Senile Cataract

course of the illness varied markedly; two cases ended on the sixth day of disease and one still survives at the thirty-seventh day now. In the intermediate examples the outstanding and most tantalising feature is the tendency to periods of remission; in one case the fluid had become practically normal only to revert to its former turbidity later. rreatment in our hands has been manifestly unsuccessful, but one essential feature must emerge from this report. That is the absolute necessity of giving meningococcal serum to every case of meningitis with a turbid fluid of unknown infection, on the chance of the case being one of cerebro-spinal fever, which is by far the commonest variety of meningitis in children. It appears to be quite impossible to differentiate clinically the several acute varieties, so that the diagnosis must depend entirely upon the bacteriologist. Nor is the infecting organism always to be recovered from the first sample of fluid; in one of these cases the h. influenzae was not found until the fourteenth day of illness. There is as yet no specific treatment to suggest. Some of the several preparations of the sulphonamide group of drugs have been used without any dramatic results to date. The prognosis seems to be almost invariably fatal, although one of these seven cases still survives. In the series of six cases from St. Thomas's Hospital one patient made an uneventful recovery, and in this case, as in the survivor of the Purdysburn series, a sulphonamide preparation was used in the treatment. I have to acknowledge my gratitude to Dr. A. Gardner Robb for his permission to record these cases and advice in the presentation of the material, and to Dr. G. F. WV. Tinsdale for the bacteriology of the cases. rHE word 'senile' in this conniection is, I think, too strong. It implies something more than old age-almost decrepitude, in fact; whereas this type of cataract is found sometimes in people who are only 50. The word, however, has been so long in use that to alter it now,, even if one wanted to do so, would be impossible. 55