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November 6, 1926


Author Affiliations


JAMA. 1926;87(19):1544-1548. doi:10.1001/jama.1926.02680190020006

This report is based on thirty-three consecutive cases of meningitis, with ten operative and one spontaneous recovery. Ten patients were not operated on because they were in a terminal stage when first seen. Thirteen postmortems were obtained from the twenty-two deaths. All cases presented the clinical picture of meningitis; and the condition found at operation warranted the diagnosis of septic meningitis, which if not surgically attacked would have ended fatally.

PHILOSOPHY  The history of the surgical treatment of the subarachnoid spaces in recent years resembles philosophically the first advances in septic peritonitis. Surgeons had to learn that the process in the abdomen was at first localized to an area outside the general peritoneal cavity. McBurney's "point" enables a diagnosis of appendicitis before the advent of the general pain of the diffuse suppuration.What is advanced is not new, but its application to the philosophy of the routine treatment of meningitis

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