Bellows Falls times. [volume] (Bellows Falls, Vt.) 1856-1965, 1873-04-11
Cerebro-Spinal Meningitis.


which is the clearest that has yet ap-
peared in print. Says DIR. Moore About
the causes of this disease little or moth
ing is known. But this, happily, is not
true in regard to its location and symp-
toms. 1t is to be regretted that there is
such diversity of opinion in regard to its
cure. My own experience satisfies me
that, as between varying schools of hon.
epathic practice, the strict observance of
the Hahnemannic rule is the only sue
cessful, and very successful course.
Each case of this disease being dis
tinctly individual, presenting forms and
shades as various as the human face,
form or disposition, each one requires
different remedies, and for that reason it
is impracticable here to lay down rule.
The first epidemic visitation of this
disease occurred in 1906, when it gradu-
ally spread through New England, Can
ada, New York and Pennsylvania from
1907 to 1912. 1t was again epidemic in
a number of the states between 1910 and
1850, and again in 1852 and 1858. But
in 1862 and 1868, during the war, it was
more widely prevalent. Since then it
has never altogether disappeared from
the country. In New York and Brook
lyn, at the beginning of 1872, consid-
erable number of fatal cases were re-
ported but it is an epidemic that has
of late years attracted the special atten-
tion of physicians. These epidemic Wis
itations are occasionally confined within
very narrow geographical limits; while
at other times, as was the case in France
between 1887 and 1912, they spread sue
cessively over extensive regions. Their
occurrence would appear to be altogeth-
er independent of any morbiic agency
referable to peculiaritles of climate, sea-
son or locality.
According to Mr.. Rollett, who de-
soribed the disease as it occurred at
Nancy, it presents itself under two
forms; in the one there is no sign of
lesion of the nervous centers themselves;
no affection of sensation or motion, though
there are all the symptoms of inlamma-
ton of the membrane; at first rigors,
then malaise, a dinning in the ears, ver-
tigo, violent pain in the head and along
the vertebral column, agitation, restless
ness, slight delirium and sometimes mod
crate fever. In the second form there is
affection of the intellectual faculties, al
so of the functions of sensation and mo-
tion, with more or less complete aboli-
tion of the senses. In this latter form
the appearances upon dissection were
vascularity of the cerebral membrane.
The cerebrum was slightly punctuated,
hnt Tho narahaIl,,,.
softened. Beneath the spinal membrane
there was purulent matter, the same as
beneath the cerebral. The substance of
the spinal cord appeared healthy. The
LESSONS here described exactly correspond
with those described by physicians who
studied the disease as it prevailed at Yer
sailles, Avignon and Strasburg. Ac-
cordlng to Dr. Mayne's interesting ac-
count of the disease as it occurred in
Ireland during the year 1916, the serous
membrane covering the brain and spinal
marrow was invariably found to be the
seat of extensive inflammation.
The first symptoms are very formida-
BILE, and the attack is very sudden. In
large number of cases the patient is in
ordinary health and spirits up to the
very moment of the seizure, experiencing
no premonitory symptoms to warn him
of danger, the disease all at once declar-
ing itself. Very generally, however, the
attack is preceded by more or less pain
in the head, especially in the forehead,
temples or occiput. The pain is usually
constant, but sometimes remittent, or
even intermittent. Pain is sometimes
experienced in the back of the neck and
along the course of the spine, with
sense of soreness in the limbs and Joints.
In some cases the attack is preceded by
gddiness, with or without dimness of
vision. Occasionally the attack begins
with an ague succeeded by slightly in
creased heat of the surface, and pain,
extending from between the shoulders to
the occiput, with stiffness of the posteri-
or cervical muscles. In other cases the
patient may exhibit pallor Of counte-
nance, coldness of the extremities, low
moaning or muttering delirium, quickly
succeeded by restlessness; flushing of
the face, frequent pulse, wild express
sion of the eyes, and hot, dry skin. In
other cases the disease may be ushered in
| by lassitude and uneasiness, considerable
prostration, and dull, heavy pain in
the head, with vertigo, eyes languid and
half closed, articulation laborious and
indistinct. Occasionally the patient is
suddenly attacked with deep coma, or
with more or less stupor, extreme debili-
ty, giddiness, dimness of sight or double
vision. Or the attack may commence
with severe pain in the abdomen, imme-
diately succeeded by nausea, and per-
haps vomiting. In violent attacks of
this kind the extremities become cold
and of blush color, and the pulse re-
duced to mere thread.
Whatever may be the initiatory symp-
toms, they are replaced, sooner or later,
by state of violent agitation, followed
by stupor, with slow, full pulse, and
dilated and immovable pupils. When
in this condition, touching any part of
the body will sometimes cause short,
plaintive cry; at others, the patient ut
ters acute cries and carries his hand fire.
quently to the head. Delrium is very
commonly present from an early period
of the attack. In the majority of cases
| there is more or less intolerance of light
and sound in some complete blindness
of one or both eyes. In some cases there
| is partial or complete deafness. An ex-