It is well known that since the introduction of the antimeningitis serum by Flexner in 1906, the mortality of meningococcus meningitis has decreased from 75 or 80 per cent. to 25 per cent, or less. Despite this fact, it is obvious that in a small percentage of cases the treatment of this disease has not yet reached perfection. That this small number of cases does not respond to the serum, in spite of its accurate and prolonged use, gives us food for thought and compels us to inquire into the causes of the occasional failure with this method of treatment.
CAUSES OF OCCASIONAL FAILURE
These causes may be grouped as follows:
Fulminating Cases.—The endotoxins of the meningococcus may be so virulent as to make neutralization by the antimeningitis serum impossible. The action of the serum is dependent on the presence of a number of immune substances, bacteriolysins or antibacterial