, 1875-06-02

posed that for instance Typhus, Malaria, Dy-
sentery etc. originate. What are the condi-
tions for the Development of this disease can
not be. positively affirmed. The quality of
the soil, position, and exposure seem to have no
influence, for it rises as we'll on dry ~plateaux as
in marshy regions. Nor does it seem that en-
demic conditions can be considered. Individu-
ais do not carry it from place to place, and the
weather has no absolute influence. To be
brief, it may perhaps be said that in it's origin
it resembles most Influenza LA grippe), and,
like that distemper, disappears quickly. although
all conditions and relations rensaan the same.
Also in this particular does this disease -resena-
bic certain other zymotic diseases that it never
attacks the same individual twice.
Some have thought that poor, ill-fed indivi-
duals were most subject to attacks, others, on
the contrary, that strong, robust persons were
most exposed. Some allege great bodily ex-
ertion las in the case of the recruits in Francel
others pay no regard to this circumstance.
One thing appears certain, viz, that adult males,
and in certain epidemics, children, are most
exposed to be attacked.
The disease may be described briefly to
o"onsistin an NEUTRALITY-SUSPICIOUS. exceed
ingly severe and acute-of the membranes en-
v~eloping the brain and the spinal chord, and,
as q consequence, all the symptoms point to o
suffering Of The central organs Of the nervous
system. This much can be said of the disease
In general, but, for the rest, it appears under g
variety Of different forms and in various man
nerS, and is what is called poIymorphouS in it's
appearance and course, all according TO the
character OF the epidemic.
1t may attack an individual suddenly, in the
midst Of his work, with such violence that a
complete collapse, loss of consciousness, and
death in a few hours is the result. This form
has been called "M6ningite foudroyante," on
account Of its striking the patient with the
rapidity of lightning. At other times. certain
fOrerunnerS make their appearance WHICH bow
ever present nothing really characteristic, at
all events would hardly be taken as prognOs-
tics Of The violent disease approaching. Such
symptoms are sometimes pain in the limbs
and the lumbar region, loss Of appetite, sick
stomach. Often again there is an apparent
Improvement before the real disease sets in,
sometimes beginning with s~hiyeriug followed
BY viol,ut headache. Sometimes the character
Of the course Of the disease is acute, termina-
ting fatally, mostly at the commencement of
the second week; at other times it drags
on for weeks, even months, until con-
valescenco begins, which is generally pro,
tracted, the patent being very ezhausted,-
or the patient dies with typhoid symptoms.
Complications often take place with other
diseases Of the brain, pulmonary attacks or
a&er-diseases, such as deafness, temporary
or permanent blindness. The celebrated ocu-
list V. Grafe even mentions q definite kind Of
disease of the eye, which he had not observed
as following any other disease than Meningitis
cerebro-spinalis. On other occasions the
symptoms are milder, subside quicker, and,the
cure is effected more speedily and complete
~. Finally there may occur in every cpl
demic these cases which must be considered
as abortiye. As a rule the disease is continual'
from beginning to end, sometimes, however,
renting, very seldom intermitting.
1t is thus easily understood that the appear
ance Of the disease is 50 manifold that it is
impossible to give q description which, even
approximatively, holds good in all cases.
l shall therefore keep to the single symptoms,
and describe them in,tho order in which they
most frequently occur.
The principal symptom is Headache. This
is %vioIent, begins sometimes in the forehead
but spreads quickly to the rest of the head,
particularly the nape of the neck. Not be-
fore this begins to abate is there reason to
hope for Improvement Of the patient. If it
increases, it is a bad symptom. The head
ache is violent, painful, makes the patient
restless he groans, comforts his face, grasps
his head, even when he is otherwise uncon'
scious. The patient often loses conscious
ness, or becomes drowsy, answers your ques'
lions tardily, lamenting and Whining
or sometimes consciousness remains unimpair'
"a