470XHG=766 XBD=1604 XBD=1710 XBD=1823 XBD=1887 XBD=2068 XBD=2163 XBD=2275 XBD=2439 XBD=2501 XHG=1376 XHG=1495 XHG=1628 XHG=1735 XHG=1849 XHG=1913 XHG=2092 XHG=2187 XHG=2294 XHG=2454 YBD=2206 YBD=2198 YBD=2202 YBD=2197 YHG=2169>CASE YHG=2169>4.-A YHG=2169>boy, YHG=2169>aged YHG=2170>10 YHG=2169>months, YHG=2168>had YHG=2169>been YHG=2168>irritable YHG=2168>for " XBD=1410 XBD=1523 XBD=1673 XBD=1759 XBD=1840 XBD=2071 XBD=2180 XBD=2306 XBD=2361 XBD=2501 XHG=1331 XHG=1426 XHG=1540 XHG=1688 XHG=1775 XHG=1857 XHG=2088 XHG=2194 XHG=2320 XHG=2376 YBD=2246 YBD=2242 YBD=2237 YHG=2209>four YHG=2209>days, YHG=2208>having YHG=2209>had YHG=2218>one YHG=2209>convulsion, YHG=2208>after YHG=2208>which YHG=2208>he YHG=2208>became |>" XBD=345 XBD=434 XBD=498 XBD=537 XBD=663 XBD=758 XBD=870 XBD=1032 XBD=1182 XBD=1267 XBD=209 XHG=238 XHG=368 XHG=457 XHG=519 XHG=561 XHG=686 XHG=782 XHG=893 XHG=1056 XHG=1205 XHG=115 YBD=2245 YBD=2236 YBD=2237 YBD=2238 YBD=2238 YHG=2208>1.-A YHG=2209>girl YHG=2209>of YHG=2209>3 YHG=2218>years YHG=2207>had YHG=2209>been YHG=2209>restless YHG=2209>CASE YHG=2209>during YHG=2208>the " XBD=2499 XBD=172 XHG=742 XBD=314 XBD=529 XBD=624 XBD=718 XBD=934 XBD=1266 XBD=1459 XBD=1658 XBD=1890 XBD=2010 XBD=2171 XBD=2262 XBD=2413 XHG=69 XHG=195 XHG=338 XHG=552 XHG=646 XHG=956 XHG=1330 XHG=1481 XHG=1678 XHG=1938 XHG=2030 XHG=2189 XHG=2280 XHG=2430 YBD=2286 YBD=2277 YBD=2286 YBD=2277 YBD=2286 YBD=2278 YBD=2277 YBD=2276 YHG=2249>night YHG=2249>before YHG=2248>admission YHG=2249>and YHG=2248>had YHG=2249>developed YHG=2249>head-retraction. YHG=2248>sleepy, YHG=2249>resenting YHG=2252>movement. YHG=2249>The YHG=2248>mother YHG=2248>had YHG=2248>noticed YHG=2247>that " XBD=2501 XBD=1385 XBD=1504 XBD=1603 XBD=1816 XBD=1942 XBD=2029 XBD=2131 XBD=2223 XBD=2412 XHG=1329 XHG=1414 XHG=1532 XHG=1633 XHG=1844 XHG=1984 XHG=2058 XHG=2159 XHG=2252 XHG=2453 YBD=2325 YBD=2322 YBD=2317 YBD=2318 YBD=2316 YHG=2289>his YHG=2288>neck YHG=2297>was YHG=2289>becoming YHG=2289>stiff; YHG=2289>he YHG=2288>had YHG=2291>not YHG=2288>vomited. YHG=2287>On XBD=320 XHG=748 XBD=454 XBD=521 XBD=727 XBD=833 XBD=1082 XBD=1153 XBD=1267 XHG=71 XHG=341 XHG=468 XHG=536 XHG=856 XHG=1099 XHG=1200 YBD=2326 YBD=2317 YBD=2325 YBD=2322 YBD=2325 YHG=2290>Temperature YHG=2287>100.40 YHG=2288>F., YHG=2288>pulse-rate YHG=2289>132 YHG=2289>respirations YHG=2289>30. YHG=2289>She ; " XBD=1267 XBD=141 XBD=304 XBD=399 XBD=699 XBD=810 XBD=1139 XHG=70 XHG=164 XHG=327 XHG=420 XHG=831 XHG=1162 YBD=2357 YBD=2356 YBD=2361 YBD=2355 YBD=2362 YBD=2356 YHG=2338>was YHG=2328>restless YHG=2328>and YHG=2327>semiconscious, YHG=2327>with YHG=2328>head-retraction, YHG=2329>neckXBD=1531XHG=722 XBD=1601 XBD=1707 XBD=1783 XBD=1904 XBD=1990 XBD=2247 XBD=2335 XHG=1331 XHG=1555 XHG=1622 XHG=1733 XHG=1810 XHG=1927 XHG=2010 XHG=2268 YBD=2361 YBD=2362 YBD=2365 YHG=2328>admission, YHG=2337>on YHG=2327>Dec. YHG=2329>15, YHG=2329>1941, YHG=2328>the YHG=2330>temperature YHG=2336>was " XBD=2501 XBD=224 XHG=814 XBD=388 XBD=504 XBD=603 XBD=789 XBD=964 XBD=1152 XBD=1265 XBD=1525 XBD=1627 XBD=1882 XBD=1955 XBD=2068 XBD=2274 XBD=2359 XHG=69 XHG=251 XHG=412 XHG=532 XHG=628 XHG=990 XHG=1178 XHG=1329 XHG=1543 XHG=1659 XHG=1903 XHG=2000 XHG=2086 XHG=2290 XHG=2374 YBD=2404 YBD=2404 YBD=2403 YBD=2396 YBD=2395 YBD=2405 YBD=2404 YBD=2405 YBD=2401 YBD=2404 YBD=2396 YBD=2395 YBD=2403 YHG=2368>rigidity, YHG=2367>staring YHG=2376>eyes, YHG=2367>and YHG=2367>bilateral YHG=2368>positive YHG=2367>Kernig’s YHG=2368>sign. YHG=2367>pulse-rate YHG=2368>152 YHG=2367>respirations YHG=2368>72. YHG=2368>His YHG=2367>fontanelle YHG=2375>was YHG=2366>bulging ; puncture " XBD=2500 XBD=1403 XBD=1463 XBD=1551 XBD=1666 XBD=1755 XBD=1920 XBD=2025 XBD=2090 XBD=2299 XHG=1331 XHG=1419 XHG=1479 XHG=1570 XHG=1683 XHG=1772 XHG=1938 XHG=2042 XHG=2106 XHG=2318 YBD=2444 YBD=2435 YBD=2443 YHG=2407>he YHG=2416>was YHG=2407>quiet YHG=2407>and YHG=2407>drowsy, YHG=2407>with YHG=2417>an YHG=2407>occasional YHG=2405>meningitie XBD=181 XHG=783 XBD=270 XBD=427 XBD=686 XBD=768 XBD=876 XBD=1078 XHG=70 XHG=198 XHG=287 XHG=442 XHG=702 XHG=922 YBD=2436 YBD=2435 YBD=2444 YBD=2434 YBD=2436 YBD=2436 YHG=2408>There YHG=2416>was YHG=2407>neither YHG=2406>photophobia YHG=2416>nor YHG=2407>rash. YHG=2407>Lumbar " XBD=2499 XBD=249 XHG=740 XBD=299 XBD=448 XBD=596 XBD=711 XBD=852 XBD=1057 XBD=1266 XBD=1403 XBD=1561 XBD=1667 XBD=1940 XBD=2223 XBD=2325 XHG=70 XHG=277 XHG=326 XHG=475 XHG=624 XHG=879 XHG=1085 XHG=1331 XHG=1449 XHG=1596 XHG=1704 XHG=1973 XHG=2256 XHG=2357 YBD=2484 YBD=2474 YBD=2475 YBD=2475 YBD=2484 YBD=2475 YBD=2483 YBD=2474 YHG=2447>produced YHG=2456>a YHG=2447>rather YHG=2446>turbid YHG=2446>fluid YHG=2447>under YHG=2447>increased YHG=2455>pressure : YHG=2456>cry. YHG=2447>There YHG=2456>was YHG=2446>considerable YHG=2446>neck.rigidity YHG=2446>and YHG=2444>bilateral " XBD=1268 XBD=153 XBD=266 XBD=357 XBD=510 XBD=661 XBD=953 XHG=72 XHG=182 XHG=293 XHG=382 XHG=536 XHG=991 YBD=2515 YBD=2515 YBD=2520 YBD=2523 YBD=2523 YHG=2487>cells YHG=2486>1200 YHG=2495>per YHG=2495>c.mm., YHG=2486>chiefly YHG=2486>lymphocytes YHG=2486>gram-negative XBD=1482XHG=685 XBD=1664 XBD=1770 XBD=1971 XBD=2162 XBD=2251 XBD=2451 XBD=2498 XHG=1329 XHG=1501 XHG=1684 XHG=1817 XHG=1988 XHG=2180 XHG=2269 XHG=2466 YBD=2524 YBD=2515 YBD=2523 YBD=2513 YHG=2486>positive ; YHG=2486>Kernig’s YHG=2486>sign. YHG=2486>Lumbar YHG=2489>puncture YHG=2494>was YHG=2485>performed YHG=2487>at " XBD=2499 XBD=1438 XBD=1526 XBD=1626 XBD=1709 XBD=1844 XBD=1895 XBD=1931 XBD=2101 XBD=2154 XBD=2229 XBD=2324 XBD=2375 XHG=1329 XHG=1464 XHG=1539 XHG=1639 XHG=1723 XHG=1856 XHG=1908 XHG=1943 XHG=2115 XHG=2168 XHG=2242 XHG=2338 XHG=2384 YBD=2560 YBD=2564 YBD=2555 YBD=2554 YBD=2557 YHG=2535>once YHG=2526>the YHG=2526>fluid YHG=2535>was YHG=2526>turbid YHG=2528>at YHG=2536>a YHG=2535>pressure YHG=2526>of YHG=2527>110 YHG=2534>mm. YHG=2525>of YHG=2527>water; ; XBD=189 XHG=892 XBD=280 XBD=328 XBD=401 XBD=523 XBD=657 XBD=735 XBD=881 XBD=983 XBD=1077 XBD=1268 XHG=71 XHG=199 XHG=290 XHG=337 XHG=411 XHG=533 XHG=669 XHG=746 XHG=994 XHG=1087 YBD=2555 YBD=2553 YBD=2560 YBD=2554 YBD=2555 YBD=2563 YBD=2564 YHG=2526>bacilli YHG=2535>seen YHG=2527>in YHG=2526>the YHG=2526>direct YHG=2535>smear, YHG=2526>but YHG=2526>culture YHG=2534>grew YHG=2526>only YHG=2527>staphylo" XBD=2500 XBD=1413 XBD=1533 XBD=1644 XBD=1917 XBD=2093 XBD=2258 XBD=2342 XBD=2427 XHG=1331 XHG=1439 XHG=1561 XHG=1668 XHG=1953 XHG=2116 XHG=2284 XHG=2362 XHG=2446 YBD=2599 YBD=2603 YBD=2594 YBD=2601 YBD=2602 YHG=2566>cells YHG=2566>1800, YHG=2565>79% YHG=2566>polymorphs YHG=2566>protein YHG=2568>content YHG=2566>125 YHG=2573>mg. YHG=2573>per ; XBD=167 XHG=968 XBD=258 XBD=517 XBD=651 XBD=761 XBD=954 XBD=990 XBD=1267 XHG=73 XHG=186 XHG=273 XHG=537 XHG=672 XHG=780 XHG=1012 YBD=2594 YBD=2602 YBD=2593 YBD=2603 YBD=2594 YHG=2565>cocci YHG=2566>and YHG=2565>diphtheroids YHG=2566>which YHG=2574>were YHG=2566>probably YHG=2575>a YHG=2566>contaminant. " XBD=2499 XBD=1396 XBD=1549 XBD=1636 XBD=1780 XBD=1995 XBD=2170 XBD=2313 XBD=2423 XHG=1335 XHG=1426 XHG=1590 XHG=1665 XHG=1825 XHG=2023 XHG=2197 XHG=2339 XHG=2445 YBD=2638 YBD=2634 YBD=2633 YBD=2641 YBD=2632 YHG=2607>100 YHG=2614>c.cm. YHG=2615>no YHG=2614>sugar. YHG=2605>Pfeiffer’s YHG=2600>bacillus YHG=2614>grown YHG=2604>from YHG=2604>the ; XBD=228 XHG=885 XBD=424 XBD=519 XBD=708 XBD=751 XBD=862 XBD=975 XBD=1068 XBD=1269 XHG=72 XHG=249 XHG=448 XHG=541 XHG=732 XHG=776 XHG=997 XHG=1090 YBD=2633 YBD=2642 YBD=2641 YBD=2633 YBD=2633 YHG=2605>Lumbar YHG=2608>puncture YHG=2614>was YHG=2604>repeated YHG=2606>3 YHG=2606>days YHG=2605>later YHG=2605>and YHG=2605>produced XBD=94 XHG=72 XBD=212 XBD=364 XBD=483 XBD=625 XBD=833 XBD=1032 XBD=1269 XHG=124 XHG=242 XHG=395 XHG=513 XHG=655 XHG=863 XHG=1066 YBD=2673 YBD=2680 YBD=2672 YBD=2673 YBD=2681 YHG=2654>a YHG=2653>very YHG=2644>turbid YHG=2643>fluid YHG=2644>under YHG=2644>increased YHG=2653>pressure, YHG=2644>containing: " XBD=2498 XBD=1428 XBD=1703 XBD=1812 XBD=1940 XBD=2013 XBD=2186 XHG=1330 XHG=1475 XHG=1741 XHG=1836 XHG=1964 XHG=2037 XHG=2225 YBD=2672 YBD=2673 YBD=2682 YBD=2678 YBD=2681 YHG=2644>fluid. YHG=2645>Treatment YHG=2644>free YHG=2645>fluids YHG=2645>by YHG=2645>mouth; YHG=2643>sulphapyridine, " XBD=2415 |>" XBD=160 XBD=299 XBD=565 XBD=699 XBD=972 XBD=1099 XBD=1270 XBD=1387 XBD=1661 XBD=1782 XBD=1901 XBD=2110 XBD=2283 XBD=2590 XHG=73 XHG=193 XHG=344 XHG=602 XHG=728 XHG=1001 XHG=1160 XHG=1333 XHG=1489 XHG=1708 XHG=1808 XHG=1928 XHG=2135 XHG=2327 XHG=2580 YBD=2712 YBD=2716 YBD=2720 YBD=2721 YBD=2721 YBD=2712 YBD=2714 YHG=2684>4000 YHG=2682>cells YHG=2683>neutrophils YHG=2683>60%, YHG=2684>lymphocytes YHG=2683>40%. YHG=2684>Many YHG=2685>0-5 YHG=2684>4-hourly. YHG=2684>The YHG=2684>child YHG=2684>improved YHG=2683>rapidly. YHG=2683>Next YHG=2703>f ; |>" " XBD=499 XBD=615 XBD=726 XBD=793 XBD=884 XBD=1024 XBD=1169 XBD=1269 XBD=1393 XBD=1667 XBD=1773 XBD=1932 XBD=1996 XBD=2160 XBD=2262 XBD=2360 XBD=2428 XBD=2499 XBD=350 XHG=381 XHG=527 XHG=646 XHG=756 XHG=821 XHG=914 XHG=1055 XHG=1198 XHG=1331 XHG=1414 XHG=1686 XHG=1792 XHG=1950 XHG=2017 XHG=2208 XHG=2280 XHG=2383 XHG=2445 XHG=73YBD=2751 YBD=2752 YBD=2760 YBD=2751 YBD=2760 YBD=2752 YBD=2757 YBD=2751 YHG=2722>bacilli YHG=2732>were YHG=2732>seen YHG=2724>in YHG=2723>the YHG=2722>gram-negative YHG=2723>direct YHG=2733>smear YHG=2724>and YHG=2724>the YHG=2723>cerebrospinal YHG=2723>fluid YHG=2723>showed YHG=2733>no YHG=2724>change. YHG=2723>On YHG=2723>Dec. YHG=2723>19, YHG=2723>the " XBD=1269 XBD=209 XBD=426 XBD=483 XBD=635 XBD=805 XBD=880 XBD=1086 XHG=74 XHG=246 XHG=462 XHG=518 XHG=669 XHG=915 XHG=1111 YBD=2790 YBD=2797 YBD=2789 YBD=2799 YBD=2791 YBD=2790 YBD=2796 YHG=2762>culture YHG=2761>produced YHG=2771>a YHG=2763>heavy YHG=2763>growth YHG=2763>of YHG=2762>Pfeiffer’s YHG=2762>bacillus, XBD=1569XHG=840 XBD=1670 XBD=1849 XBD=2072 XBD=2182 XBD=2424 XBD=2496 XHG=1331 XHG=1599 XHG=1706 XHG=1881 XHG=2107 XHG=2212 XHG=2452 YBD=2799 YBD=2800 YBD=2790 YHG=2765>temperature YHG=2771>was YHG=2762>100° YHG=2763>pulse-rate YHG=2763>160, YHG=2762>respirations YHG=2762>56. F., mouth; XBD=312 XHG=827 XBD=521 XBD=796 XBD=898 XBD=1022 XBD=1097 XHG=74 XHG=334 XHG=570 XHG=919 XHG=1048 YBD=2837 YBD=2837 YBD=2830 YBD=2829 YHG=2800>Hcemophilus YHG=2801>influenzce. YHG=2802>Treatment YHG=2802>free YHG=2801>fluids YHG=2802>by : " XBD=2496 XBD=1624 XBD=1790 XBD=1841 XBD=1957 XBD=2004 XBD=2249 XBD=2330 XBD=2425 XHG=1333 XHG=1638 XHG=1803 XHG=1858 XHG=1971 XHG=2020 XHG=2262 XHG=2344 XHG=2437 YBD=2839 YBD=2830 YBD=2838 YBD=2829 YHG=2802>Sulphapyridine YHG=2802>reduced YHG=2804>to YHG=2803>0-375 YHG=2811>g. YHG=2802>4-hourly-for YHG=2805>two YHG=2801>days YHG=2801>and XBD=372 XHG=885 XBD=420 XBD=480 XBD=607 XBD=667 XBD=757 XBD=861 XBD=972 XBD=1089 XBD=1271 XHG=74 XHG=401 XHG=447 XHG=503 XHG=621 XHG=681 XHG=773 XHG=987 XHG=1105 YBD=2877 YBD=2876 YBD=2878 YBD=2869 YBD=2877 YHG=2839>sulphapyridine, YHG=2840>3 YHG=2849>g. YHG=2840>given YHG=2850>on YHG=2841>first YHG=2841>day; YHG=2841>then YHG=2842>4-5 YHG=2841>daily g. for " XBD=2496 XBD=1420 XBD=1512 XBD=1561 XBD=1750 XBD=1869 XBD=1982 XBD=2111 XBD=2166 XBD=2306 XBD=2359 XHG=1331 XHG=1436 XHG=1528 XHG=1579 XHG=1797 XHG=1888 XHG=1998 XHG=2127 XHG=2184 XHG=2322 XHG=2376 YBD=2877 YBD=2869 YBD=2875 YBD=2870 YBD=2878 YHG=2841>then YHG=2842>0-25 YHG=2850>g. YHG=2841>4-hourly. YHG=2841>The YHG=2841>child YHG=2841>began YHG=2843>to YHG=2841>vomit, YHG=2850>so YHG=2840>sulphaXBD=172 XHG=886 XBD=283 XBD=456 XBD=516 XBD=547 XBD=592 XBD=702 XBD=766 XBD=877 XBD=985 XBD=1096 XBD=1204 XBD=1271 XHG=73 XHG=184 XHG=295 XHG=467 XHG=528 XHG=562 XHG=607 XHG=711 XHG=779 XHG=1031 XHG=1108 XHG=1215 YBD=2909 YBD=2908 YBD=2916 YBD=2909 YBD=2917 YHG=2881>three YHG=2879>followed YHG=2880>by YHG=2880>3 YHG=2889>g. YHG=2880>daily YHG=2880>for YHG=2881>three YHG=2880>days, YHG=2881>5 4YHG=2881>daily YHG=2881>for g. ; " XBD=2496 XBD=1482 XBD=1576 XBD=1723 XBD=1830 XBD=1984 XBD=2159 XBD=2241 XBD=2431 XHG=1331 XHG=1504 XHG=1597 XHG=1757 XHG=1853 XHG=2007 XHG=2179 XHG=2261 XHG=2469 YBD=2916 YBD=2917 YBD=2909 YBD=2918 YBD=2908 YHG=2880>thiazole YHG=2889>was YHG=2880>given YHG=2880>this YHG=2881>change YHG=2880>checked YHG=2880>the YHG=2881>vomiting. YHG=2880>A " XBD=2495 XBD=1455 XBD=1577 XBD=1650 XBD=1761 XBD=1833 XBD=1951 XBD=2086 XBD=2352 XBD=2434 XHG=1331 XHG=1482 XHG=1605 XHG=1677 XHG=1791 XHG=1860 XHG=1976 XHG=2111 XHG=2376 XHG=2456 YBD=2947 YBD=2956 YBD=2957 YBD=2949 YBD=2948 YHG=2920>throat YHG=2920>swab YHG=2929>on YHG=2919>Dec. YHG=2920>20 YHG=2928>grew YHG=2928>many YHG=2920>pneumococci YHG=2920>but YHG=2928>no XBD=236 XHG=923 XBD=351 XBD=423 XBD=471 XBD=548 XBD=635 XBD=730 XBD=823 XBD=900 XBD=956 XBD=1075 XBD=1152 XBD=1270 XHG=75 XHG=253 XHG=370 XHG=438 XHG=494 XHG=570 XHG=659 XHG=752 XHG=846 XHG=980 XHG=1097 XHG=1174 YBD=2958 YBD=2947 YBD=2956 YBD=2948 YBD=2957 YBD=2957 YHG=2920>eighteen YHG=2919>days, YHG=2920>7-5 YHG=2920>for YHG=2928>one YHG=2920>day YHG=2921>and YHG=2921>4-5 YHG=2928>g. YHG=2920>daily YHG=2920>for YHG=2920>eight " XBD=2493 XBD=1504 XBD=1654 XBD=1757 XBD=1862 XBD=1944 XBD=2107 XBD=2322 XHG=1333 XHG=1526 XHG=1703 XHG=1781 XHG=1890 XHG=1968 XHG=2129 XHG=2356 YBD=2987 YBD=2992 YBD=2988 YBD=2997 YHG=2959>Pfeiffer’s YHG=2951>bacilli. YHG=2959>On YHG=2960>Dec. YHG=2960>23, YHG=2959>lumbar YHG=2962>puncture YHG=2967>pressure XBD=173 XHG=876 XBD=384 XBD=429 XBD=486 XBD=549 XBD=854 XBD=947 XBD=1074 XBD=1271 XHG=75 XHG=234 XHG=411 XHG=453 XHG=510 XHG=569 XHG=971 XHG=1097 YBD=2997 YBD=2986 YBD=2987 YBD=2996 YBD=2988 YBD=2996 YBD=2995 YHG=2961>days. YHG=2958>Finally, YHG=2959>6 YHG=2968>g. YHG=2959>of YHG=2959>sulphapyridine YHG=2968>was YHG=2960>given YHG=2959>daily for: " XBD=2495 XBD=1399 XBD=1496 XBD=1549 XBD=1689 XBD=1796 XBD=1985 XBD=2246 XBD=2316 XHG=1337 XHG=1410 XHG=1510 XHG=1557 XHG=1716 XHG=1810 XHG=1998 XHG=2271 XHG=2328 YBD=3031 YBD=3026 YBD=3036 YBD=3027 YBD=3035 YHG=2999>100 YHG=3008>mm. YHG=2998>of YHG=3002>water YHG=2998>cells YHG=2998>290, YHG=2999>polymorphs YHG=3008>no YHG=3000>organisms ; ; XBD=195 XHG=835 XBD=318 XBD=487 XBD=530 XBD=638 XBD=693 XBD=770 XBD=819 XBD=872 XBD=1080 XBD=1195 XHG=74 XHG=219 XHG=341 XHG=509 XHG=546 XHG=653 XHG=707 XHG=786 XHG=889 XHG=1096 YBD=3028 YBD=3035 YBD=3026 YBD=3035 YHG=3000>fifteen YHG=2999>days, YHG=2998>making YHG=3008>a YHG=2999>total YHG=2998>of YHG=2999>245 YHG=3007>g. YHG=2999>in YHG=2999>forty-nine YHG=2999>days.82% XBD=1438XHG=952 XBD=1593 XBD=1733 XBD=1824 XBD=1918 XBD=1974 XBD=2046 XBD=2152 XBD=2232 XBD=2404 XBD=2492 XHG=1333 XHG=1458 XHG=1606 XHG=1769 XHG=1834 XHG=1932 XHG=1984 XHG=2058 XHG=2160 XHG=2242 XHG=2412 YBD=3070 YBD=3065 YBD=3075 YBD=3069 YHG=3046>seen ; YHG=3038>culture YHG=3038>sterile. YHG=3037>On YHG=3037>Dec. YHG=3038>24 YHG=3038>the YHG=3038>child YHG=3047>was YHG=3038>clinically YHG=3037>well " XBD=1270 XBD=222 XBD=302 XBD=400 XBD=481 XBD=591 XBD=711 XBD=870 XBD=929 XBD=995 XBD=1112 XHG=119 XHG=240 XHG=321 XHG=418 XHG=502 XHG=611 XHG=733 XHG=891 XHG=1017 XHG=1134 YBD=3075 YBD=3065 YBD=3066 YBD=3066 YHG=3039>After YHG=3038>the YHG=3038>first YHG=3040>ten YHG=3038>days YHG=3038>there YHG=3038>seemed YHG=3041>to YHG=3038>be YHG=3047>some YHG=3038>clinical " XBD=2492 XBD=1569 XBD=1682 XBD=1755 XBD=1966 XBD=2070 XBD=2316 XBD=2383 XHG=1332 XHG=1590 XHG=1696 XHG=1777 XHG=1989 XHG=2096 XHG=2335 XHG=2424 YBD=3104 YBD=3113 YBD=3109 YBD=3114 YBD=3106 YBD=3105 YHG=3079>temperature YHG=3076>99.60 YHG=3076>F.; YHG=3076>pulse-rate YHG=3078>140 YHG=3077>respirations YHG=3078>30. YHG=3077>Two ; XBD=342 XHG=739 XBD=430 XBD=524 XBD=615 XBD=720 XBD=906 XBD=1154 XBD=1270 XHG=74 XHG=365 XHG=451 XHG=544 XHG=637 XHG=925 XHG=1177 YBD=3115 YBD=3105 YBD=3112 YBD=3113 YBD=3110 YHG=3078>improvement, YHG=3077>but YHG=3077>this YHG=3085>was YHG=3076>only YHG=3077>partially YHG=3077>maintained, YHG=3077>since " XBD=2323 XBD=2490XHG=756 XBD=136 XBD=307 XBD=474 XBD=567 XBD=734 XBD=926 XBD=1084 XBD=1167 XBD=1269 XBD=1420 XBD=1521 XBD=1631 XBD=1713 XBD=1750 XBD=1900 XBD=1980 XBD=2032 XBD=2277 XHG=74 XHG=159 XHG=328 XHG=496 XHG=588 XHG=947 XHG=1104 XHG=1190 XHG=1333 XHG=1431 XHG=1533 XHG=1642 XHG=1729 XHG=1766 XHG=1914 XHG=1992 XHG=2042 XHG=2286 XHG=2337 YBD=3145 YBD=3145 YBD=3144 YBD=3152 YBD=3152 YBD=3143 YBD=3152 YBD=3144 YBD=3148 YHG=3117>the YHG=3116>cervical YHG=3115>rigidity YHG=3116>and YHG=3115>pyrexia YHG=3115>persisted YHG=3115>though YHG=3116>the YHG=3115>CSF YHG=3116>days YHG=3115>later YHG=3115>there YHG=3124>was YHG=3125>a YHG=3116>sudden YHG=3116>rise YHG=3116>of YHG=3117>temperature YHG=3119>to YHG=3115>104-6° F., " XBD=2491 XBD=217 XHG=694 XBD=386 XBD=527 XBD=654 XBD=784 XBD=955 XBD=1162 XBD=1270 XBD=1394 XBD=1598 XBD=1691 XBD=1857 XBD=1946 XBD=2026 XBD=2094 XBD=2307 XBD=2407 XHG=817 XHG=75 XHG=258 XHG=432 XHG=567 XHG=989 XHG=1199 XHG=1331 XHG=1409 XHG=1620 XHG=1713 XHG=1870 XHG=1960 XHG=2046 XHG=2108 XHG=2323 XHG=2419 YBD=3184 YBD=3184 YBD=3183 YBD=3191 YBD=3182 YBD=3192 YBD=3190 YBD=3187 YBD=3182 YBD=3191 YBD=3192 YBD=3184 YHG=3156>became YHG=3155>sterile. YHG=3155>Four YHG=3155>days YHG=3154>later YHG=3155>lumbar YHG=3157>puncture YHG=3155>the YHG=3154>fontanelle YHG=3163>was YHG=3154>slightly YHG=3154>full, YHG=3155>but YHG=3164>no YHG=3154>meningitic YHG=3155>signs YHG=3163>were XBD=1517 XBD=1718 XBD=1912 XBD=2160 XBD=2302 XBD=2402 XBD=2454 XHG=1333 XHG=1563 XHG=1739 XHG=2138 XHG=2182 XHG=2323 XHG=2422 XHG=2474 YBD=3230 YBD=3222 YBD=3223 YBD=3221 YHG=3195>apparent. YHG=3193>Lumbar YHG=3196>puncture YHG=3203>a YHG=3194>turbid YHG=3194>fluid YHG=3197>at YHG=3202>a " XBD=2491 XBD=240 XHG=921 XBD=318 XBD=599 XBD=714 XBD=849 XBD=908 XBD=992 XBD=1078 XBD=1271 XHG=74 XHG=253 XHG=330 XHG=612 XHG=726 XHG=860 XHG=1006 XHG=1092 YBD=3231 YBD=3223 YBD=3230 YBD=3231 YBD=3221 YBD=3231 YHG=3195>repeated YHG=3203>one YHG=3194>intervertebral YHG=3202>space YHG=3193>higher YHG=3203>up YHG=3194>and YHG=3193>this YHG=3193>produced

" XBD=2490 XBD=97 XHG=75 XBD=262 XBD=426 XBD=542 XBD=619 XBD=720 XBD=955 XBD=1059 XBD=1137 XBD=1270 XBD=1489 XBD=1546 XBD=1624 XBD=1723 XBD=1782 XBD=1924 XBD=2035 XBD=2150 XBD=2385 XHG=112 XHG=280 XHG=473 XHG=557 XHG=634 XHG=736 XHG=972 XHG=1074 XHG=1153 XHG=1331 XHG=1507 XHG=1563 XHG=1639 XHG=1741 XHG=1793 XHG=1956 XHG=2053 XHG=2167 XHG=2400 YBD=3262 YBD=3270 YBD=3263 YBD=3262 YBD=3261 YBD=3269 YBD=3271 YBD=3260 YBD=3265 YBD=3261 YBD=3266 YBD=3270 YBD=3271 YHG=3243>a YHG=3233>positive YHG=3234>culture. YHG=3234>For YHG=3233>the YHG=3235>next YHG=3232>twenty-five YHG=3233>days YHG=3232>her ; ; YHG=3232>condiYHG=3241>pressure YHG=3233>105 YHG=3241>mm. YHG=3232>of YHG=3234>water YHG=3232>cells YHG=3233>3300, YHG=3233>polymorphs YHG=3233>60% " XBD=2491 XBD=1440 XBD=1738 XBD=1880 XBD=2007 XBD=2181 XBD=2304 XHG=1331 XHG=1465 XHG=1763 XHG=1902 XHG=2045 XHG=2205 XHG=2346 YBD=3307 YBD=3299 YBD=3305 YBD=3300 YBD=3308 YBD=3301 YHG=3280>many YHG=3270>gram-negative YHG=3270>bacilli YHG=3280>seen YHG=3272>culture YHG=3281>grew. YHG=3271>Pfeiffer’s ; XBD=151 XHG=709 XBD=357 XBD=592 XBD=683 XBD=856 XBD=1065 XBD=1268 XHG=75 XHG=177 XHG=384 XHG=621 XHG=883 XHG=1091 YBD=3300 YBD=3301 YBD=3309 YBD=3307 YBD=3309 YHG=3273>tion YHG=3272>remained YHG=3273>stationary, YHG=3273>the YHG=3271>pyrexia YHG=3272>becoming YHG=3271>irregular, " XBD=2491 |>" XBD=140 XBD=252 XBD=298 XBD=549 XBD=656 XBD=882 XBD=1064 XBD=1159 XBD=1270 XBD=1490 XBD=1839 XBD=1923 XBD=1995 XBD=2128 XBD=2314 XBD=2388 XBD=2543 XHG=74 XHG=164 XHG=276 XHG=321 XHG=572 XHG=681 XHG=927 XHG=1087 XHG=1183 XHG=1331 XHG=1538 XHG=1869 XHG=1951 XHG=2024 XHG=2156 XHG=2337 XHG=2409 XHG=2540 YBD=3340 YBD=3340 YBD=3339 YBD=3348 YBD=3349 YBD=3347 YBD=3339 YBD=3338 YBD=3347 YBD=3349 YBD=3340 YBD=3345 YHG=3311>but YHG=3312>with YHG=3320>a YHG=3311>persistently YHG=3312>high YHG=3312>pulse-rate. YHG=3311>During YHG=3310>this YHG=3310>time YHG=3310>bacillus. YHG=3310>Sulphapyridine, YHG=3311>0-5 YHG=3320>g., YHG=3311>given YHG=3311>4-hourly YHG=3312>for YHG=3312>three YHG=3339>, |>" " XBD=135 XBD=348 XBD=391 XBD=564 XBD=644 XBD=733 XBD=793 XBD=831 XBD=964 XBD=1043 XBD=1102 XBD=1183 XBD=1271 XBD=1443 XBD=1576 XBD=1763 XBD=1831 XBD=2138 XBD=2250 XBD=2312 XBD=2489 XBD=1443 XHG=74 XHG=156 XHG=368 XHG=410 XHG=583 XHG=665 XHG=754 XHG=810 XHG=851 XHG=984 XHG=1063 XHG=1121 XHG=1204 XHG=1332 XHG=1488 XHG=1606 XHG=1792 XHG=1863 XHG=2175 XHG=2281 XHG=2342 XHG=1436 YBD=3377 YBD=3387 YBD=3380 YBD=3379 YBD=3378 YBD=3378 YBD=3378 YBD=3385 YBD=3377 YBD=3379 YBD=3387 YBD=3383 YHG=3350>she YHG=3350>developed YHG=3359>a YHG=3351>swelling YHG=3351>the YHG=3352>size YHG=3351>of YHG=3360>a YHG=3349>man’s YHG=3350>fist YHG=3352>at YHG=3350>the YHG=3350>site YHG=3350>days YHG=3349>then YHG=3349>changed YHG=3351>to YHG=3349>sulphathiazole YHG=3351>0.25 YHG=3359>g. YHG=3351>4-hourly. YHG=3360>; ; the XBD=118 XHG=74 YBD=3416 YHG=3388>of " XBD=2488 XBD=282 XBD=439 XBD=656 XBD=776 XBD=879 XBD=1073 XBD=1182 XBD=1271 XBD=1388 XBD=1480 XBD=1527 XBD=1639 XBD=1714 XBD=1819 XBD=1901 XBD=2011 XBD=2123 XBD=2365 XBD=2429 XHG=205 XHG=299 XHG=454 XHG=703 XHG=792 XHG=896 XHG=1091 XHG=1198 XHG=1333 XHG=1399 XHG=1500 XHG=1545 XHG=1652 XHG=1727 XHG=1830 XHG=1915 XHG=2023 XHG=2138 XHG=2378 XHG=2439 YBD=3417 YBD=3426 YBD=3418 YBD=3425 YBD=3417 YBD=3416 YBD=3425 YBD=3422 YBD=3426 YBD=3419 YBD=3421 YHG=3389>first YHG=3389>lumbar YHG=3392>punctures. YHG=3388>The YHG=3389>fluid YHG=3389>aspirated YHG=3389>from ; YHG=3388>this YHG=3389>On YHG=3388>Jan. YHG=3390>1, YHG=3389>1942, YHG=3388>the YHG=3387>child YHG=3397>was YHG=3388>quite YHG=3389>well YHG=3391>temperature YHG=3389>98° YHG=3389>F.; " XBD=1269 XBD=166 XBD=363 XBD=548 XBD=626 XBD=987 XBD=1054 XBD=1142 XHG=75 XHG=193 XHG=390 XHG=593 XHG=1014 XHG=1079 XHG=1169 YBD=3462 YBD=3455 YBD=3456 YBD=3457 YBD=3457 YBD=3456 YHG=3435>grew YHG=3426>Pfeiffer’s YHG=3427>bacillus. YHG=3429>A YHG=3428>blood-transfusion YHG=3428>of YHG=3428>290 YHG=3437>c.cm. XBD=1522XHG=652 XBD=1637 XBD=1891 XBD=1969 XBD=2171 XBD=2430 XBD=2489 XHG=1331 XHG=1552 XHG=1667 XHG=1917 XHG=2014 XHG=2190 XHG=2447 YBD=3461 YBD=3464 YBD=3465 YHG=3428>pulse-rate YHG=3428>112; YHG=3426>respirations YHG=3428>28. YHG=3428>Lumbar YHG=3430>puncture YHG=3430>atwas the XBD=145 XHG=715 XBD=283 XBD=383 XBD=479 XBD=680 XBD=894 XBD=1173 XHG=75 XHG=179 XHG=317 XHG=417 XHG=512 XHG=928 YBD=3493 YBD=3500 YBD=3494 YBD=3503 YBD=3496 YBD=3501 YHG=3473>was YHG=3465>given YHG=3466>but YHG=3466>the YHG=3467>patient’s YHG=3468>condition YHG=3467>deteriorated, " XBD=2331 XBD=1493 XBD=1613 XBD=1700 XBD=1790 XBD=2058 XBD=2170 XBD=2269 XHG=1331 XHG=1511 XHG=1633 XHG=1719 XHG=1809 XHG=2116 XHG=2190 XHG=2290 YBD=3504 YBD=3495 YBD=3497 YBD=3496 YHG=3467>tempted YHG=3467>twice YHG=3466>but YHG=3475>was YHG=3467>unsuccessful. YHG=3466>On YHG=3467>Jan. YHG=3469>14

1.

1040 F.;

day ,

g.,

produced

sulphon-

557

" XBD=1225 XBD=1300XHG=921 XBD=249 XBD=358 XBD=640 XBD=761 XBD=887 XBD=991 XHG=134 XHG=274 XHG=387 XHG=688 XHG=794 XHG=1021 XHG=1254 YBD=229 YBD=227 YBD=226 YBD=225 YBD=234 YBD=225 YHG=199>amides YHG=207>were YHG=197>discontinued. YHG=198>The YHG=198>child YHG=207>was YHG=198>discharged YHG=206>on " XBD=1183 XBD=205 XHG=638 XBD=250 XBD=362 XBD=421 XBD=507 XBD=622 XBD=784 XBD=870 XBD=1027 XHG=801 XHG=135 XHG=223 XHG=266 XHG=377 XHG=437 XHG=525 XHG=886YBD=264 XHG=1044 YBD=269 YBD=266 YBD=265 YBD=273 YBD=272 YBD=272 YBD=272 YHG=239>Feb. YHG=238>6, YHG=237>when YHG=237>he YHG=246>was YHG=236>quite YHG=237>healthy YHG=236>and YHG=236>gaining YHG=236>weight.

TETANUS IN THE IMMUNISED SUBJECT H. BATHURST

" XBD=883 XHG=588 YBD=347 YHG=314>DISCUSSION .

" XBD=2558 XBD=269 XHG=821 XBD=352 XBD=463 XBD=624 XBD=739 XBD=800 XBD=926 XBD=1050 XBD=1137 XBD=1300 XBD=1602 XBD=1662 XBD=1767 XBD=1868 XBD=1984 XBD=2174 XBD=2319 XHG=173 XHG=289 XHG=372 XHG=485 XHG=645 XHG=759 XHG=937YBD=400 XHG=1072 XHG=1161 XHG=1415 XHG=1621 XHG=1678 XHG=1783 XHG=1885 XHG=2002 XHG=2192 XHG=2335 YBD=405 YBD=401 YBD=407 YBD=406 YBD=399 YBD=399 YBD=398 YBD=407 YBD=406 YHG=372>With YHG=372>the YHG=370>high YHG=370>dosage YHG=370>used YHG=370>in YHG=370>these YHG=350>cases YHG=369>the YHG=369>danger YHG=377>TETANUS YHG=377>in YHG=386>men YHG=378>who YHG=378>have YHG=376>received YHG=376>active YHG=376>immunisa-

" XBD=1024 XBD=1300 XBD=208 XBD=383 XBD=450 XBD=536 XBD=852 XBD=952 XHG=132 XHG=230 XHG=407 XHG=470 XHG=562 XHG=976 XHG=1048 YBD=448 YBD=439 YBD=446 YBD=438 YBD=437 YBD=445 YHG=413>that YHG=410>crystals YHG=409>of YHG=409>the YHG=408>sulphonamide YHG=408>will YHG=407>be YHG=408>precipitated XBD=1449XHG=876 XBD=1579 XBD=1702 XBD=1816 XBD=1885 XBD=1969 XBD=2121 XBD=2185 XBD=2417 XBD=2560 XHG=2434 XHG=1364 XHG=1467 XHG=1598 XHG=1719 XHG=1835 XHG=1904 XHG=1989 XHG=2141 XHG=2198 YBD=446 YBD=453 YHG=415>tion YHG=416>sheds YHG=425>some YHG=416>light YHG=426>on YHG=417>the YHG=416>degree YHG=415>of YHG=416>protection YHG=415>which XBD=166 XBD=240 XBD=359 XBD=478 XBD=529 XBD=832 XBD=978 XBD=1094 XBD=1300 XHG=132 XHG=181 XHG=258 XHG=377 XHG=497 XHG=549 XHG=997YBD=476 XHG=1113 YBD=485 YBD=479 YBD=477 YBD=482 YBD=476 YBD=477 YHG=456>in YHG=452>the YHG=449>renal YHG=448>tract YHG=448>is YHG=447>considerable YHG=447>fluids YHG=455>were YHG=447>therefore ; " XBD=2450 XBD=2559XHG=866 XBD=1458 XBD=1768 XBD=1902 XBD=2072 XBD=2166 XBD=2233 XBD=2304 XHG=1364 XHG=1477 XHG=1788 XHG=1954 XHG=2094 XHG=2186 XHG=2254 XHG=2326 XHG=2470 YBD=492 YBD=484 YBD=485 YHG=455>such YHG=455>immunisation YHG=456>gives. YHG=455>There YHG=464>can YHG=454>be YHG=464>no YHG=455>doubt YHG=455>that " XBD=2557 XBD=272 XHG=740 XBD=369 XBD=459 XBD=572 XBD=713 XBD=823 XBD=1014 XBD=1141 XBD=1206 XBD=1300 XBD=1388 XBD=1506 XBD=1623 XBD=1854 XBD=1909 XBD=2117 XBD=2196 XBD=2287 XBD=2466 XHG=94 XHG=322 XHG=394 XHG=487 XHG=600 XHG=2492 XHG=851 XHG=1045 XHG=1169 XHG=1235 XHG=1364 XHG=1413 XHG=1531 XHG=1647 XHG=1878 XHG=1936 XHG=2143 XHG=2221 XHG=2313 YBD=532 YBD=517 YBD=516 YBD=522 YBD=523 YBD=522 YBD=521 YBD=516 YBD=522 YBD=530 YBD=532 YBD=524 YBD=525 YBD=531 YBD=523 YHG=489>pushed. YHG=488>In YHG=487>the YHG=496>case YHG=486>given YHG=486>drip YHG=486>therapy YHG=487>(case YHG=486>2) YHG=487>the YHG=503>a YHG=502>very YHG=494>high YHG=494>immunity YHG=495>is YHG=495>achieved YHG=495>by YHG=494>the YHG=494>routine YHG=493>ad" XBD=1624 XBD=1681 XBD=1709 XBD=1830 XBD=1889 XBD=2051 XBD=2198 XBD=2262 XBD=2350 XHG=1364 XHG=1637 XHG=1692 XHG=1725 XHG=1846 XHG=1897 XHG=2063 XHG=2211 XHG=2274 XHG=2364 YBD=561 YBD=562 YBD=563 YHG=532>ministration YHG=533>1 YHG=542>c.cm. YHG=533>of YHG=534>tetanus YHG=533>toxoid YHG=542>on YHG=533>two YHG=533>occasions |>"XBD=2559 XBD=211 XBD=493 XBD=608 XBD=831 XBD=899 XBD=982 XBD=1101 XBD=1163 XBD=1298 XBD=1225 XHG=131 XHG=228 XHG=511 XHG=627 XHG=848 XHG=916 XHG=1000 XHG=1120 XHG=1243 XHG=1178 YBD=562 YBD=564 YBD=555 YBD=554 YBD=553 YBD=554 YBD=553 YBD=560 YHG=529>fluid YHG=525>requirements YHG=534>were YHG=524>estimated YHG=534>on YHG=524>the YHG=524>basis YHG=524>of YHG=533>oz. YHG=524>2t

" " " " " " " "

XBD=189 XBD=260 XBD=333 XBD=628 XBD=838 XBD=1124 XBD=1208 XBD=1298 XHG=130 XHG=213 XHG=291 XHG=357 XHG=866YBD=592 XHG=1155 XHG=1242 YBD=608 YBD=596 YBD=594 YBD=602 YBD=598 YBD=597YHG=563>Sodium YHG=577>per YHG=567>lb. YHG=566>of YHG=563>body-weight. YHG=563>bicarbonate, YHG=572>gr. YHG=563>10, XBD=2559XHG=680 XBD=1407 XBD=1477 XBD=1661 XBD=1724 XBD=1762 XBD=1916 XBD=1978 XBD=2075 XBD=2286 XBD=2347 XBD=2433 XHG=1364 XHG=1427 XHG=1497 XHG=1681 XHG=1741 XHG=1782 XHG=1937 XHG=1998 XHG=2095 XHG=2306 XHG=2366 XHG=2454 YBD=599 YBD=600 YBD=606 YBD=602 YBD=601 YBD=609 YHG=571>at YHG=579>an YHG=571>interval YHG=571>of YHG=571>6 YHG=572>weeks, YHG=581>as YHG=581>was YHG=572>practised YHG=572>in YHG=572>the YHG=571>early XBD=229 XHG=619 XBD=332 XBD=438 XBD=545 XBD=604 XBD=942 XBD=1063 XBD=1122 XBD=1301 XHG=130 XHG=241 XHG=346 XHG=455 XHG=561 XHG=957YBD=640 XHG=1081 XHG=1139 YBD=646 YBD=635 YBD=633 YBD=632 YBD=639 YBD=633YHG=602>sulphapyridine, YHG=608>given YHG=604>with YHG=604>each YHG=598>dose YHG=602>of YHG=602>helps YHG=603>to YHG=603>prevent XBD=1453 XBD=1512 XBD=1588 XBD=1755 XBD=1857 XBD=2025 XBD=2164 XBD=2358 XBD=2423 XBD=2558 XHG=1364 XHG=1468 XHG=1522 XHG=1603 XHG=1769 XHG=1907 XHG=2043 XHG=2180 XHG=2373 XHG=2439 YBD=639 YBD=648 YBD=649 YBD=640 YBD=647 YHG=609>part YHG=610>of YHG=610>the YHG=610>present YHG=620>war. YHG=611>Perry YHG=612>(1940) YHG=611>reported YHG=620>no YHG=611>single XBD=312 XBD=419 XBD=586 XBD=657 XBD=823 XBD=939 XBD=1012 XBD=1203 XBD=1299 XHG=132 XHG=343 XHG=449 XHG=616 XHG=686 XHG=971 XHG=1043 XHG=1233 YBD=680 YBD=673 YBD=672 YBD=671 YBD=678 YBD=679 YBD=672 YBD=679 YBD=672 YHG=644>vomiting, YHG=642>and YHG=642>should YHG=642>in YHG=641>theory YHG=641>help YHG=642>to YHG=643>prevent YHG=642>the XBD=1450XHG=852 XBD=1520 XBD=1697 XBD=1862 XBD=2071 XBD=2295 XBD=2360 XBD=2556 XHG=1365 XHG=1476 XHG=1541 XHG=1722 XHG=1884 XHG=2096 XHG=2319 XHG=2384 YBD=678 YBD=687 YBD=688 YBD=680 YBD=685 YHG=658>case YHG=649>of YHG=649>tetanus YHG=659>among YHG=651>wounded YHG=651>personnel YHG=651>in YHG=649>France ; XBD=1491XHG=837 XBD=1636 XBD=1696 XBD=1737 XBD=1855 XBD=1985 XBD=2048 XBD=2275 XBD=2320 XBD=2500 XBD=2563 XBD=380 XBD=441 XBD=581 XBD=760 XBD=819 XBD=902 XBD=1039 XHG=130 XHG=398 XHG=455 XHG=601 XHG=778 XHG=1364 XHG=1514 XHG=1656 XHG=1713 XHG=1755 XHG=1874 XHG=2004 XHG=2062 XHG=2296 XHG=2338 XHG=2519 XHG=921 YBD=725 YBD=717 YBD=710 YBD=710 YBD=717 YBD=725 YBD=724 YBD=719 YBD=718 YHG=682>precipitation YHG=681>of YHG=681>acetyl YHG=681>crystals YHG=682>in YHG=681>the YHG=681>urine. YHG=688>Smith YHG=688>(1941) YHG=689>in YHG=697>a YHG=688>large YHG=689>series YHG=690>casualties, YHG=699>a YHG=690>number YHG=690>of XBD=243 XHG=949 XBD=344 XBD=448 XBD=501 XBD=748 XBD=809 XBD=927 XBD=991 XBD=1074 XBD=1300 XHG=172 XHG=263 XHG=364 XHG=470 XHG=523 XHG=768 XHG=830 XHG=1009 XHG=1097 YBD=752 YBD=751 YBD=750 YBD=756 YBD=749 YBD=749 YHG=722>The YHG=721>first YHG=728>case YHG=720>is YHG=720>interesting YHG=719>in YHG=720>view YHG=720>of YHG=720>the YHG=720>unusually XBD=1490 XBD=1585 XBD=1781 XBD=1896 XBD=2102 XBD=2187 XBD=2274 XBD=2353 XBD=2395 XBD=2499 XBD=2562 XHG=1364 XHG=1507 XHG=1602 XHG=1798 XHG=1915 XHG=2122 XHG=2205 XHG=2292 XHG=2372 XHG=2414 XHG=2518 YBD=756 YBD=763 YBD=758 YBD=757 YHG=728>whom YHG=727>had YHG=728>returned YHG=728>from YHG=727>Dunkirk, YHG=728>did YHG=729>not YHG=738>see YHG=738>a YHG=738>case YHG=728>of XBD=332 XBD=482 XBD=550 XBD=634 XBD=812 XBD=1046 XBD=1110 XBD=1201 XBD=1300 XHG=130 XHG=354 XHG=506 XHG=568 XHG=863 XHG=1068 XHG=1131 XHG=1223 YBD=801 YBD=787 YBD=788 YBD=789 YBD=789 YBD=787 YBD=789 YHG=760>protracted YHG=767>course YHG=758>of YHG=758>the YHG=758>disease. YHG=758>Whether YHG=768>or YHG=759>not YHG=758>this XBD=1532XHG=657 XBD=1795 XBD=1870 XBD=2072 XBD=2233 XBD=2360 XBD=2416 XBD=2557 XHG=1364 XHG=1584 XHG=1828 XHG=1904 XHG=2110 XHG=2268 XHG=2394 XHG=2453 YBD=794 YBD=795 YBD=802 YBD=804 YBD=796 YBD=797 YHG=766>tetanus. YHG=766>According YHG=766>to YHG=766>Bensted YHG=767>(1940) YHG=768>only YHG=768>8 YHG=776>cases XBD=195 XHG=506 XBD=299 XBD=374 XBD=475 XBD=695 XBD=1038 XBD=1233 XBD=1300 XHG=130 XHG=229 XHG=334 XHG=410 XHG=728YBD=827 XHG=1070 XHG=1268 YBD=831 YBD=828 YBD=834 YBD=827 YHG=809>was YHG=799>due YHG=799>to YHG=798>the YHG=797>intensive YHG=797>sulphapyridine YHG=798>therapy YHG=798>is XBD=1460 XBD=1659 XBD=1778 XBD=1865 XBD=2032 XBD=2356 XBD=2495 XBD=2558 XHG=1363 XHG=1481 XHG=1679 XHG=1799 XHG=1886 XHG=2053 XHG=2377 XHG=2517 YBD=841 YBD=834 YBD=843 YBD=836 YBD=835 YHG=814>were YHG=805>reported YHG=805>from YHG=805>the YHG=805>British YHG=805>Expeditionary YHG=806>Force YHG=806>in XBD=328 XHG=678 XBD=400 XBD=514 XBD=645 XBD=934 XBD=1043 XBD=1191 XBD=1300 XHG=129 XHG=360 XHG=434 XHG=567 XHG=967YBD=873 XHG=1076 XHG=1223 YBD=875 YBD=866 YBD=865 YBD=866 YBD=866 YHG=836>impossible YHG=837>to YHG=845>say. YHG=836>The YHG=837>temperature YHG=845>was YHG=845>never YHG=846>any XBD=1509 XBD=1668 XBD=1755 XBD=1906 XBD=2107 XBD=2181 XBD=2242 XBD=2351 XBD=2457 XBD=2557 XHG=1364 XHG=1532 XHG=1689 XHG=1776 XHG=1931 XHG=2130 XHG=2201 XHG=2262 XHG=2371 XHG=2479 YBD=882 YBD=880 YBD=879 YBD=873 YBD=874 YBD=875 YHG=844>France YHG=844>during YHG=845>the YHG=844>period YHG=844>1939-40, YHG=844>all YHG=845>in YHG=854>men YHG=846>who YHG=845>had

" " " " " " " " " "

XBD=195 XHG=973 XBD=306 XBD=564 XBD=665 XBD=809 XBD=875 XBD=949 XBD=997 XBD=1124 XBD=1302 XHG=129 XHG=217 XHG=329 XHG=588 XHG=690 XHG=835 XHG=900 XHG=1020 XHG=1148 YBD=986 YBD=991 YBD=985 YBD=984 YBD=984 YBD=985 YHG=964>was YHG=954>high YHG=955>throughout YHG=955>and YHG=964>seems YHG=955>to YHG=954>be YHG=964>a YHG=964>more YHG=954>reliable XBD=2557 XBD=1503 XBD=1593 XBD=1701 XBD=1800 XBD=1935 XBD=2003 XBD=2101 XBD=2165 XBD=2255 XBD=2422 XHG=1366 XHG=1527 XHG=1617 XHG=1725 XHG=1826 XHG=1960 XHG=2023 XHG=2124 XHG=2189 XHG=2279 XHG=2448 YBD=990 YBD=991 YBD=992 YBD=998 YHG=961>during YHG=962>first YHG=962>two YHG=971>years YHG=961>of YHG=971>war YHG=962>in YHG=962>the YHG=962>Middle YHG=963>East, XBD=228 XBD=284 XBD=521 XBD=632 XBD=727 XBD=861 XBD=949 XBD=1005 XBD=1107 XBD=1159 XBD=1301 XHG=128 XHG=244 XHG=302 XHG=555 XHG=650 XHG=744 XHG=965 XHG=1023 XHG=1126 XHG=1179 YBD=1032 YBD=1031 YBD=1024 YBD=1023 YBD=1023 YBD=1025 YBD=1029 YBD=1024 YHG=993>guide YHG=994>to YHG=994>prognosis YHG=994>this YHG=1003>was YHG=994>borne YHG=994>out YHG=994>in YHG=1003>case YHG=994>4, YHG=995>where XBD=1496XHG=879 XBD=1548 XBD=1680 XBD=1749 XBD=1943 XBD=2198 XBD=2407 XBD=2507 XBD=2556 XHG=1364 XHG=1527 XHG=1578 XHG=1708 XHG=1777 XHG=1970 XHG=2226 XHG=2460 XHG=2536 YBD=1031 YBD=1038 YBD=1030 YHG=1001>record ; YHG=1001>5 YHG=1010>cases YHG=1001>in YHG=1001>actively YHG=1001>immunised YHG=1001>subjects. YHG=1002>In YHG=1002>2 XBD=185 XHG=772 XBD=406 XBD=624 XBD=748 XBD=918 XBD=1005 XBD=1122 XBD=1185 XBD=1299 XHG=128 XHG=206 XHG=430 XHG=645 XHG=940YBD=1070 XHG=1028 XHG=1143 XHG=1206 YBD=1069 YBD=1063 YBD=1063 YBD=1063 YHG=1034>the YHG=1033>pulse-rate YHG=1033>remained YHG=1033>high, YHG=1033>despite YHG=1033>the YHG=1034>drop YHG=1034>in YHG=1034>temXBD=1409 XBD=1539 XBD=1632 XBD=1842 XBD=1945 XBD=2216 XBD=2319 XBD=2560 XHG=1365 XHG=1432 XHG=1566 XHG=1658 XHG=1867 XHG=1969 XHG=2242 XHG=2345 YBD=1070 YBD=1076 YBD=1069 YBD=1071 YHG=1041>of YHG=1041>these YHG=1039>the YHG=1040>infection YHG=1050>was YHG=1040>fulminating YHG=1040>and YHG=1041>associated XBD=300 XHG=810 XBD=528 XBD=600 XBD=778 XBD=900 XBD=1029 XBD=1125 XBD=1301 XHG=126 XHG=332 XHG=558 XHG=631 XHG=930YBD=1109 XHG=1060 XHG=1156 YBD=1110 YBD=1102 YBD=1103 YBD=1102 YBD=1110 YHG=1073>perature, YHG=1072>returning YHG=1073>to YHG=1073>normal YHG=1073>only YHG=1072>after YHG=1073>the YHG=1073>relapse XBD=1459 XBD=1550 XBD=1750 XBD=1818 XBD=1952 XBD=2142 XBD=2284 XBD=2349 XBD=2558 XHG=1364 XHG=1483 XHG=1574 XHG=1775 XHG=1837 XHG=1976 XHG=2166 XHG=2308 XHG=2373 YBD=1116 YBD=1109 YBD=1114 YHG=1079>with YHG=1080>the YHG=1088>presence YHG=1079>of YHG=1079>much YHG=1079>necrotic YHG=1079>tissue YHG=1079>in YHG=1080>wounds ; XBD=226 XBD=310 XBD=432 XBD=568 XBD=642 XBD=957 XBD=1169 XBD=1300 XHG=127 XHG=246 XHG=333 XHG=455 XHG=591 XHG=979 XHG=1222 YBD=1142 YBD=1140 YBD=1141 YBD=1149 YBD=1149 YBD=1141 YHG=1111>when YHG=1111>the YHG=1111>child YHG=1112>made YHG=1121>an YHG=1112>uninterrupted YHG=1121>recovery. YHG=1112>The XBD=1405XHG=664 XBD=1499 XBD=1738 XBD=1787 XBD=1920 XBD=2054 XBD=2160 XBD=2376 XBD=2491 XBD=2564 XHG=1363 XHG=1432 XHG=1527 XHG=1767 XHG=1817 XHG=1949 XHG=2082 XHG=2188 XHG=2403 XHG=2520 YBD=1147 YBD=1149 YBD=1156 YBD=1148 YHG=1120>in YHG=1119>the YHG=1119>remaining YHG=1119>3 YHG=1128>cases YHG=1119>there YHG=1128>was YHG=1119>apparent YHG=1118>lack YHG=1119>of XBD=379 XHG=891 XBD=450 XBD=524 XBD=700 XBD=771 XBD=863 XBD=963 XBD=1034 XBD=1123 XBD=1301 XHG=127 XHG=406 XHG=473 XHG=551 XHG=729 XHG=799 XHG=991YBD=1181 XHG=1057 XHG=1150 YBD=1187 YBD=1180 YBD=1180 YBD=1181 YHG=1150>development YHG=1150>of YHG=1160>an YHG=1150>abscess YHG=1152>at YHG=1151>the YHG=1151>site YHG=1151>of YHG=1151>the YHG=1152>lumbar XBD=1542 XBD=1602 XBD=1909 XBD=2021 XBD=2105 XBD=2371 XBD=2500 XBD=2564 XHG=1363 XHG=1561 XHG=1621 XHG=1927 XHG=2040 XHG=2124 XHG=2390 XHG=2521 YBD=1195 YBD=1188 YBD=1187 YHG=1167>response YHG=1158>to YHG=1157>immunisation YHG=1158>with YHG=1158>the YHG=1158>two’routine YHG=1158>doses YHG=1158>of XBD=299 XHG=810 XBD=359 XBD=554 XBD=661 XBD=781 XBD=973 XBD=1050 XBD=1301 XHG=127 XHG=328 XHG=389 XHG=583 XHG=690 XHG=1003 XHG=1081 YBD=1220 YBD=1219 YBD=1227 YBD=1220 YHG=1189>puncture YHG=1189>is YHG=1190>unusual YHG=1190>and YHG=1200>may YHG=1191>perhaps YHG=1190>be YHG=1190>considered XBD=1501 XBD=1673 XBD=1832 XBD=2070 XBD=2165 XBD=2306 XBD=2378 XBD=2427 XBD=2560 XHG=1362 XHG=1529 XHG=1726 XHG=1860 XHG=2099 XHG=2193 XHG=2334 XHG=2402 XHG=2454 YBD=1234 YBD=1226 YBD=1227 YHG=1198>formol YHG=1197>toxoid. YHG=1197>They YHG=1197>emphasise YHG=1197>the YHG=1197>value YHG=1197>of YHG=1207>a YHG=1196>third XBD=273 XBD=376 XBD=447 XBD=535 XBD=672 XBD=877 XBD=1054 XBD=1298 XHG=126 XHG=299 XHG=403 XHG=470 XHG=565 XHG=904 XHG=1081 YBD=1258 YBD=1259 YBD=1260 YBD=1266 YHG=1228>another YHG=1228>risk YHG=1228>of YHG=1229>too YHG=1229>often YHG=1229>lumbar YHG=1230>punctures. XBD=1407XHG=698 XBD=1462 XBD=1696 XBD=1820 XBD=1965 XBD=2039 XBD=2122 XBD=2318 XBD=2394 XBD=2560 XHG=1364YBD=1266 XHG=1442 XHG=1480 XHG=1731 XHG=1853 XHG=1997 XHG=2070 XHG=2152 XHG=2349 XHG=2422 YBD=1249YHG=1230>repeated YBD=1273 YBD=1265 YHG=1246>or YHG=1237>&dquo; YHG=1236>boosting YHG=1236>dose YHG=1236>given YHG=1237>at YHG=1233>an YHG=1236>interval YHG=1236>of YHG=1236>twelve &dquo; XBD=196 XHG=725 XBD=357 XBD=481 XBD=698 XBD=949 XBD=1016 XBD=1138 XBD=1210 XBD=1299 XHG=127 XHG=223 XHG=385 XHG=511 XHG=975YBD=1305 XHG=1043 XHG=1167 XHG=1234 YBD=1296 YBD=1297 YBD=1304 YBD=1298 YBD=1298 YBD=1299 YHG=1267>The YHG=1268>second YHG=1277>case, YHG=1268>although YHG=1269>interesting YHG=1269>in YHG=1270>view YHG=1269>of YHG=1269>the XBD=1519 XBD=1649 XBD=1742 XBD=1909 XBD=2181 XBD=2324 XBD=2560 XHG=1363 XHG=1549 XHG=1676 XHG=1771 XHG=1937 XHG=2233 XHG=2351 YBD=1306 YBD=1305 YBD=1304 YBD=1312 YHG=1276>months YHG=1276>after YHG=1276>the YHG=1275>second YHG=1275>inoculation. YHG=1275>This YHG=1275>procedure XBD=224 XHG=734 XBD=451 XBD=584 XBD=693 XBD=988 XBD=1193 XBD=1299 XHG=128 XHG=262 XHG=494 XHG=625 XHG=1027 XHG=1233 YBD=1343 YBD=1337 YBD=1344 YBD=1337 YBD=1338 YHG=1306>rapid YHG=1315>recovery, YHG=1308>does YHG=1308>not YHG=1308>conclusively YHG=1308>indicate YHG=1309>the XBD=1433 XBD=1547 XBD=1670 XBD=1864 XBD=1933 XBD=2026 XBD=2203 XBD=2398 XBD=2467 XBD=2560 XHG=1364 XHG=1461 XHG=1574 XHG=1696 XHG=1891 XHG=1960 XHG=2052 XHG=2230 XHG=2426 XHG=2493 YBD=1345 YBD=1344 YBD=1351 YBD=1343 YHG=1315>has YHG=1324>now YHG=1315>been YHG=1314>adopted YHG=1324>as YHG=1315>the YHG=1314>routine YHG=1314>practice YHG=1313>in YHG=1314>the

" XBD=1228 XBD=1301 XBD=229 XBD=298 XBD=393 XBD=559 XBD=798 XBD=933 XBD=995 XBD=1133 XHG=130 XHG=258 XHG=329 XHG=425 XHG=591 XHG=832 XHG=1027 XHG=1163 XHG=1259 YBD=915 YBD=911 YBD=906 YBD=905 YBD=906 YHG=877>guide YHG=876>to YHG=876>the YHG=875>child’s YHG=876>condition, YHG=876>since YHG=876>often YHG=876>fell YHG=876>to XBD=1434XHG=964 XBD=1565 XBD=1764 XBD=2023 XBD=2186 XBD=2297 XBD=2558 XHG=2329YBD=905 XHG=1366 XHG=1467 XHG=1597 XHG=1784 XHG=2074 XHG=2219 YBD=912YHG=875>it YBD=920 YBD=913 YBD=914 YHG=884>not YHG=883>been YHG=879>actively YHG=883>immunised. YHG=884>Boyd YHG=884>and YHG=884>Maclennan XBD=260 XHG=838 XBD=368 XBD=428 XBD=520 XBD=564 XBD=661 XBD=723 XBD=818 XBD=945 XBD=1075 XBD=1302 XHG=128 XHG=279 XHG=386 XHG=448 XHG=540 XHG=584 XHG=680 XHG=742 XHG=997YBD=945 XHG=1095 YBD=947 YBD=944 YBD=952 YBD=946 YBD=945 YBD=953 YHG=915>normal YHG=915>only YHG=915>to YHG=915>rise YHG=925>a YHG=915>day YHG=924>or YHG=916>two YHG=915>later. YHG=915>The YHG=915>pulse-rate " XBD=2558 XBD=1505 XBD=1624 XBD=1755 XBD=1971 XBD=2069 XBD=2294 XBD=2371 XHG=1369 XHG=1539 XHG=1657 XHG=1787 XHG=2003 XHG=2101 XHG=2328 XHG=2400 YBD=958 YBD=952 YBD=954 YHG=922>(1942), YHG=922>who YHG=923>have YHG=922>reviewed YHG=923>the YHG=922>incidence YHG=923>of YHG=924>tetanus

" " " " "" "

XBD=1301 XBD=226 XBD=289 XBD=630 XBD=755 XBD=844 XBD=1060 XBD=1226 XHG=126 XHG=248 XHG=307 XHG=654 XHG=865 XHG=1084 XHG=1248 YBD=1375 YBD=1374 YBD=1384 YBD=1377 YBD=1376 YBD=1382 YBD=1384 YHG=1345>value YHG=1346>of YHG=1346>sulphapyridine, YHG=1347>since YHG=1348>the YHG=1347>infection, YHG=1347>judged YHG=1347>by XBD=1512XHG=778 XBD=1678 XBD=1774 XBD=1837 XBD=1924 XBD=2098 XBD=2213 XBD=2306 XBD=2562 XHG=1364 XHG=1533 XHG=1701 XHG=1794 XHG=1858 XHG=1946 XHG=2119 XHG=2239 XHG=2334 YBD=1391 YBD=1383 YBD=1390 YBD=1382 YBD=1389 YHG=1354>British YHG=1354>Army YHG=1354>but YHG=1354>at YHG=1354>the YHG=1354>present YHG=1353>time YHG=1353>the YHG=1352>proportion ; XBD=183 XHG=883 XBD=328 XBD=469 XBD=524 XBD=605 XBD=721 XBD=814 XBD=868 XBD=960 XBD=1059 XBD=1144 XBD=1298 XHG=126 XHG=197 XHG=342 XHG=483 XHG=538 XHG=622 XHG=736 XHG=829 XHG=976YBD=1423 XHG=1074 XHG=1159 YBD=1414 YBD=1421 YBD=1416 YBD=1415 YBD=1416 YBD=1416 YHG=1384>the YHG=1385>scanty YHG=1385>bacilli YHG=1386>in YHG=1386>the YHG=1386>CSF, YHG=1395>was YHG=1387>in YHG=1395>any YHG=1395>case YHG=1387>not YHG=1394>severe. XBD=1409 XBD=1520 XBD=1765 XBD=1886 XBD=1978 XBD=2109 XBD=2307 XBD=2561 XHG=1364 XHG=1431 XHG=1547 XHG=1791 XHG=1912 XHG=2005 XHG=2136 XHG=2333 YBD=1424 YBD=1422 YBD=1428 YBD=1421 YHG=1393>of YHG=1402>men YHG=1392>inoculated YHG=1392>with YHG=1393>the YHG=1401>more YHG=1392>recently YHG=1391>introduced XBD=308 XHG=901 XBD=475 XBD=713 XBD=857 XBD=998 XBD=1300 XHG=128 XHG=351 XHG=526 XHG=759 XHG=1043 YBD=1460 YBD=1461 YBD=1454 YBD=1455 YHG=1424>Recovery YHG=1425>might YHG=1425>therefore YHG=1425>have YHG=1426>been YHG=1426>spontaneous XBD=1469 XBD=1576 XBD=1622 XBD=1760 XBD=2002 XBD=2063 XBD=2140 XBD=2252 XBD=2332 XBD=2366 XBD=2562 XHG=1364 XHG=1485 XHG=1591 XHG=1639 XHG=1811 XHG=2019 XHG=2073 XHG=2156 XHG=2266 XHG=2342 XHG=2381 YBD=1462 YBD=1461 YBD=1460 YBD=1467 YHG=1432>third YHG=1432>dose YHG=1432>is YHG=1432>small. YHG=1432>Evidence YHG=1432>of YHG=1431>the YHG=1431>need YHG=1431>for YHG=1439>a YHG=1430>boosting Sweet XBD=861 XBD=906 XBD=1042 XBD=1108 XBD=1172 XBD=1300 XHG=785 XHG=929 XHG=1064 XHG=1127 XHG=1197 YBD=1494 YBD=1494 YBD=1494 YBD=1493 YHG=1464>in YHG=1474>a YHG=1464>series YHG=1464>of YHG=1464>78 YHG=1473>cases XBD=296 XBD=525 XBD=626 XHG=125 XHG=319 XHG=548 YBD=1500 YBD=1493 YHG=1462>although YHG=1462>Fothergill YHG=1464>and XBD=1455XHG=882 XBD=1502 XBD=1704 XBD=1773 XBD=1854 XBD=2062 XBD=2174 XHG=1365 XHG=1470 XHG=1519 XHG=1719 XHG=1788 XHG=1870 XHG=2078 YBD=1501 YBD=1508 YBD=1500 YHG=1471>dose YHG=1471>is YHG=1471>provided YHG=1471>by YHG=1471>the YHG=1470>following YHG=1479>case. XBD=234 XBD=355 XBD=459 XBD=580 XBD=658 XBD=945 XBD=1169 XBD=1301 XHG=127 XHG=266 XHG=388 XHG=495 XHG=615 XHG=687 XHG=978 XHG=1221 YBD=1540 YBD=1532 YBD=1533 YBD=1541 YBD=1541 YBD=1533 YHG=1501>found YHG=1502>only YHG=1512>one YHG=1512>case YHG=1504>of YHG=1504>spontaneous YHG=1513>recovery. XBD=2115 XHG=1826 YBD=1554 YHG=1503>The YHG=1531>CASE-HISTORY XBD=219 XHG=742 XBD=328 XBD=432 XBD=664 XBD=714 XBD=869 XBD=1080 XBD=1207 XBD=1300 XHG=125 XHG=245 XHG=355 XHG=461 XHG=690 XHG=897YBD=1573 XHG=1107 XHG=1234 YBD=1571 YBD=1572 YBD=1580 YBD=1573 YBD=1572 YBD=1573 YHG=1541>third YHG=1550>case YHG=1551>was YHG=1543>obviously YHG=1552>a YHG=1552>severe YHG=1543>infection YHG=1543>from YHG=1543>the

" XBD=2561 XBD=1438 XBD=1589 XBD=1699 XBD=1764 XBD=1858 XBD=2058 XBD=2118 XBD=2298 XBD=2366 XBD=2482 XHG=1408 XHG=1461 XHG=1610 XHG=1722 XHG=1787 XHG=1881 XHG=2079 XHG=2142 XHG=2320 XHG=2388 XHG=2511 YBD=1604 YBD=1611 YBD=1602 YBD=1603 YBD=1607 YHG=1576>A YHG=1576>soldier YHG=1576>aged YHG=1576>27 YHG=1584>was YHG=1575>admitted YHG=1577>to YHG=1574>hospital YHG=1584>on YHG=1575>Nov. YHG=1574>13, XBD=224 XHG=674 XBD=321 XBD=408 XBD=591 XBD=657 XBD=835 XBD=1072 XBD=1227 XBD=1301 XHG=125 XHG=246 XHG=342 XHG=430 XHG=614 XHG=856YBD=1612 XHG=1096 XHG=1248 YBD=1616 YBD=1611 YBD=1617 YBD=1612 YBD=1618 YHG=1581>start, YHG=1582>and YHG=1582>the YHG=1582>absence YHG=1582>of YHG=1583>somatic YHG=1583>resistance, YHG=1582>shown YHG=1582>by " XBD=2561 XBD=1461 XBD=1565 XBD=1667 XBD=1785 XBD=2051 XBD=2120 XBD=2342 XBD=2457 XHG=1367 XHG=1508 XHG=1594 XHG=1696 XHG=1815 XHG=2081 XHG=2146 XHG=2371 XHG=2488 YBD=1642 YBD=1649 YBD=1650 YBD=1640 YHG=1615>1942. YHG=1615>He YHG=1614>had YHG=1615>been YHG=1614>complaining YHG=1614>of YHG=1613>increasing YHG=1613>pain YHG=1613>and XBD=183 XHG=845 XBD=261 XBD=474 XBD=526 XBD=604 XBD=703 XBD=757 XBD=834 XBD=928 XBD=1089 XBD=1299 XHG=126 XHG=193 XHG=272 XHG=485 XHG=537 XHG=617 XHG=715 XHG=768 XHG=939YBD=1652 XHG=1100 YBD=1650 YBD=1651 YBD=1651 YBD=1658 YHG=1620>the YHG=1620>low YHG=1620>cell-count YHG=1621>in YHG=1621>CSF YHG=1622>at YHG=1622>the YHG=1622>first YHG=1621>lumbar YHG=1622>puncture, " XBD=2563 XBD=1518 XBD=1570 XBD=1647 XBD=1754 XBD=1823 XBD=1860 XBD=1974 XBD=2131 XBD=2219 XBD=2323 XBD=2451 XHG=1362 XHG=1533 XHG=1585 XHG=1663 XHG=1769 XHG=1839 XHG=1876 XHG=2020 XHG=2147 XHG=2234 XHG=2338 XHG=2467 YBD=1690 YBD=1681 YBD=1689 YBD=1680 YHG=1654>stiffness YHG=1654>in YHG=1653>the YHG=1653>back YHG=1652>for YHG=1654>4 YHG=1654>days. YHG=1653>There YHG=1652>had YHG=1653>been YHG=1653>septic YHG=1661>sores XBD=237 XHG=858 XBD=333 XBD=447 XBD=681 XBD=756 XBD=843 XBD=992 XBD=1051 XBD=1237 XBD=1299 XHG=126 XHG=251 XHG=348 XHG=468 XHG=696 XHG=777 XHG=1010 XHG=1073 XHG=1258 YBD=1696 YBD=1691 YBD=1690 YBD=1697 YHG=1659>might YHG=1659>well YHG=1659>have YHG=1661>accounted YHG=1660>for YHG=1661>the YHG=1660>failure YHG=1660>respond YHG=1660>to " XBD=1409 XBD=1519 XBD=1609 XBD=1685 XBD=1747 XBD=1855 XBD=1992 XBD=2212 XBD=2370 XBD=2430 XBD=2562 XHG=1362 XHG=1429 XHG=1537 XHG=1629 XHG=1707 XHG=1768 XHG=1875 XHG=2013 XHG=2234 XHG=2389 XHG=2445 YBD=1728 YBD=1725 YBD=1720 YBD=1719 YHG=1702>on YHG=1692>both YHG=1692>legs YHG=1693>for YHG=1692>14 YHG=1692>days YHG=1692>before YHG=1692>admission, YHG=1692>several YHG=1692>of YHG=1691>which " XBD=330 XBD=461 XBD=615 XBD=720 XBD=924 XBD=1101 XBD=1300 XHG=127 XHG=382 XHG=481 XHG=635 XHG=740 XHG=946 XHG=1121 YBD=1728 YBD=1729 YBD=1737 YBD=1729 YBD=1728 YHG=1698>treatment. YHG=1698>The YHG=1699>fourth YHG=1708>case YHG=1699>produces YHG=1699>definite YHG=1699>evidence " XBD=1434 XBD=1612 XBD=1733 XBD=1835 XBD=1932 XBD=2044 XBD=2272 XBD=2387 XBD=2431 XHG=1361 XHG=1459 XHG=1639 XHG=1779 XHG=1860 XHG=1956 XHG=2068 XHG=2297 XHG=2416 XHG=2460 YBD=1760 YBD=1758 YBD=1759 YHG=1731>scabbed YHG=1741>over. YHG=1732>He YHG=1732>had YHG=1732>been YHG=1731>inoculated YHG=1731>with YHG=1732>I YHG=1740>c.cm. " XBD=2561 XBD=204 XHG=742 XBD=545 XBD=651 XBD=709 XBD=966 XBD=1114 XBD=1200 XBD=1300 XHG=127 XHG=236 XHG=581 XHG=684 XHG=1001 XHG=1148 XHG=1233 YBD=1767 YBD=1775 YBD=1769 YBD=1768 YBD=1767 YBD=1768 YHG=1737>that YHG=1738>sulphapyridine YHG=1739>has YHG=1748>a YHG=1737>favourable YHG=1737>effect YHG=1747>on YHG=1738>the " XBD=2563 XBD=1506 XBD=1649 XBD=1982 XBD=2046 XBD=2156 XBD=2228 XBD=2347 XBD=2440 XHG=1360 XHG=1524 XHG=1665 XHG=2001 XHG=2063 XHG=2179 XHG=2253 XHG=2367 XHG=2458 YBD=1798 YBD=1809 YBD=1804 YBD=1805 YBD=1799 YBD=1807 YHG=1774>tetanus YHG=1771>toxoid YHG=1771>prophylactically YHG=1780>on YHG=1771>Nov. YHG=1771>18, YHG=1771>1940, YHG=1771>and YHG=1771>again XBD=244 XHG=615 XBD=305 XBD=385 XBD=563 XBD=878 XBD=1077 XBD=1136 XBD=1179 XBD=1300 XHG=127 XHG=263 XHG=321 XHG=406 XHG=897YBD=1815 XHG=1096 XHG=1155 XHG=1199 YBD=1807 YBD=1808 YBD=1814 YBD=1806 YHG=1786>course YHG=1777>of YHG=1777>the YHG=1777>disease. YHG=1778>Spontaneous YHG=1786>recovery YHG=1777>in YHG=1786>a YHG=1777>child " XBD=2563 XBD=1410 XBD=1509 XBD=1583 XBD=1701 XBD=1836 XBD=1965 XBD=2020 XBD=2100 XBD=2257 XBD=2405 XBD=2465 XHG=1362 XHG=1427 XHG=1533 XHG=1607 XHG=1747 XHG=1853 XHG=1982 XHG=2037 XHG=2117 XHG=2273 XHG=2425 XHG=2483 YBD=1837 YBD=1844 YBD=1839 YBD=1847 YBD=1838 YHG=1819>on YHG=1810>Jan. YHG=1811>13, YHG=1811>1941. YHG=1810>Pain YHG=1811>began YHG=1811>in YHG=1811>the YHG=1810>lumbar YHG=1811>region, YHG=1812>at YHG=1810>first XBD=234 XHG=843 XBD=272 XBD=378 XBD=425 XBD=648 XBD=744 XBD=827 XBD=953 XBD=1149 XBD=1206 XBD=1299 XHG=126 XHG=248 XHG=288 XHG=394 XHG=443 XHG=668 XHG=760 XHG=969YBD=1853 XHG=1165 XHG=1222 YBD=1846 YBD=1852 YBD=1848 YBD=1847 YBD=1852 YBD=1845 YHG=1816>under YHG=1826>a YHG=1826>year YHG=1816>is YHG=1817>unknown, YHG=1817>and YHG=1817>the YHG=1817>rapid YHG=1824>recovery YHG=1816>in YHG=1816>this " XBD=2564 XBD=1399 XBD=1621 XBD=1800 XBD=1919 XBD=2086 XBD=2296 XBD=2501 XHG=1361 XHG=1424 XHG=1647 XHG=1847 XHG=1945 XHG=2111 XHG=2321 XHG=2526 YBD=1885 YBD=1886 YBD=1878 YBD=1877 YHG=1849>in YHG=1850>spasmodic YHG=1850>attacks. YHG=1849>The YHG=1850>attacks YHG=1850>gradually YHG=1850>increased YHG=1850>in XBD=200 XHG=828 XBD=293 XBD=485 XBD=617 XBD=748 XBD=812 XBD=893 XBD=1057 XBD=1109 XBD=1299 XHG=127 XHG=218 XHG=312 XHG=538 XHG=638 XHG=769 XHG=913YBD=1886 XHG=1076 XHG=1129 YBD=1887 YBD=1892 YBD=1885 YBD=1893 YBD=1890 YHG=1864>case YHG=1865>was YHG=1856>striking. YHG=1856>The YHG=1865>cause YHG=1856>of YHG=1856>the YHG=1856>relapse YHG=1856>is YHG=1855>obscure, " XBD=2564 XBD=1554 XBD=1644 XBD=1835 XBD=1946 XBD=2082 XBD=2171 XBD=2286 XBD=2377 XBD=2459 XHG=1361 XHG=1573 XHG=1661 XHG=1853 XHG=1964 XHG=2100 XHG=2190 XHG=2306 XHG=2395 XHG=2477 YBD=1916 YBD=1917 YBD=1925 YHG=1888>frequency YHG=1889>and YHG=1888>intensity YHG=1889>until YHG=1898>spasm YHG=1898>was YHG=1889>tonic YHG=1890>and YHG=1889>the YHG=1889>pain XBD=358 XBD=471 XBD=555 XBD=660 XBD=752 XBD=921 XBD=1072 XBD=1299 XHG=125 XHG=371 XHG=488 XHG=574 XHG=675 XHG=767 XHG=936 XHG=1123 YBD=1932 YBD=1925 YBD=1924 YBD=1924 YBD=1930 YHG=1894>particularly YHG=1895>after YHG=1895>the YHG=1895>CSF YHG=1895>had YHG=1895>become YHG=1895>sterile. YHG=1894>Further, " XBD=1482 XBD=1574 XBD=1813 XBD=1926 XBD=2036 XBD=2197 XBD=2346 XBD=2438 XHG=1363 XHG=1502 XHG=1593 XHG=1860 XHG=1945 XHG=2054 XHG=2216 XHG=2365 XHG=2457 YBD=1955 YBD=1956 YHG=1936>severe YHG=1928>continuous. YHG=1927>His YHG=1928>back YHG=1928>became YHG=1929>arched YHG=1928>and YHG=1928>could " XBD=2564 XBD=293 XHG=851 XBD=421 XBD=519 XBD=821 XBD=970 XBD=1043 XBD=1173 XBD=1301 XHG=124 XHG=322 XHG=452 XHG=550 XHG=1001 XHG=1074 XHG=1204 YBD=1965 YBD=1964 YBD=1971 YBD=1963 YBD=1963 YHG=1934>infection YHG=1934>from YHG=1934>the YHG=1934>nasopharynx YHG=1942>seems YHG=1934>to YHG=1933>have YHG=1934>been " XBD=2564 XBD=1427 XBD=1485 XBD=1755 XBD=2045 XBD=2154 XBD=2306 XBD=2457 XHG=1362 XHG=1442 XHG=1501 XHG=1802 XHG=2058 XHG=2169 XHG=2321 XHG=2473 YBD=1994 YBD=2003 YBD=1996 YBD=2004 YBD=1995 YHG=1968>not YHG=1966>be YHG=1966>straightened. YHG=1966>Occasionally YHG=1976>more YHG=1967>intense YHG=1976>spasms YHG=1975>were XBD=355 XHG=896 XBD=424 XBD=523 XBD=716 XBD=811 XBD=873 XBD=962 XBD=1168 XBD=1301 XHG=123 XHG=391 XHG=445 XHG=545 XHG=738 XHG=833 XHG=984YBD=2002 XHG=1189 YBD=2008 YBD=2003 YBD=2009 YBD=2008 YHG=1968>eliminated YHG=1973>it YHG=1982>was YHG=1972>possibly YHG=1972>due YHG=1973>to YHG=1973>the YHG=1972>breaking YHG=1972>down ; " XBD=2567 XBD=1627 XBD=1748 XBD=1835 XBD=1956 XBD=2214 XBD=2317 XBD=2499 XHG=1363 XHG=1651 XHG=1773 XHG=1861 XHG=1982 XHG=2261 XHG=2344 XHG=2527 YBD=2042 YBD=2035 YBD=2034 YHG=2006>superimposed YHG=2014>upon YHG=2006>the YHG=2006>tonic YHG=2007>contraction. YHG=2007>No YHG=2007>stiffness YHG=2007>of XBD=162 XHG=673 XBD=196 XBD=350 XBD=490 XBD=657 XBD=739 XBD=1031 XBD=1192 XBD=1302 XHG=123 XHG=173 XHG=209 XHG=366 XHG=506 XHG=756YBD=2042 XHG=1047 XHG=1207 YBD=2043 YBD=2041 YBD=2049 YBD=2049 YBD=2041 YHG=2013>of YHG=2022>a YHG=2012>lbculus YHG=2012>which YHG=2011>flooded YHG=2012>the YHG=2011>cerebrospinal YHG=2011>system YHG=2011>with " XBD=2174 XBD=1426 XBD=1511 XBD=1566 XBD=1655 XBD=1819 XBD=1906 XBD=2009 XHG=1363 XHG=1440 XHG=1526 XHG=1580 XHG=1670 XHG=1833 XHG=1920 XHG=2022 YBD=2081 YBD=2072 YBD=2073 YBD=2074 YHG=2044>the YHG=2045>jaw YHG=2054>or YHG=2045>face YHG=2045>muscles YHG=2045>had YHG=2046>been YHG=2046>noticed. XBD=198 XHG=783 XBD=285 XBD=342 XBD=586 XBD=700 XBD=757 XBD=920 XBD=1045 XBD=1251 XBD=1301 XHG=124 XHG=248 XHG=310 XHG=368 XHG=612 XHG=726 XHG=947YBD=2081 XHG=1071 XHG=1277 YBD=2088 YBD=2087 YBD=2079 YBD=2080 YBD=2085 YHG=2060>pus. YHG=2051>It YHG=2052>is YHG=2050>suggestive YHG=2050>that YHG=2050>it YHG=2050>should YHG=2051>have YHG=2050>occurred YHG=2060>a " XBD=2563 XBD=1371 XBD=1464 XBD=1677 XBD=1805 XBD=1907 XBD=2175 XBD=2446 XHG=1363 XHG=1410 XHG=1486 XHG=1707 XHG=1836 XHG=1940 XHG=2199 XHG=2474 YBD=2095 YBD=2112 YBD=2113 YBD=2121 YBD=2114 YHG=2086>’ YHG=2084>On YHG=2084>admission YHG=2084>there YHG=2093>was YHG=2084>considerable YHG=2084>opisthotonus YHG=2085>with XBD=193 XHG=589 XBD=328 XBD=548 XBD=654 XBD=1016 XBD=1147 XBD=1302 XHG=124 XHG=231 XHG=367 XHG=694YBD=2119 XHG=1069 XHG=1191 YBD=2128 YBD=2121 YBD=2127 YBD=2126 YBD=2119 YBD=2127 YHG=2090>day YHG=2090>after YHG=2090>stopping YHG=2089>the YHG=2089>sulphapyridine. YHG=2090>The YHG=2081>rapid |>" XBD=1483 XBD=1563 XBD=1651 XBD=1815 XBD=2156 XBD=2292 XBD=2477 XBD=2563 XBD=1960 XHG=1363 XHG=1522 XHG=1588 XHG=1681 XHG=1997 XHG=2195 XHG=2331 XHG=2516 XHG=1853 YBD=2159 YBD=2151 YBD=2157 YBD=2152 YBD=2153 YBD=2160 YHG=2132>spasm YHG=2123>of YHG=2124>the YHG=2125>erector YHG=2124>muscles, YHG=2133>more YHG=2124>definite YHG=2134>on YHG=2124>spinse " XBD=290 XBD=441 XBD=641 XBD=1002 XBD=1218 XBD=1302 XHG=125 XHG=341 XHG=491 XHG=691 XHG=1054 XHG=1269 YBD=2166 YBD=2159 YBD=2160 YBD=2167 YBD=2166 YBD=2158 YHG=2138>recovery YHG=2129>after YHG=2129>further YHG=2128>sulphapyridine YHG=2129>therapy YHG=2128>is " XBD=2563 XBD=1426 XBD=1513 XBD=1608 XBD=1721 XBD=1805 XBD=1933 XBD=2053 XBD=2279 XBD=2452 XHG=1362 XHG=1447 XHG=1536 XHG=1631 XHG=1742 XHG=1827 XHG=1979 XHG=2075 XHG=2300 XHG=2473 YBD=2190 YBD=2200 YBD=2191 YBD=2192 YHG=2162>left YHG=2162>side YHG=2162>than YHG=2162>the YHG=2163>right. YHG=2163>The YHG=2163>abdominal YHG=2163>muscles YHG=2173>were XBD=336 XHG=122 YBD=2206 YHG=2168>significant. " XBD=2563 XBD=1464 XBD=1570 XBD=1714 XBD=1868 XBD=1968 XBD=2086 XBD=2277 XBD=2362 XBD=2396 XHG=1362 XHG=1511 XHG=1579 XHG=1724 XHG=1880 XHG=1980 XHG=2098 XHG=2290 XHG=2375 XHG=2408 YBD=2238 YBD=2229 YBD=2231 YBD=2230 YBD=2239 YHG=2201>rigid. YHG=2202>All YHG=2202>tendon YHG=2201>reflexes YHG=2211>were YHG=2202>much YHG=2201>increased YHG=2202>and YHG=2211>a YHG=2203>positive XBD=241 XHG=916 XBD=424 XBD=492 XBD=617 XBD=836 XBD=891 XBD=982 XBD=1117 XBD=1200 XBD=1302 XHG=167 XHG=264 XHG=448 XHG=513 XHG=642 XHG=859 XHG=1007 XHG=1139 XHG=1224 YBD=2238 YBD=2237 YBD=2236 YBD=2236 YBD=2243 YHG=2208>The YHG=2207>number YHG=2206>of YHG=2215>cases YHG=2205>described YHG=2206>is YHG=2207>too YHG=2206>small YHG=2206>for YHG=2215>any

" " "

XBD=2563 XBD=1526 XBD=1618 XBD=1791 XBD=1948 XBD=2042 XBD=2159 XBD=2353 XHG=1362 XHG=1547 XHG=1640 XHG=1837 XHG=1969 XHG=2064 XHG=2182 XHG=2374 YBD=2277 YBD=2270 YBD=2269 YBD=2278 YBD=2279 YHG=2239>jaw-jerk YHG=2241>elicited. YHG=2241>There YHG=2250>was YHG=2250>some YHG=2241>fibrillary YHG=2241>twitching XBD=254 XHG=868 XBD=519 XBD=590 XBD=667 XBD=839 XBD=942 XBD=1069 XBD=1176 XBD=1305 XHG=124 XHG=284 XHG=548 XHG=620 XHG=697 XHG=968YBD=2275 XHG=1098 XHG=1204 YBD=2283 YBD=2276 YBD=2274 YBD=2280 YBD=2275 YBD=2276 YHG=2247>precise YHG=2246>conclusions YHG=2246>to YHG=2244>be YHG=2245>drawn, YHG=2245>but YHG=2245>from YHG=2245>this YHG=2245>brief XBD=1404 XBD=1476 XBD=1639 XBD=1694 XBD=1794 XBD=1937 XBD=2188 XBD=2308 XBD=2458 XBD=2563 XHG=1363 XHG=1414 XHG=1490 XHG=1655 XHG=1704 XHG=1806 XHG=1984 XHG=2200 XHG=2322 XHG=2472 YBD=2307 YBD=2308 YBD=2317 YBD=2309 YHG=2279>of YHG=2280>the YHG=2281>muscles YHG=2281>of YHG=2280>both YHG=2280>thighs. YHG=2280>Occasional YHG=2279>reflex YHG=2289>spasms YHG=2291>were XBD=330 XHG=712 XBD=417 XBD=520 XBD=635 XBD=695 XBD=920 XBD=1060 XBD=1123 XBD=1212 XBD=1299 XHG=124 XHG=351 XHG=434 XHG=535 XHG=651 XHG=940YBD=2315 XHG=1082 XHG=1139 XHG=1249 YBD=2323 YBD=2316 YBD=2314 YBD=2316 YBD=2314 YBD=2315 YBD=2320 YHG=2286>experience YHG=2286>the YHG=2285>best YHG=2284>form YHG=2284>of YHG=2284>treatment YHG=2293>seems YHG=2284>to : YHG=2284>be YHG=2285>(1) XBD=1535 XBD=1691 XBD=1781 XBD=1886 XBD=1936 XBD=2054 XBD=2124 XBD=2210 XBD=2369 XBD=2565 XHG=1363 XHG=1565 XHG=1718 XHG=1809 XHG=1916 XHG=1966 XHG=2084 XHG=2148 XHG=2238 XHG=2415 YBD=2355 YBD=2347 YBD=2348 YHG=2318>observed YHG=2319>during YHG=2319>first YHG=2320>3 YHG=2320>days YHG=2319>of YHG=2319>the YHG=2319>illness. YHG=2320>Neither XBD=335 XHG=897 XBD=528 XBD=769 XBD=854 XBD=945 XBD=1166 XBD=1300 XHG=125 XHG=376 XHG=570 XHG=813 XHG=986YBD=2352 XHG=1209 YBD=2362 YBD=2354 YBD=2361 YBD=2360 YBD=2361YHG=2322>be YHG=2324>Diagnostic YHG=2324>lumbar YHG=2324>puncture, YHG=2323>to YHG=2323>repeated YHG=2324>only

" XBD=2564 XBD=1507 XBD=1598 XBD=1820 XBD=1914 XBD=2061 XBD=2196 XBD=2464 XHG=1361 XHG=1533 XHG=1623 XHG=1844 XHG=1940 XHG=2121 XHG=2222 XHG=2490 YBD=2386 YBD=2395 YBD=2387 YHG=2358>trismus YHG=2367>nor YHG=2358>dysphagia YHG=2367>was YHG=2358>noted. YHG=2358>The YHG=2360>temperature YHG=2359>and XBD=154 XHG=811 XBD=410 XBD=523 XBD=777 XBD=966 XBD=1300 XHG=124 XHG=181 XHG=445 XHG=557 XHG=999YBD=2392 YBD=2394 YBD=2393 YBD=2399 YBD=2392 YHG=2364>if YHG=2364>restlessness YHG=2363>and YHG=2362>irritability YHG=2362>become YHG=2362>uncontrollable " XBD=2563 XBD=1461 XBD=1572 XBD=1756 XBD=1902 XBD=1984 XBD=2027 XBD=2138 XBD=2253 XBD=2476 XHG=1361 XHG=1482 XHG=1593 XHG=1777 XHG=1923 XHG=2008 XHG=2050 XHG=2160 XHG=2273 XHG=2500 YBD=2433 YBD=2434 YBD=2431 YBD=2425 YHG=2397>pulse YHG=2406>were YHG=2398>elevated YHG=2397>during YHG=2398>3 YHG=2397>days YHG=2397>after YHG=2397>admission, YHG=2397>the XBD=172 XHG=806 XBD=259 XBD=382 XBD=528 XBD=586 XBD=711 XBD=790 XBD=900 XBD=1039 XBD=1101 XBD=1300 XHG=125 XHG=185 XHG=273 XHG=396 XHG=544 XHG=600 XHG=725 XHG=913YBD=2431 XHG=1053 XHG=1116 YBD=2440 YBD=2433 YBD=2432 YBD=2438 YBD=2439 YHG=2402>by YHG=2412>any YHG=2403>other YHG=2411>means YHG=2411>or YHG=2401>when YHG=2402>the YHG=2401>fluid YHG=2402>might YHG=2401>be YHG=2402>expected "|>"XBD=2563 XBD=1782 XBD=1931 XBD=1994 XBD=2070 XBD=2208 XBD=2298 XBD=1602 XHG=1616 XHG=1800 XHG=1949 XHG=2009 XHG=2079 XHG=2217 XHG=2346 XHG=1361 YBD=2472 YBD=2464 YBD=2473 YBD=2465 YBD=2473 YHG=2436>reaching YHG=2435>100° YHG=2445>on YHG=2435>the YHG=2437>second YHG=2437>day. YHG=2436>There YHG=2428>temperature F.were " XBD=161 XBD=224 XBD=366 XBD=477 XBD=609 XBD=694 XBD=862 XBD=1078 XBD=1166 XBD=1301 XHG=125 XHG=180 XHG=244 XHG=390 XHG=498 XHG=629 XHG=715 XHG=882 XHG=1096 XHG=1186 YBD=2472 YBD=2476 YBD=2470 YBD=2471 YBD=2472 YBD=2471 YBD=2470 YHG=2442>to YHG=2442>be YHG=2442>sterile YHG=2441>(i.e., YHG=2440>when YHG=2441>the YHG=2440>clinical YHG=2441>condition YHG=2441>has YHG=2441>much " XBD=2563 XBD=1385 XBD=1554 XBD=1612 XBD=1738 XBD=1836 XBD=1981 XBD=2046 XBD=2154 XBD=2255 XBD=2372 XBD=2432 XHG=1363 XHG=1403 XHG=1573 XHG=1627 XHG=1757 XHG=1854 XHG=2000 XHG=2064 XHG=2171 XHG=2274 XHG=2391 XHG=2447 YBD=2504 YBD=2502 YBD=2511 YBD=2503 YHG=2483>a YHG=2475>number YHG=2475>of YHG=2475>septic YHG=2475>skin YHG=2475>lesions YHG=2484>on YHG=2475>both YHG=2475>legs, YHG=2484>some YHG=2476>of YHG=2475>which XBD=337 XHG=891 XBD=468 XBD=789 XBD=864 XBD=958 XBD=1300 XHG=125 XHG=389 XHG=501 XHG=821 XHG=988YBD=2508 YBD=2518 YBD=2509 YBD=2510 YBD=2517 YHG=2478>improved). YHG=2480>The YHG=2479>concentration YHG=2479>of YHG=2479>the YHG=2479>sulphapyridine " XBD=2564 XBD=1502 XBD=1552 XBD=1718 XBD=1925 XBD=2053 XBD=2199 XBD=2296 XBD=2449 XHG=1361 XHG=1530 XHG=1578 XHG=1745 XHG=1951 XHG=2079 XHG=2224 XHG=2322 XHG=2474 YBD=2547 YBD=2549 YBD=2541 YBD=2542 YHG=2513>yielded YHG=2522>a YHG=2514>sanious YHG=2513>discharge YHG=2513>while YHG=2513>others YHG=2514>had YHG=2514>healed YHG=2513>with XBD=161 XHG=766 XBD=241 XBD=347 XBD=504 XBD=572 XBD=634 XBD=746 XBD=809 XBD=1003 XBD=1101 XBD=1300 XHG=125 XHG=179 XHG=262 XHG=367 XHG=524 XHG=593 XHG=654 XHG=828YBD=2547 XHG=1023 XHG=1120 YBD=2549 YBD=2548 YBD=2555 YBD=2555 YBD=2548 YBD=2555 YHG=2518>in YHG=2520>the YHG=2519>CSF YHG=2519>should YHG=2518>be YHG=2519>high YHG=2527>as YHG=2518>possible, YHG=2518>and YHG=2518>repeated " XBD=1447 XHG=1363 XHG=1463 YBD=2580 YBD=2581 YHG=2552>scab YHG=2552>formation. " XBD=1666 XBD=264 XHG=874 XBD=480 XBD=585 XBD=706 XBD=844 XBD=915 XBD=1083 XBD=1180 XBD=1298 XHG=126 XHG=293 XHG=512 XHG=616 XHG=737 XHG=947YBD=2587 XHG=1114 XHG=1212 YBD=2588 YBD=2596 YBD=2594 YBD=2587 YBD=2588 YBD=2587 YHG=2557>lumbar YHG=2558>puncture YHG=2566>can YHG=2558>only YHG=2566>serve YHG=2558>to YHG=2557>reduce YHG=2557>the YHG=2566>con-

" " "

XBD=2564XHG=758 XBD=1463 XBD=1559 XBD=1686 XBD=1854 XBD=1974 XBD=2263 XBD=2329 XHG=1408 XHG=1486 XHG=1583 XHG=1712 XHG=1877 XHG=1997 XHG=2289 XHG=2349 YBD=2620 YBD=2628 YBD=2624 YBD=2627 YBD=2619 YHG=2591>He YHG=2600>was YHG=2592>given YHG=2591>200,000 YHG=2591>units YHG=2591>intravenously YHG=2591>of YHG=2591>antitetanic XBD=338 XBD=444 XBD=591 XBD=729 XBD=802 XBD=1135 XBD=1301 XHG=126 XHG=392 XHG=470 XHG=620 XHG=826YBD=2626 XHG=1164 YBD=2633 YBD=2634 YBD=2627 YBD=2634 YHG=2597>centration. YHG=2597>(2) YHG=2597>Large YHG=2597>doses YHG=2596>of YHG=2595>sulphapyridine YHG=2596>should XBD=1479 XBD=1737 XBD=1846 XBD=2061 XBD=2182 XBD=2305 XBD=2458 XBD=2564 XHG=1362 XHG=1495 XHG=1753 XHG=1861 XHG=2108 XHG=2197 XHG=2321 XHG=2473 YBD=2657 YBD=2666 YBD=2658 YHG=2639>serum YHG=2630>immediately YHG=2629>after YHG=2627>admission. YHG=2629>The YHG=2630>reflex YHG=2638>spasms YHG=2639>were XBD=167 XHG=819 XBD=454 XBD=541 XBD=654 XBD=691 XBD=744 XBD=804 XBD=865 XBD=1121 XBD=1301 XHG=126 XHG=182 XHG=468 XHG=558 XHG=670 XHG=710 XHG=761 XHG=881YBD=2665 XHG=1136 YBD=2666 YBD=2667 YBD=2672 YBD=2664 YBD=2665 YHG=2634>be YHG=2637>given-never YHG=2636>less YHG=2635>than YHG=2636>3 YHG=2644>g. YHG=2635>in YHG=2635>24 YHG=2635>hours-and YHG=2636>reduced XBD=1497 XBD=1717 XBD=1792 XBD=1878 XBD=2190 XBD=2252 XBD=2324 XBD=2390 XBD=2501 XBD=2568 XHG=1360 XHG=1523 XHG=1742 XHG=1815 XHG=1904 XHG=2211 XHG=2273 XHG=2351 XHG=2412 XHG=2528 YBD=2697 YBD=2704 YBD=2695 YBD=2705 YBD=2696 YHG=2668>readily YHG=2669>controlled YHG=2669>by YHG=2668>the YHG=2668>administration YHG=2677>gr. YHG=2670>15 YHG=2669>each YHG=2669>of XBD=225 XHG=930 XBD=389 XBD=467 XBD=612 XBD=701 XBD=774 XBD=900 XBD=954 XBD=1172 XBD=1301 XHG=127 XHG=254 XHG=419 XHG=499 XHG=641 XHG=732 XHG=804 XHG=983YBD=2704 XHG=1202 YBD=2706 YBD=2711 YBD=2703 YBD=2711 YHG=2673>doses YHG=2675>should YHG=2675>be YHG=2675>given YHG=2674>for YHG=2675>at YHG=2674>least YHG=2683>a YHG=2674>fortnight YHG=2674>after

" "

XBD=2563 XBD=1502 XBD=1738 XBD=1880 XBD=1974 XBD=2104 XBD=2222 XBD=2299 XBD=2443 XHG=1362 XHG=1526 XHG=1763 XHG=1903 XHG=1999 XHG=2128 XHG=2236 XHG=2324 XHG=2468 YBD=2855 YBD=2860 YBD=2852 YBD=2853 YBD=2851 YHG=2824>further YHG=2824>antitetanic YHG=2832>serum YHG=2832>was YHG=2824>given YHG=2824>after YHG=2825>the YHG=2824>initial YHG=2824>dose. XBD=173 XHG=852 XBD=441 XBD=554 XBD=721 XBD=825 XBD=929 XBD=1133 XBD=1186 XBD=1299 XHG=127 XHG=197 XHG=470 XHG=583 XHG=747 XHG=957YBD=2860 XHG=1162 XHG=1214 YBD=2864 YBD=2868 YBD=2861 YBD=2867 YBD=2859YHG=2831>this YHG=2827>by YHG=2830>intravenous YHG=2830>drip YHG=2831>salines YHG=2830>and YHG=2830>provides YHG=2839>a YHG=2839>conXBD=1478 XBD=1588 XBD=1662 XBD=1892 XBD=1951 XBD=2012 XBD=2212 XBD=2312 XBD=2376 XBD=2488 XBD=2562 XHG=1363 XHG=1497 XHG=1599 XHG=1675 XHG=1911 XHG=1964 XHG=2028 XHG=2228 XHG=2329 XHG=2393 XHG=2509 YBD=2899 YBD=2897 YBD=2889 YBD=2891 YBD=2890 YBD=2894 YHG=2862>Apart YHG=2862>from YHG=2862>the YHG=2870>appearance YHG=2862>of YHG=2871>an YHG=2863>urticarial YHG=2863>rash YHG=2871>on YHG=2863>Nov. YHG=2863>21, XBD=270 XHG=609 XBD=468 XBD=569 XBD=676 XBD=1027 XBD=1111 XBD=1299 XHG=127 XHG=310 XHG=508 XHG=718YBD=2900 XHG=1067 XHG=1147 YBD=2897 YBD=2899 YBD=2900 YBD=2898 YBD=2906 YHG=2867>venient YHG=2869>method YHG=2869>for YHG=2869>the YHG=2868>administration YHG=2869>of YHG=2868>sulpha-

" " "

XBD=2565 XBD=1496 XBD=1665 XBD=1753 XBD=1965 XBD=2150 XBD=2274 XBD=2313 XBD=2436 XHG=1362 XHG=1512 XHG=1681 XHG=1770 XHG=1982 XHG=2170 XHG=2293 XHG=2330 XHG=2454 YBD=2745 YBD=2734 YBD=2740 YBD=2744 YBD=2735 YBD=2743 YHG=2707>chloral YHG=2707>hydrate YHG=2707>and YHG=2700>potassium YHG=2706>bromide, YHG=2707>given YHG=2708>4 YHG=2708>times YHG=2707>daily. XBD=333 XHG=636 XBD=592 XBD=735 XBD=1039 XBD=1144 XBD=1302 XHG=126 XHG=377 XHG=781YBD=2743 XHG=1094 XHG=1170 YBD=2750 YBD=2751 YBD=2749 YHG=2714>meningitic YHG=2714>symptoms YHG=2714>have YHG=2713>disappeared. YHG=2713>(3) YHG=2712>Fluids XBD=1437 XBD=1563 XBD=1675 XBD=1735 XBD=1811 XBD=1895 XBD=1998 XBD=2153 XBD=2215 XBD=2440 XBD=2565 XHG=1362 XHG=1450 XHG=1576 XHG=1689 XHG=1749 XHG=1823 XHG=1908 XHG=2011 XHG=2166 XHG=2228 XHG=2455 YBD=2781 YBD=2773 YBD=2774 YBD=2783 YBD=2775 YHG=2746>The YHG=2747>septic YHG=2755>areas YHG=2755>on YHG=2745>the YHG=2745>legs YHG=2754>were YHG=2747>treated YHG=2747>by YHG=2747>hypertonic YHG=2746>saline XBD=251 XHG=787 XBD=322 XBD=499 XBD=565 XBD=697 XBD=763 XBD=949 XBD=1076 XBD=1300 XHG=127 XHG=275 XHG=345 XHG=522 XHG=588 XHG=722 XHG=971YBD=2789 XHG=1101 YBD=2783 YBD=2782 YBD=2781 YBD=2789 YHG=2751>should YHG=2753>be YHG=2753>pressed YHG=2752>in YHG=2753>order YHG=2752>to YHG=2752>prevent YHG=2752>renal YHG=2752>complicaXBD=1535 XBD=1622 XBD=1725 XBD=1800 XBD=2030 XBD=2084 XBD=2365 XBD=2457 XBD=2560 XHG=1361 XHG=1551 XHG=1634 XHG=1737 XHG=1814 XHG=2045 XHG=2095 XHG=2383 XHG=2505 YBD=2821 YBD=2814 YBD=2812 YBD=2820 YBD=2822 YBD=2813 YHG=2785>dressings YHG=2786>and YHG=2785>later YHG=2784>the YHG=2784>application YHG=2785>of YHG=2785>gentian-violet YHG=2785>1%. YHG=2785>No XBD=228 XHG=892 XBD=544 XBD=648 XBD=864 XBD=956 XBD=1070 XBD=1301 XHG=126 XHG=278 XHG=571 XHG=677 XHG=984YBD=2821 XHG=1098 YBD=2820 YBD=2828 YBD=2829 YBD=2821 YHG=2789>tions. YHG=2791>Dehydration YHG=2792>and YHG=2791>vomiting YHG=2800>are YHG=2791>best YHG=2791>combated

" XBD=2503 XBD=1462 XBD=1594 XBD=1779 XBD=1847 XBD=1883 XBD=1997 XBD=2180 XBD=2265 XHG=1368 XHG=1479 XHG=1607 XHG=1793 XHG=1864 XHG=1899 XHG=2013 XHG=2194 XHG=2280 YBD=2935 YBD=2928 YBD=2927 YBD=2937 YBD=2929 YHG=2902>1942, YHG=2901>which YHG=2900>persisted YHG=2900>for YHG=2900>2 YHG=2900>days, YHG=2910>recovery YHG=2910>was YHG=2899>uneventful. XBD=299 XHG=126 YBD=2941 YHG=2901>pyridine. " XBD=2060 XHG=1866 YBD=2983 YHG=2959>COMMENT XBD=809 XHG=611 YBD=2987 YHG=2963>SUMMARY

" " " " " " " " " " " " " "

XBD=2563XHG=744 XBD=1503 XBD=1650 XBD=1738 XBD=1916 XBD=2005 XBD=2111 XBD=2224 XBD=2309 XHG=1416 XHG=1527 XHG=1669 XHG=1757 XHG=1935 XHG=2022 XHG=2129 XHG=2241 XHG=2327 YBD=3036 YBD=3030 YBD=3029 YBD=3035 YHG=3000>Cole YHG=3001>(1942) YHG=3001>has YHG=3000>pointed YHG=3001>out YHG=3001>that YHG=3000>with YHG=3001>the YHG=2999>widespread XBD=264 XBD=400 XBD=479 XBD=711 XBD=963 XBD=1060 XBD=1302 XHG=168 XHG=298 XHG=435 XHG=508 XHG=996YBD=3046 XHG=1094 YBD=3035 YBD=3038 YBD=3039 YBD=3038 YBD=3043YHG=3009>meningitis YHG=3005>Four YHG=3016>cases YHG=3008>of YHG=3009>influenzal YHG=3017>are YHG=3008>described, XBD=1432XHG=805 XBD=1500 XBD=1709 XBD=1859 XBD=1949 XBD=2065 XBD=2134 XBD=2292 XBD=2406 XBD=2561 XHG=1364 XHG=1456 XHG=1520 XHG=1733 XHG=1882 XHG=1972 XHG=2090 XHG=2153 XHG=2316 XHG=2430 YBD=3068 YBD=3069 YBD=3075 YBD=3067 YBD=3066 YHG=3048>use aged YHG=3038>of YHG=3038>antitoxic YHG=3047>serum YHG=3040>the YHG=3040>type YHG=3039>of YHG=3038>wound YHG=3038>that YHG=3046>causes XBD=144 XBD=204 XBD=442 XBD=503 XBD=545 XBD=783 XBD=848 XBD=1300 XHG=125 XHG=163 XHG=218 XHG=461 XHG=521 XHG=565 XHG=867YBD=3077 YBD=3069 YBD=3073 YBD=3076 YBD=3084 YBD=3083 YHG=3041>2 YHG=3044>of YHG=3045>them-one YHG=3048>in YHG=3056>a YHG=3048>child YHG=3049>10 YHG=3047>months-recovering. XBD=1522 XBD=1619 XBD=1744 XBD=2001 XBD=2218 XBD=2350 XBD=2564 XHG=1365 XHG=1550 XHG=1648 XHG=1771 XHG=2027 XHG=2270 XHG=2377 YBD=3107 YBD=3114 YBD=3106 YBD=3105 YHG=3077>tetanus YHG=3076>has YHG=3077>been YHG=3078>profoundly YHG=3076>modified. YHG=3076>The YHG=3076>infection XBD=481 XBD=621 XBD=681 XBD=748 XBD=890 XBD=932 XBD=1039 XBD=1097 XBD=1166 XBD=1300 XHG=168 XHG=500 XHG=639 XHG=700 XHG=766 XHG=909 XHG=951 XHG=1056 XHG=1115 XHG=1184 YBD=3121 YBD=3116 YBD=3115 YBD=3115 YBD=3116 YBD=3115 YBD=3119 YHG=3081>Sulphapyridine YHG=3095>seems YHG=3086>to YHG=3087>be YHG=3086>worth YHG=3095>a YHG=3085>trial YHG=3086>in YHG=3086>all YHG=3094>cases, XBD=1397 XBD=1502 XBD=1665 XBD=1774 XBD=1890 XBD=1960 XBD=2138 XBD=2306 XBD=2395 XBD=2442 XBD=2562 XHG=1363 XHG=1416 XHG=1520 XHG=1684 XHG=1791 XHG=1908 XHG=1977 XHG=2156 XHG=2355 XHG=2409 XHG=2457 YBD=3145 YBD=3144 YBD=3143 YHG=3115>is YHG=3124>now YHG=3114>seldom YHG=3125>seen YHG=3116>after YHG=3125>an YHG=3115>obvious YHG=3115>wound. YHG=3114>It YHG=3114>is YHG=3123>more XBD=217 XHG=911 XBD=452 XBD=600 XBD=667 XBD=747 XBD=894 XBD=954 XBD=1031 XBD=1190 XBD=1302 XHG=123 XHG=230 XHG=468 XHG=616 XHG=681 XHG=764 XHG=965YBD=3153 XHG=1048 XHG=1205 YBD=3150 YBD=3152 YBD=3154 YBD=3155 YBD=3153 YBD=3154 YBD=3153 YHG=3117>since YHG=3121>favourable YHG=3123>effects YHG=3133>on YHG=3125>the YHG=3134>course YHG=3124>of YHG=3124>the YHG=3125>disease YHG=3132>were XBD=1481XHG=972 XBD=1543 XBD=1705 XBD=1823 XBD=1966 XBD=2142 XBD=2204 XBD=2419 XBD=2564 XHG=1363 XHG=1499 XHG=1563 XHG=1722 XHG=1841 XHG=1983 XHG=2161 XHG=2222 XHG=2439 YBD=3190 YBD=3183 YBD=3182 YHG=3153>likely YHG=3154>to YHG=3162>appear YHG=3154>after YHG=3155>minor YHG=3153>wounds YHG=3162>or YHG=3152>abrasions YHG=3152>which XBD=266 XBD=327 XBD=369 XBD=497 XBD=590 XBD=654 XBD=706 XBD=977 XHG=123 XHG=287 XHG=348 XHG=393 XHG=519 XHG=611 XHG=672 YBD=3188 YBD=3189 YBD=3192 YBD=3191 YBD=3172 YHG=3158>noticed YHG=3160>in YHG=3161>2 YHG=3170>cases YHG=3163>out YHG=3163>of YHG=3163>4. YHG=3163>’ XBD=1429 XBD=1516 XBD=1762 XBD=1918 XBD=1977 XBD=2160 XBD=2337 XBD=2563 XHG=1364 XHG=1445 XHG=1532 XHG=1777 XHG=1935 XHG=1995 XHG=2175 XHG=2353 YBD=3222 YBD=3220 YBD=3228 YBD=3223 YBD=3221 YBD=3226 YHG=3201>are YHG=3192>not YHG=3192>sufficiently YHG=3193>serious YHG=3193>to YHG=3191>demand YHG=3191>medical YHG=3191>attention, XBD=242 XHG=856 XBD=358 XBD=522 XBD=598 XBD=726 XBD=830 XBD=992 XBD=1067 XBD=1302 XHG=168 XHG=269 XHG=384 XHG=549 XHG=624 XHG=752 XHG=1019YBD=3231 XHG=1095 YBD=3227 YBD=3228 YBD=3229 YBD=3237 YBD=3230YHG=3201>should YBD=3231 YHG=3196>The YHG=3198>dose YHG=3200>should YHG=3201>be YHG=3201>large YHG=3202>and YHG=3202>be YHG=3200>continued XBD=1407 XBD=1524 XBD=1813 XBD=2071 XBD=2225 XBD=2293 XBD=2406 XBD=2560 XHG=1363 XHG=1434 XHG=1551 XHG=1842 XHG=2099 XHG=2260 XHG=2328 XHG=2435 YBD=3267 YBD=3260 YBD=3259 YBD=3266 YHG=3239>so YHG=3230>that YHG=3231>prophylactic YHG=3231>antitetanic YHG=3239>serum YHG=3230>is YHG=3230>not YHG=3230>given. XBD=213 XHG=728 XBD=297 XBD=555 XBD=692 XBD=827 XBD=1137 XBD=1301 XHG=122 XHG=248 XHG=333 XHG=591 XHG=864YBD=3269 XHG=1189 YBD=3264 YBD=3266 YBD=3274 YBD=3275 YBD=3277 YBD=3268YHG=3240>have YHG=3233>after YHG=3237>all YHG=3239>meningitic YHG=3239>signs YHG=3239>disappeared YHG=3238>fluids ; XBD=1502XHG=327 XBD=1748 XBD=1828 XBD=1984 XBD=2057 XBD=2234 XBD=2398 XBD=2564 XHG=1363 XHG=1530 XHG=1775 XHG=1853 XHG=2013 XHG=2079 XHG=2262 XHG=2424 YBD=3306 YBD=3297 YBD=3298 YHG=3268>Active YHG=3269>protection YHG=3270>by YHG=3277>means YHG=3268>of YHG=3268>tetanus YHG=3268>toxoid YHG=3268>should XBD=248 XBD=311 XBD=492 XHG=121 XHG=264 YBD=3304 YBD=3312 YHG=3271>should YHG=3274>be YHG=3277>pressed. XBD=1530 XBD=1616 XBD=1905 XBD=1963 XBD=2087 XBD=2211 XBD=2447 XBD=2563 XHG=1363 XHG=1549 XHG=1637 XHG=1920 XHG=1979 XHG=2107 XHG=2231 XHG=2466 YBD=3343 YBD=3344 YBD=3336 YBD=3337 YHG=3307>prevent YHG=3307>the YHG=3299>development YHG=3307>of YHG=3307>these YHG=3315>cases YHG=3307>associated YHG=3307>with XBD=181 XHG=884 XBD=278 XBD=332 XBD=463 XBD=542 XBD=698 XBD=867 XBD=955 XBD=1033 XBD=1166 XBD=1302 XHG=163 XHG=195 XHG=293 XHG=349 XHG=479 XHG=561 XHG=717 XHG=971YBD=3354 XHG=1051 XHG=1184 YBD=3349 YBD=3351 YBD=3352 YBD=3353 YBD=3354 YBD=3363YHG=3327>and YBD=3353 YHG=3321>I YHG=3323>wish YHG=3326>to YHG=3324>thank YHG=3326>Dr. YHG=3325>Wilfrid YHG=3326>Sheldon YHG=3327>Dr. YHG=3326>Philip YHG=3327>Evans

" |>" XBD=1624 XBD=2596 XHG=1363 XHG=1643 XHG=2581 YBD=3380 YBD=3375 YBD=3375 YHG=3345>insignificant YHG=3347>trauma. YHG=3360>< " XBD=1806 XBD=172 XBD=387 XBD=445 XBD=606 XBD=723 XBD=848 XHG=121 XHG=188 XHG=405 XHG=464 XHG=624 XHG=743 YBD=3386 YBD=3398 YBD=3400 YBD=3390 YBD=3391 YHG=3357>for YHG=3362>permission YHG=3366>to YHG=3363>publish YHG=3363>these YHG=3372>cases. " XBD=2563 XBD=1449 XHG=2389 XBD=1552 XBD=1612 XBD=1782 XBD=1838 XBD=1878 XBD=2031 XBD=2130 XBD=2225 XBD=2375 XHG=1413 YBD=3415 XHG=1466 XHG=1569 XHG=1624 XHG=1796 XHG=1853 XHG=1892 XHG=2046 XHG=2147 XHG=2241 YBD=3411 YHG=3384>received YBD=3412 YBD=3413 YBD=3414 YHG=3383>A YHG=3392>case YHG=3384>of YHG=3384>tetanus YHG=3385>in YHG=3392>a YHG=3382>soldier YHG=3384>who YHG=3383>had YHG=3384>earlier

1. Fothergill, and Sweet, L. K. J. Pediat. 1933, 2, 696. L. D. YBD=3453 " XBD=2565 XBD=1443 XBD=1684 XBD=1768 XBD=2015 XBD=2186 XBD=2457 XHG=1365 XHG=1481 XHG=1723 XHG=1801 XHG=2052 XHG=2226 XHG=2497 YBD=3450 YBD=3458 YBD=3451 YBD=3462 YHG=3423>the YHG=3421>two YHG=3421>injections YHG=3422>of YHG=3422>protective YHG=3422>toxoid YHG=3422>emphasises

NORMAN, GM, DM OXFD, MAJOR RAMC

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