Treatment of tuberculous meningitis.

When isoniazid is used for the chemotherapy of tuberculous meningitis the need for intrathecal therapy is controversial. A Scottish Joint Committee (1957) concluded from a comparative trial, including both adults and children, that intrathecal streptomycin is not now an essential part of the treatment. But, in fact, all the patients reported did receive intrathecal streptomycin for at least one week. Lincoln (1958) and Gaisford (1958) have abandoned intrathecal therapy but Smith, Vollum, Taylor and Taylor (1956) and Lorber (1956) maintain that some, not necessarily prolonged, treatment by the intrathecal route should be given and Miller (1958) concurs with this, opinion. Since February, 1954, routine intrathecal therapy has been abandoned by one medical unit in the Royal Hospital for Sick Children, Glasgow, but retained by the other. In both units, however, the alternative method of treatment has occasionally been used when the clinician in charge judged this advisable. The purpose of the present paper is to compare the results obtained with these two methods of treatment.