The treatment of meningococcus or epidemic cerebrospinal meningitis in infants, especially in the hospital class of patients, has not been entirely satisfactory. The mortality rate and the incidence of sequels, even with careful serum treatment, are too high. The results obtained at the Infants' Hospital in a series of cases treated by lumbar puncture before the use of serum did not differ materially from a series treated later with serum. In other words, for some reason, serum has not proved so helpful in the treatment of hospital infants as has been expected. Why this should be so has been a subject for consideration with us for several years that we might find a reason and hence improve the treatment.
It seems to us that two factors are responsible for a high rate of mortality and sequels in infancy. The patients are seen late or are admitted to the hospital after