You do not want to miss it—the story of H influenzae meningitis
The 1940 film The Courageous Dr. Christian shows a meningitis outbreak in “squatter town.” When Dr Christian (Jean Hersholt) is called in to diagnose a child, he warns the community of more to come. Once informed, the unfazed mayor interjects that the slums alone are at risk. Dr Christian—deeply serious and upset by the mayor's lack of compassion for the poor—tells him the infection could also get to the town administrators. The outbreak portrayed in The Courageous Dr. Christian might have superficially represented an actual meningococcal meningitis epidemic that hit major American cities in the early 1900s.
Epidemic meningitis, with its devastating consequences (nearly 100% mortality if caused by Haemophilus influenzae), is also one of the main story lines in Janet Gilsdorf's engagingly written and revelatory book on bacterial meningitis. The catchy book title Continual Raving: A History of Meningitis and the People Who Conquered It refers to the diagnosis of phrensy, which Thomas Willis described as a “continual raving or the depravation of the chief faculties of the brain arising from inflammation of the meninges with a continual fever.” It remains hypothetical if Willis was truly diagnosing infectious meningitis, because the key symptoms are actually the opposite: patients were typically withdrawn and obtunded. Definitive descriptions of meningitis came from John Abercrombie, who specifically pointed to meningeal inflammation as the main substrate and identified different types of severity involving the base of the brain and the convexities, as well as a type with additional pus in the ventricles, emphasising hydrocephalus as an important additional complication (figure).
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