See also:

• MENINGITIS (from Gr. z veyE, a membrane)

MENINGITIS (from Gr. z veyE, a membrane)  , a See also:

• TERM

term in See also:

• MEDICINE

medicine applied to inflammation affecting the membranes of the See also:

• BRAIN (A.S. braegen)

brain (cerebral See also:

• MENINGITIS (from Gr. z veyE, a membrane)

meningitis) or See also:

• SPINAL

spinal See also:

• CORD (derived through the Fr. corde, from the Lat. chorda, Gr. xop(5rt, the string of a musical instrument)

cord (spinal meningitis) or both . Tubercular cerebral meningitis (or Acute Hydrocephalus) is a disease due to inflammation of the meninges of the brain produced by the presence of a tubercle bacillus . This disease is most See also:

• COMMON

common in See also:

• CHILDREN, LAW RELATING TO

children under ten years of See also:

• AGE (Fr. age, through late Lat. aetaticum, from aetas)

age, but may affect adults . The tubercular constitution is an important See also:

• FACTOR (from Lat. facere, to make or do)

factor in this malady . In numerous cases it is manifestly connected with See also:

• BAD, BCD

bad hygienic conditions, with insufficient or improper feeding, or with over exercise of the See also:

• MENTAL

mental See also:

• POWERS, HIRAM (1805-1873)

powers, all of which will doubtless more readily exert their See also:

• INFLUENCE (Late Lat. influentia, from influere, to flow in)

influence where an inherited liability. exists, and the same may be said regarding its occasional occurrence as one of the after consequences of certain of the diseases of childhood, especially See also:

• MEASLES, (Morbilli, Rubeola; the M. E. word is maseles, properly a diminutive of a word meaning " spot," O.H.G. m¢sa, cf. " mazer "; the equivalent is Ger. Masern; Fr. Rougeole)

measles and whooping-cough . There are certain typical features characterizing the disease in each of its stages . The premonitory symptoms are mostly such as relate to the See also:

• GENERAL
• GENERAL (Lat. generalis, of or relating to a genus, kind or class)

general See also:

• NUTRITION

nutrition . A falling off in flesh and failure of strength are often observed for a considerable See also:

• TIME (0. Eng. Lima, cf. Icel. timi, Swed. timme, hour, Dan. time; from the root also seen in " tide," properly the time of between the flow and ebb of the sea, cf. O. Eng. getidan, to happen, " even-tide," &c.; it is not directly related to Lat. tempus)
• TIME, MEASUREMENT OF
• TIME, STANDARD

time before the characteristic phenomena of the disease appear . The patient, if a See also:

• CHILD
• CHILD, FRANCIS JAMES (1825-1896)
• CHILD, L
• CHILD, LYDIA MARIA (1802-1880)
• CHILD, SIR FRANCIS (1642-1713)
• CHILD, SIR JOHN (d. 1690)
• CHILD, SIR JOSIAH (163o - 1699)

child, becomes listless and easily fatigued, loses appetite, and is restless at See also:

• NIGHT

night . There is headache after exertion, and the child becomes unusually irritable . These symptoms may persist during many See also:

• WEEKS, EDWIN LORD (1849-1903)

weeks; but on the other See also:

• HAND
• HAND (a word common to Teutonic languages; cf. Ger. Hand, Goth. handus)
• HAND, FERDINAND GOTTHELF (1786-185r)

hand such premonitory indications may be entirely wanting, and the disease be See also:

• DEVELOPED

developed to all See also:

• APPEARANCE (from Lat. apparere, to appear)

appearance suddenly . The onset is in most instances marked by the occurrence of vomiting, often severe, but sometimes only slight, and there is in general obstinate See also:

• CONSTIPATION (from Lat. constipare, to press closely together, whence also the adjective " costive ")

constipation .

In not a few cases the first symptoms are See also:

• CONVULSIONS

convulsions, which, however, may in this See also:

• EARLY
• EARLY, JUBAL ANDERSON (1816-1894)

early See also:

• STAGE (Fr. 6/age; from Lat. stare, to stand)

stage subside, and remain absent, or reappear at a later See also:

• PERIOD
• PERIOD (Gr. irepioSos, a going or way round, circuit, aepi, round, and &Sis, way, road)

period . Headache is one of the most See also:

• CONSTANT, BENJAMIN (1845-1902)

constant of the earlier symptoms, and is generally intense and accompanied with sharper paroxysms, which cause the patient to scream, with a See also:

• PECULIAR

peculiar and characteristic cry . There is See also:

• GREAT

great intolerance of See also:

• LIGHT

light and See also:

• SOUND
• SOUND, THE (Danish Oresund)

sound, and general See also:

• NERVOUS

nervous sensitiveness . See also:

• FEVER (Lat. febris, connected with fervere, to burn)

Fever is See also:

• PRESENT

present to a greater or less extent, the temperature ranging from toe to 103 F.; yet the See also:

• PULSE

pulse is not quickened in proportion, being on the contrary rather slow, but exhibiting a tendency to irregularity, and liable to become rapid on slight exertion . The breathing, too, is somewhat irregular . Symptoms of this See also:

• CHARACTER (Gr. xapareri7p, from xap&crew, to scratch)

character, constituting the stage of excitement, continue for a period varying from one to two weeks, when they are succeeded by the stage of depression . There is now a marked See also:

• CHANGE (derived through the Fr. from the Late Lat. cambium, cambiare, to barter; the ultimate derivation is probably from the root which appears in the Gr. «a urmu', to bend)

change in the symptoms, which is See also:

• APT

apt to See also:

• LEAD
• LEAD (pronounced iced)

lead to the belief that a favourable turn has taken See also:

• PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)

place . The patient becomes quieter and inclines to See also:

• SLEEP (0. Eng. slcepan; Ger. schlafen; cf. Lat. labi, to glide, and " slip ")

sleep, but it will be found on careful watching that this quietness is but a See also:

• CONDITION (Lat. condicio, from condicere, to agree upon, arrange; not connected with conditio, from condere, conditum, to put together)

condition of apathy or partial stupor into which the child has sunk . The vomiting has ceased, and there is less fever; the pulse is slower, and shows a still greater tendency to irregularity than before, while the breathing is of markedly unequal character, being rapid and shallow at one time, and See also:

• LONG, GEORGE (1800-1879)
• LONG, JOHN DAVIS (1838– )

long See also:

• DRAWN

drawn out and sinking away at another . There is manifestly little suffering, although the peculiar cry may still be uttered, and the patient lies prostrate, occasionally See also:

• ROLLING

rolling the See also:

• HEAD (in 0. Eng. heafad; the word is common to Teutonic languages; cf. Dutch hoofd, Ger. Haupt, generally taken to be in origin connected with Lat. caput, Gr. KerbOvi7)
• HEAD, SIR EDMUND WALKER, BART
• HEAD, SIR FRANCIS BOND, BART

head uneasily upon the See also:

• PILLOW (O. Eng. pylu; Lat. pulvinus, a cushion)

pillow, or picking at the bedclothes or at his See also:

• FACE (from Lat. fades, derived either from facere, to make, or from a root fa-, meaning " appear "; cf. Gr. cbatvstv)

face with his fingers . He does not ask for See also:

• FOOD
• FOOD (like the verb " to feed," from a Teutonic root, whence O. Eng. foda; cf. " fodder "; connected with Gr. lrareicOae, to feed)

food, but readily swallows what is offered . The countenance is See also:

• PALE (through Fr. pal, from Lat. palms, a stake, for paglus, from the stem pag- of pangere, to fix; " pole " is from the same original source)

pale, but is apt to flush up suddenly for a time .

The eyes present important alterations, the pupils being dilated or unequal, and scarcely responding to light . There may be See also:

• DOUBLE
• DOUBLE (from the Mid. Eng. duble, the form which gives the present pronunciation, through the Old Er. duble, from Lat. duplus, twice as much)

double See also:

• VISION (from Lat. videre, to see), or SIGHT

vision, or partial or See also:

• COMPLETE

complete See also:

• BLINDNESS

blindness . Squinting is common in this stage, and there may also be drooping of an eyelid, due to See also:

• PARALYSIS, or PALSY (from Gr. aapal,6a , to relax; Wycliffe has palesy, and another old form of the word is parlesy)

paralysis of the See also:

• PART

part, and one or more limbs may be likewise paralysed . To this succeeds the third or final stage, in which certain of the former symptoms recur, while others become intensified . There is generally a return of the fever, the temperature rising sometimes very high . The pulse becomes feeble, rapid, and exceedingly irregular, as is also the See also:

• CASE
• CASE, JOHN (d. 1600)

case with the breathing . See also:

• COMA (Gr. K(.7)

Coma is profound, but yet the patient may still be got to See also:

• SWALLOW (A. S. swalewe, Icel. svala, Du. zwaluw, Ger. Schwalbe)

swallow nourishment, though not so readily as before . Convulsions are apt to occur, while paralysis, more or less extensive, affects portions of the See also:

• BODY

body or See also:

• GROUPS
• GROUPS, THEORY

groups of muscles . The pupils are now widely dilated, and there is generally complete blindness and often deafness . In this condition the patient's strength undergoes rapid decline, and the body becomes markedly emaciated . See also:

• DEATH

Death takes place either suddenly in a See also:

• FIT

fit, or more gradually from exhaustion . Shortly before death it is not uncommon for the patient, who, it may be for many days previously, See also:

• LAY

lay in a See also:

• STATE
• STATE, GREAT OFFICERS OF

state of profound stupor, to awake up, ask for food, and talk to those around .

The duration of a case varies somewhat,' but in general death takes place within three weeks from the onset of the symptoms . The disease may be said to bealmost invariably fatal, yet cases presenting all the See also:

• PRINCIPAL

principal symptoms occasionally recover . Much may be done in the way of prevention of this disease, and, in its earlier stages, even in the way of cure . It is most important in families where the See also:

• HISTORY

history indicates a tuberculous or scrofulous tendency, and particularly where acute hydrocephalus has already occurred, that every effort should be used to fortify the See also:

• SYSTEM

system and avoid the causes already alluded to as favouring the development of the disease during that period in which children are liable to suffer from it . With this view wholesome food, warm clothing, cleanliness, regularity,,and the avoidance of over-exertion, See also:

• PHYSICAL

physical and mental, are of the utmost consequence . Timely use of remedies may mitigate and even occasionally remove the symptoms when they arise . The See also:

• MAINTENANCE (Fr. maintenance, from maintenir, to maintain, support, Lat. manu tenere, to hold in the hand)

maintenance of the patient's strength by light nourishment and the use of sedatives to compose the nervous system are the See also:

• MEASURES

measures most likely to be attended with success . Bromide, combined with iodide of See also:

• POTASSIUM [symbol K (from kalium), atomic weight 39.114 0=16)]

potassium, is the medicinal See also:

• AGENT (from Lat. agere, to act)

agent of most value for this purpose . Should convulsions occur, they are best treated by See also:

• CHLORAL

chloral or See also:

• CHLOROFORM (trichlor-methane), CHC13

chloroform . In what is known as suppurative, or See also:

• SIMPLE

simple acute meningitis (non-tubercular), the disease arises from various causes, and the symptoms are similar to those described above . In posterior-basic meningitis, inflammation of the membranes investing the posterior basic spinal cord, the See also:

• CHIEF (from Fr. chef, head, Lat. caput)

chief symptoms are fever, with severe See also:

• PAIN (from Lat. poena, Gr. robin, penalty, that which must be paid: O. Fr. peine)
• PAIN, BARRY (1867– )

pain in the back or loins See also:

• SHOOTING

shooting down-wards into the limbs (which are the seat of frequent painful involuntary startings), accompanied with a feeling of tightness See also:

• ROUND (O. Fr. rond, Lat. rotundus, the Fr. is the source also of Du. rond; Ger., Swed., Dan. and Nor. rond)

round the body . The See also:

• LOCAL

local symptoms See also:

• BEAR
• BEAR, BLACK
• BEAR, BROWN
• BEAR, GRIZZLY
• BEAR, ISABELLINE
• BEAR, WHITE

bear reference to the portion of the cord the membranes of which are involved .

Thus when the inflammation is located in the cervical portion the muscles of the arms and See also:

• CHEST (Gr. Kiarl, Lat. cista, O. Eng. cist, test, &c.)

chest are spasmodically contracted, and there may be difficulty of swallowing or breathing, or embarrassed See also:

• HEART
• HEART, LUNG

heart's See also:

• ACTION

action, while when the disease is seated in the See also:

• LOWER

lower portion, the lower limbs and the See also:

• BLADDER (from A.S. blaeddre, connected with bl¢wan, to blow, cf. Ger. blase)

bladder and rectum are the parts affected in this way . At first there is excited sensibility (hyperaesthesia) in the parts of the See also:

• SURFACE

surface of the body in relation with the portion of cord affected . As the disease advances these symptoms give place to those of partial loss of See also:

• POWER [WILLIAM GRATTAN] TYRONE (1797-1841)

power in the affected muscles, and also partial See also:

• ANAESTHESIA

anaesthesia . These various phenomena may entirely pass away, and the patient after some weeks or months recover; or, on the other hand, they may increase, and end in permanent paralysis . Some observers regard these forms as sporadic cases of cerebrospinal fever; and Still, See also:

• WILLIAM
• WILLIAM (1143-1214)
• WILLIAM (1227-1256)
• WILLIAM (1J33-1584)
• WILLIAM (A.S. Wilhelm, O. Norse Vilhidlmr; O. H. Ger. Willahelm, Willahalm, M. H. Ger. Willehelm, Willehalm, Mod.Ger. Wilhelm; Du. Willem; O. Fr. Villalme, Mod. Fr. Guillaume; from " will," Goth. vilja, and " helm," Goth. hilms, Old Norse hidlmr, meaning
• WILLIAM (c. 1130-C. 1190)
• WILLIAM, 13TH

William See also:

• HUNTER, JOHN (1728-1793)
• HUNTER, ROBERT MERCER TALIAFERRO (r8o9-1887)
• HUNTER, SIR WILLIAM WILSON (1840-19oo)
• HUNTER, WILLIAM (1718–1783)
• HUNTER, WILLIAM ALEXANDER (1844-1898)

Hunter and See also:

• GEORGE
• GEORGE, 8TH MARQUESS OF TWEEDDALE (1787-1876)
• GEORGE, HENRY (1839—1897)
• GEORGE, LAKE
• GEORGE, SAINT (d. 303)

George See also:

• NUTTALL, THOMAS (1786-1859)

Nuttall have isolated an organism similar to the diplococcus intracellularis, while See also:

• HENRY
• HENRY (1129-1195)
• HENRY (c. 1108-1139)
• HENRY (c. 1174–1216)
• HENRY (Fr. Henri; Span. Enrique; Ger. Heinrich; Mid. H. Ger. Heinrich and Heimrich; O.H.G. Haimi- or Heimirih, i.e. " prince, or chief of the house," from O.H.G. heim, the Eng. home, and rih, Goth. reiks; compare Lat. rex " king "—" rich," therefore " mig
• HENRY, EDWARD LAMSON (1841– )
• HENRY, JAMES (1798-1876)
• HENRY, JOSEPH (1797-1878)
• HENRY, MATTHEW (1662-1714)
• HENRY, PATRICK (1736–1799)
• HENRY, PRINCE OF BATTENBERG (1858-1896)
• HENRY, ROBERT (1718-1790)
• HENRY, VICTOR (1850– )
• HENRY, WILLIAM (1795-1836)

Henry Koplik in New See also:

• YORK
• YORK (HOUSE OF)
• YORK, EDMUND OF LANGLEY, DUKE OF (1341-1402)
• YORK, EDWARD
• YORK, FREDERICK AUGUSTUS, DUKE OF (1763-1827)
• YORK, RICHARD, DUKE

York found cases of typical posterior-basic meningitis due to the diplococcus intracellularis . The treatment is directed to allaying the pain and inflammatory action by opiates . See also:

• ERGOT, or SPURRED RYE

Ergot is recommended by many physicians . The patient should have perfect See also:

• REST (O. Eng. rest, reste, bed, cognate with other Teutonic forms, e.g. Ger. Rast, Riiste, rest, and probably Gothic Rasta, league, i.e. resting or stopping place)

rest in the recumbent, or better still in the prone, position . See also:

• COLD (in O. Eng. cald and ceald, a word coming ultimately from a root cognate with the Lat. gelu, gelidus, and common in the Teutonic languages, which usually have two distinct forms for the substantive and the adjective, cf. Ger. Kolte, kalt, Dutch koude

Cold applications to the spine may be of use, while See also:

• ATTENTION (from Lat. ad-tendo, await, expect; the condition of being " stretched " or " tense ")

attention to the functions of the bladder and bowels, and to the condition of the skin with the view of preventing See also:

• BED
• BED (a common Teutonic word, cf. German Bett, probably connected with the Indo-European root bhodh, seen in the Lat. fodere, to dig; so " a dug-out place " for safe resting, or in the same sense as a garden " bed ")

bed-sores, is all-important . Cerebro-spinal fever or epidemic cerebro-spinal meningitis, popularly called " spotted fever," is an infectious disease occur-See also:

• RING (O.E. hring; a word common to Teutonic languages; and probably cognate with the Lat. circus, Gr. KtpKOS or KpLKOS, Skt'. chakra, wheel, circle, cf. also " harangue "); in art, a band of circular shape of varying sizes, made of any material and used f

ring sporadically or in epidemics, and due to the diplococcus intracellularis discovered by Weichselbaum in 1887 . This disease was not recognized until the 19th See also:

• CENTURY (from Lat. centuria, a division of a hundred men)

century . It was first described at See also:

• GENEVA
• GENEVA (Fr. Geneve, Ger. Genf, Ital. Ginevra, Late Lat. Gebenna, though Genava in good Latin)
• GENEVA, LAKE OF

Geneva in 18o5 and small outbreaks followed in See also:

• PARIS
• PARIS (also called ALEXANDROS)
• PARIS, ALEXIS PAULIN (1800-x881)
• PARIS, BRUNO PAULIN GASTON (1839-1903)
• PARIS, FRANCOIS DE (169o-1727)
• PARIS, LOUIS PHILIPPE ALBERT
• PARIS, TREATIES OF (1814-1815)

Paris (1814), See also:

• METZ

Metz and See also:

• GENOA (anc. Genua, Ital. Genova, Fr. GPnes)

Genoa (1815), and See also:

• WESTPHALIA (Ger. Westfalen)
• WESTPHALIA, TREATY OF

Westphalia (1822), but in the See also:

• UNITED

United States there was a wicspread epidemic, including New See also:

• ENGLAND
• ENGLAND, THE CHURCH OF

England and spreading as far as See also:

• KENTUCKY

Kentucky and See also:

• OHIO

Ohio .

Fresh outbreaks in See also:

• EUROPE

Europe took place between 1837 and 1850 . In 1837 it prevailed in the See also:

• SOUTH
• SOUTH, ROBERT (1634–1716)

south of See also:

• FRANCE
• FRANCE, ANATOLE (1844– )

France chiefly amongst troops in See also:

• GARRISON
• GARRISON, WILLIAM LLOYD (1805-1879)

garrison, and fresh outbreaks continued throughout France in 1846 with epidemics in See also:

• ALGIERS (Fr. Alger, Arab. Jezair, i.e. The Islands)

Algiers, See also:

• ITALY
• ITALY (Italia)

Italy and See also:

• SICILY (Ital. Sicilia)

Sicily . In Great See also:

• BRITAIN (Gr. Hperavuml vi7vot, Bperravia; Lat. Britannia, rarely Britannia)

Britain it first showed itself in the Irish workhouses in 1846, where it was known as " the See also:

• BLACK
• BLACK, ADAM (1784-1874)
• BLACK, JEREMIAH SULLIVAN (1810–1883)
• BLACK, WILLIAM (1841-1898)

black death " or " See also:

• MALIGNANT (Lat. malignus, evil-disposed, from maligenus)

malignant-, purpuric fever." After 1866 except for sporadic cases it disappeared from Great Britain, but small outbreaks took place in 1885 to 190o in See also:

• DUBLIN

Dublin . In 19o5. there was an extensive epidemic in New York, followed by an outbreak in See also:

• SCOTLAND
• SCOTLAND, CHURCH OF
• SCOTLAND, EPISCOPAL CHURCH OF

Scotland in 1906, and in Scotland and See also:

• IRELAND
• IRELAND, CHURCH
• IRELAND, CHURCH OF
• IRELAND, JOHN (1761-1842)
• IRELAND, JOHN (1838- )
• IRELAND, WILLIAM HENRY (1777-1835)

Ireland in 1907-1908 . The registrar-general's returns for 1907 give io18 deaths in Scotland due to the disease, of which 711 were at See also:

• GLASGOW

Glasgow and 148 at See also:

• EDINBURGH

Edinburgh . In the same See also:

• YEAR

year See also:

• BELFAST

Belfast was visited by a severe epidemic, 495 deaths out of the See also:

• TOTAL

total death-See also:

• RATE

rate of 631 taking place in that See also:

• DISTRICT

district . The mode of infection is obscure, but the organism is thought to gain See also:

• ACCESS (Lat. accessus)

access to the circulation through the mucous membrane of the See also:

• NOSE (O.Eng. nosu, cf. Dutch neus, Swed. nos, snout; the Aix in Provence. Both at Aix and at Lyons he acquired great connexion with O.Eng. nasu is obscure, cf. Ger. Nase, Lat. pares, distinction by his labours during outbreaks of the plague. In nostrils,

nose and conjunctiva, as the organism has been isolated from the mucous membrane of the nose, not only of those suffering from the disease but from healthy persons who have been in contact with cases . Cerebro-spinal fever has an undoubted tendency to follow bad sanitary conditions and to prevail in See also:

• DAMP

damp, sunless houses . It is a disease of temperate climates, and the outbreaks usually take place in the See also:

• SPRING (from " to spring," " to leap or jump up," " burst out," O. Eng., springau, a common Teut. word, cf. Ger. springer, possibly allied to Gr. QnrFpxecOac, to move rapidly)

spring of the year . The victims are mostly children and See also:

• YOUNG
• YOUNG, A
• YOUNG, ARTHUR (1741-1820)
• YOUNG, BRIGHAM (1801-1877)
• YOUNG, CHARLES MAYNE (1777–1856)
• YOUNG, EDWARD (1683–1765)
• YOUNG, JAMES (1811-1883)
• YOUNG, THOMAS (1773-1829)

young adults, and Koplik states that few recoveries take place in children under two years of age . The onset of symptoms is sudden, as contrasted with tubercular meningitis, in which the onset is See also:

• GRADUAL (Med. Lat. gradualis, of or belonging to steps or degrees; gradus, step)

gradual . The attack comes on sharply with intense headache, rigors and vomiting .

The pain soon localizes itself in the back of the See also:

• NECK (O. Eng. hnecca; the word appears in many Teutonic languages; cf. Dutch ride, Ger. Nacken; in O. E. the common word was heals; cf. Ger. Hals)

neck and occiput, and may thence radiate down the spine, limbs and See also:

• ABDOMEN (a Latin word, either from abdere, to hide, or from a form adipomen, from adeps, fat)

abdomen . The pain is soon followed by a characteristic symptom, namely retraction of the head . The head is drawn back and rigidly fixed, the spine arched and the limbs drawn up, and See also:

• MUSCULAR

muscular spasms may take place . There is general hyperaesthaesia, the slightest contact producing pain . More or less fever is present, but the temperature is not characteristic . The headache continues with great severity and restlessness and See also:

• DELIRIUM (a Latin medical term for madness, from delirare, to be mad, literally to wander from the lira, or furrow)

delirium supervene, or there may be long periods when the patient is comatose . Twitching of the limbs and general convulsions may occur and facial paralysis is frequent . Paralysis of the ocular nerves causing See also:

• SQUINT (possibly connected with Swed. svinka, to flinch; 0. Eng. swiccan, avoid)

squint, dilatations and See also:

• CON

con-tractions of the See also:

• PUPIL (Lat. pupillus, orphan, minor, dim. of pupus, boy, allied to puer, from root pm- or peu-, to beget, cf. "pupa," Lat. for " doll," the name given to the stage intervening between the larval and imaginal stages in certain insects)

pupil are common as in other varieties of meningitis . Some of the most striking symptoms are the rashes . These usually occur about the See also:

• FOURTH

fourth See also:

• DAY (O. Eng. dreg, Ger. Tag; according to the New English Dictionary, " in no way related to the Lat. dies")
• DAY, JOHN (1574-1640?)
• DAY, THOMAS (1748-1789)

day of illness and vary widely in character, resembling erythema, urticaria, See also:

• ROSE
• ROSE (Rosa)
• ROSE, GEORGE (1744-1818)
• ROSE, HUGH JAMES (1795—1838)
• ROSE, WILLIAM STEWART (1775-1843)

rose spots, or purpuric spots . The rashes have usually no relation to the gravity of the disease, but severe cutaneous haemorrhages usually indicate a severe See also:

• FORM (Lat. forma)

form of illness . Should the patient survive the first See also:

• SHOCK, or COLLAPSE

shock of the attack serious complications may arise; the eyes may be attacked by severe conjunctivitis, iritis or keratitis or inflammation of the deeper parts may take place leading to detachment of the retina .

More frequent even is disease of the auditory apparatus, and purulent otitis See also:

• MEDIA

media or disease of the See also:

• LABYRINTH (Gr. Xa(3vpcvOos, Lat. labyrinthus)

labyrinth may lead to permanent deafness . Serous effusion may take place into See also:

• JOINTS

joints which are painful, red and swollen as in acute See also:

• RHEUMATISM (from Gr. /56µa, flux)

rheumatism . Certain forms of the disease are rapidly fatal, these are known as the fulminant type, and death may take place within 12 to 24 See also:

• HOURS, CANONICAL

hours of the onset . Death usually occurs between the fifth and the eighth day, but many cases See also:

• DRAG (from the Old Eng. dragan, to draw; the word preserves the g which phonetically developed into w)

drag on for weeks with rapid and progressive emaciation, and recovery is slow . The mortality has varied in different epidemics . See also:

• HIRSCH, MAURICE DE, BARON HIRSCH AUF GEREUTH
• HIRSCH, SAMSON RAPHAEL (r8o8-1888)

Hirsch's tables of See also:

• FORTY

forty-one epidemics give a mortality of from 25 to 75%, and Koplik rates it at 48 to 9o% . During 1907, 623 cases of cerebro-spinal fever were notified in Belfast, and the deaths numbered 495 . During that year the disease was made notifiable in 48 Irish See also:

• URBAN
• URBAN (Urbanus)

urban and 55 rural districts . The mortality in Dublin was 75 % . See also:

• OSIER (through Fr. from Late Lat. osaria, auxaria, a bundle of osier or willow twigs)

Osier states that in children under one year (in New York) the mortality reached 87.6% . The changes found after death from cerebro-spinal fever are an acute inflammation of the pia-arachnoid membrane both of the brain and spinal cord, with effusion of serum or pus into the ventricular and subarachnoid spaces . With such rapidity may the effusion become purulent that it has been found purulent in a case where death took place within five hours from the apparent onset .

The operation of lumbar puncture (or puncture of the spinal See also:

• CANAL
• CANAL (from Lat. canalis, " channel " and " kennel " being doublets of the word)

canal between the lumbar vertebrae) has enabled the physician to make an accurate diagnosis by bacteriological examination of the contents of the spinal fluid . Lumbar puncture too has been found to be of eminent service in many cases, the withdrawal of from 30 to 50 cc. of the spinal fluid serving to relieve pressure and at least temporarily ameliorate the symptoms . Up to a few years ago it may be said that there was no effective treatment for cerebro-spinal fever but that of endeavouring to alleviate pain by the See also:

• ADMINISTRATION (Lat. administrare, to serve)

administration of See also:

• OPIUM (Gr. amov, dim. from Orbs, juice)

opium, but with the See also:

• RECENT

recent introduction of serum therapy the future is full of See also:

• HOPE, ANTHONY
• HOPE, THOMAS (c. 1770-1831)

hope . In the epidemic in New York (1905) the serum of Flexner and Jobling was used, and the most striking results were seen in young patients, the death-rate where the serum was used sinking to 46.3% as against 90% without . Like other serum treatments, to get the best results the serum must be administered early in the disease . Of 221 patients injected during the first See also:

• WEEK (from A.S. wicu, Germanic *wikon, probably=change, turn)

week of illness the mortality was only 18%, while of 107 others injected after the first week of the disease the mortality was double that amount . When given subcutaneously, as in See also:

• DIPHTHERIA (from 8c4BEpa, a skin or membrane)

diphtheria, the serum has little or no effect, and to obtain See also:

• GOOD, JOHN MASON (1764-1827)

good results it must be injected directly into the spinal canal after the removal of a certain amount of the spinal fluid . The injections are then continued daily as required according to the severity of the case . Dr Robb of Belfast reports that during the epidemic there, of 275 cases treated by See also:

• ORDINARY (med. Lat. ordinarius, Fr. ordinaire)

ordinary means, the death-rate was 72.3%, but in 90 cases treated with injections of Flexner and Jobling's serum the death-rate was only 30% . Dr See also:

• IVY (A.S. ifig, Ger. Epheu, perhaps connected with apium, anent)

Ivy See also:

• MCKENZIE, SIR JOHN (1838-19or)

McKenzie and Dr W . B . See also:

• MARTIN (Martinus)
• MARTIN, BON LOUIS HENRI (1810-1883)
• MARTIN, CLAUD (1735-1800)
• MARTIN, FRANCOIS XAVIER (1762-1846)
• MARTIN, HOMER DODGE (1836-1897)
• MARTIN, JOHN (1789-1854)
• MARTIN, LUTHER (1748-1826)
• MARTIN, SIR THEODORE (1816-1909)
• MARTIN, SIR WILLIAM FANSHAWE (1801–1895)
• MARTIN, ST (c. 316-400)
• MARTIN, WILLIAM (1767-1810)

Martin of Glasgow have published a See also:

• SERIES (a Latin word from serere, to join)

series of cases treated with the highly immune serum of patients who have recovered from the disease with encouraging results .