Occasionally rashes occur several days after the inoculation, but such disturbances are insignificant except for the immediate discomfort experienced. Antitoxin concentrated by the Gibson method has reduced to a considerable extent the number of cases in which rashes occur.
Treatment other than by antitoxin is symptomatic. Where the disease occurs in the wind-pipe, it may be necessary to pass a tube into its upper opening to allow the patient to breathe, and in other instances the wind-pipe is itself opened from the outside in order to permit a sufficient amount of air to enter the lungs to maintain life.
It is of the utmost importance that patients be kept in bed until all danger of complications has passed. Death from heart-failure several weeks after the diphtheria in the throat is well, is not an uncommon result of the disease, and is especially prone to follow even the slightest exertion. Patients under such circumstances have been known to die from raising themselves up in the bed.
Meningitis, or spotted fever, is one of the most terrible and fatal of all diseases, every case proving fatal in some local epidemics.
Although the cause of the disease has been known for a number of years, the exact method by which the germ that produces it spreads from man to man was until quite recently entirely unrecognized, and even now it cannot be said that the whole matter has been demonstrated.
_Character and Course of the Disease._--Cerebrospinal meningitis is produced by a minute vegetable (bacterium), the _Micrococcus intracellularis_. This germ does not appear to occur normally in any of the lower animals, nor has it been found in the outer world, and is therefore to be regarded as distinctly a human parasite. It is very fortunately a germ of low vitality, as it develops only at about blood heat, and when expelled from its normal dwelling-place in the human body it dies very quickly.
The accompanying illustration shows how these bacteria appear under the microscope; the drawing was made from fluid taken from the spinal canal of a patient suffering from cerebrospinal meningitis. These germs get within the skull and spinal canal, and produce violent inflammation of the coverings of the brain and cord; these membranes are called "meninges," hence the name "cerebrospinal meningitis." Within a short time after their entrance pus is produced, and the condition becomes practically one of abscess around the brain and spinal cord.
