Year: 1873

The influence of cercbrO-spinal menin-
gifts on the mortality reports of the city
for some weeks past has been generally
noted, and has occasioned not little
alarm. The disease, being comparatively
new and not at all familiar to those who
have not come in contact with it, has had
the effect to increase this alarm, and now
it is common question asked among
those who are sufficiently venturesome to
this new i'll that flesh is succumbing to so
rapidly? What is this cerebro-spinal
meningitis? It might be answered briefly
that it is an affection of the brain and
spinal marrow, but that would hardly be
definite enough to give satisfaction.


The disease has been in this country
more or less since the early spart of the
century, and has afflicted Europe for
many years. 1t had never attracted much
attention in either country until it appear
ed in epidemic form, when leading physi-
clans commenced seriously to investigate
its characteristics. At present this city is
quite seriously afflicted, and for few
weeks back the deaths have averaged
about twenty each week. 1t visited Mis-
souri, once before, some years ago, but we
have no record at hand to give satisfactory
statistics as to its Tavages then. In those
days, however, and up to within a recent
period, it was supposed that the disease
was almost exclusively confined to male
children under the age of fifteen years.
At present, however, there is patient in
the hospital aged over thirty years, who is
considered an exceptionally bad case, and
we understand also that now it is not at
all confined to either sex. Though for
merly ii was considered necessarily fatal,
the science and experience of the present
day is making considerable headway to-
ward alleviating the severity of the terrible
disorder.


The symptoms by which the disease
commences are in general of very form
idable character, and its accession is often
alarmingly sudden. In a large number of
cases the patient appears in ordinary
health and spirits up to the very moment
ofthe seizure, and experiences no premon-
itory symptoms by way of warning. As
an instance of this, four cases which oc-
Cured during the prevalence of the dis
ease in Ireland in 1916 are reported; four
boys had eaten a hearty dinner and re-
tired to bed, in apparent health, when the
disease all at once declared itself


Very generally however, the disease is
preceded by more or less pain in the head,
especially of the forehead, temples or occi-
put. The pain is usually constant, but
sometimes remittent or even intermittent.
Pain is also sometimes felt in the back of
the neck, and along the course of the spine,
with "A sense of soreness in the limbs and
joints. In a few cases the, attack is pre-
ceded by a sense of giddiness, with or with
out dimness of vision. The disease in
general is characterized by acute and fixed
pain of the head, aversion from light, in
creased sensibility of the surface, acute
cries, low muttering delirium, or coma,
pain and stiffness of the posterior cervicu-
lar muscles, with permanent retraction of
the head, often rigidity of the large exten-
sors of the spine, spasmOdic twitching of
the muscles, especially of the face, and
tetanic convulsiOns of the limbs. q


The most striking Characteristic of
cerebrospinal meningitis is that presented
by the condition of the muscular system
The muscles of the neck in particular be-
come rigidly contracted, drawing back
the head upon the vertebral column, and
firmly fixing it in that position, so that
the patient is unable to move it for
ward neither can this be done by attend
ants with the employment of any justifia-
Bile degree of force. Rigidity is very com
monty observed also in the muscles of the
lower eXtremities, and the patient loses
the power of moving his limbs and of as
suming an upright position. In some
epidemies the spinal column has been
known TO have been similarly affected, it
being so rigidly bent in bow shape as to
prevent the patient lying on his back. ..


The duration of the disease is very
variable. Death may occur in few hours
after the attack. The generality of eases
are protracted to over fourteen, twenty or
even fifty days. Convalescence is usually
slow and lingering, and secondary dis
eases, even after apparently perfect recov-
cry, are apt TO occur, and sooner or later
destroy the patient A few, more FORUM