CEREBRO-SPINAL MENINGITIS.—This is an acute infectious disease. It comes in epidemics, when there are many cases, or appears here and there as a separate case (sporadic). It is caused by a specific organism (germ) and the disease attacks the membranes of the brain and spinal cord.
Of late years great progress has been made by patient investigation, and a serum is now prepared for the treatment of this disease. The results of this treatment are better than the treatments formerly used, and there is good reason to believe that in a few years this treatment will be as effective in this disease as antitoxin is in diphtheria.
Cause.—Young adults and children are affected most often. Bad surroundings and over-exertion are predisposing factors.
Conditions.—There is congestion of the membranes of the brain and spinal cord which are covered with an exudate confined on the brain, chiefly to the base.
Symptoms. Ordinary Form.—Incubation is of unknown length and occasionally marked by want of appetite, headache, and pain in the back. The invasion is usually sudden, chill, projectile vomiting, throwing forward, severe headache, pain and rigidity of the back of the neck, pain in various parts of the body, skin over-sensitive, irritable, and temperature about 102 degrees, with all symptoms of an active fever. Later, pains are very severe, especially in the head, neck and back; the head is drawn back; often the back is rigid; the muscles of the neck and back are tender and attempts to stretch them cause intense pain. The vomiting now is less prominent. Temperature is extremely irregular, 99 to 105 degrees or more. Pulse is slow, often 50 to 60, and full and strong at first. The delirium is of a severe and variable type in common, alternating with partial or complete coma, the latter predominating toward the close of fatal attacks. Stimulation of nerve centers causes cross-eyed look, drooping of upper eyelid, movement of eyeballs unequal, contracted, dilated, or sluggish pupils; acute and painful hearing, spasmodic contractions of the muscles followed by paralysis of the face muscles, etc. The disease may last several hours or several months. Many die within five days. In fatal cases the patient passes into seemingly deep sleep with symptoms of a very prostrating and weakening fever, and often retention of urine. Mild cases occur with only a little fever, headache, stiff muscles of the neck, discomfort in back and extremities. The malignant type occurs epidemically or sporadically.
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Malignant type.—Sudden invasion with severe chills, slight rise in temperature, pain in the back of the neck, headaches, stupor, muscular spasms, a slow pulse, often purple bleeding, eruption, coma and death within hours, rather than days. This is a terrible disease, and a physician is needed from the first. The death rate varies from twenty to seventy-live per cent. Treatment must be given by a physician. Spinal meningitis is inflammation of the membrane of the spinal cord along with the accompanying back and extremity symptoms, while the head remains clear and free from complications.
MENINGITIS.—This is an inflammation of the membranes covering the brain alone, and generally commences with fever and severe headaches, with avoidance of light and noise as these are painful. In some cases we have delirium, stupor and coma.
Treatment.—Treatment must be given by a physician, but cold applications to the head and back are generally good. The bowels also must be kept open.
MENINGITIS. Tubercular, (Basilar Meningitis).—This affection which is also known as acute hydrocephalus (meaning water on the brain), is essentially an acute tuberculosis in which the membranes of the brain, sometimes of the cord bear the brunt of the attack. It is more common in children than in adults. It is more frequent between the second and fifth years, than in the first year. It is caused by the tubercular infection, and follows the usual course of this disease. Ordinary meningitis is rapid and well defined in its course, with "high fever," severe pains in the head, intense nervousness, avoidance of light and sound, loss of appetite and constipation. These symptoms are easily understood and are generally clearly read by those around the patient. Unfortunately in tubercular meningitis the clearly defined symptoms are absent in the beginning, and when the physician is called the condition is dangerous. Usually the patient complains but little. There is a slight headache, low fever, no heat in the head, patient is pale most of the time, has little appetite, vomits occasionally and desires to sleep. He is nervous, stupid and lies on his side curled up with eyes away from the light. This disease appears mostly in delicate children, who are poor eaters and fond of books; usually in those inheriting poor constitutions. The mortality is very high. Parents who have thin, pale sallow children with dainty appetites, who frequently complain of headaches and are fond of books, should be afraid of infection from tuberculosis and make the little ones live in the open air and keep away from school. But earlier in the lives of these children care must be taken. A child with that pale, thin, sallow, delicate face and poor body should be fed with the best of food and live in the open air. I once had a family who lost their only two babies through this disease. After the first one died I instructed them carefully how to treat the second child. However, they loved their child foolishly and not wisely and fed it everything it wanted, and you know the children take an advantage of their parents. Give plenty of good, wholesome digestible food. Dress them comfortably and warm and keep them out in the open air. No cakes, candy, peanuts or any food that is not nourishing and easy to digest.