A Typical Case of Tubercular Meni?igitis. i8t 



accountable irritability of temper. This state of things pro- 

 gressed from bad to worse, until April 4th, when I was called. 

 About that time she became rapidly worse, and the symptoms 

 assumed an intermittent, febrile type. At first, I was inclined 

 to regard the case as one of simple intermittent fever, and the 

 disturbed condition of the nervous centers was looked upon as 

 the natural impatience and restlessness of a sick child. But a 

 few days' observation of the case, together with the prompt de- 

 velopment of the ^cerebral tache or macula, led me to suspect tu- 

 bercular meningitis. An inquiry into the history of the case 

 strengthened this opinion; and, upon consultation with Drs. 

 Norman Bridge and Chas. W. Earle, the conclusion was fully 

 adopted by all of us, that we had to deal with quite a typical case 

 of this fearful disease. Subsequent events demonstrated the 

 correctness of this conclusion: the symptoms developed them- 

 selves and the case proceeded to its fatal termination without 

 any intercurrent complications or interruptions of any kind. I 

 do not stop to detail the treatment pursued, as it is the purpose 

 of this paper to deal mainly with pathology. 



I may say, however, that the treatment was essentially such 

 as is generally pursued by the profession under similar circum- 

 stances, and, for curative purposes, was thoroughly ineffectual. 

 My little patient was the pet and favorite of a large 

 family of relatives. Among them was an uncle who was 

 profoundly grieved at the prospect of losing his little niece; 

 and when I announced that I could not save the child, his 

 thoughts very naturally turned toward homoeopathy, and 

 he asked me to allow him to call in a homoeopathic physician, 

 to which I very cheerfully assented. I advised him to call Dr. 

 T. C. Duncan, a homoeopathic physician of excellent reputation, 

 and at the same time, a courteous gentleman. The result was 

 a very pleasant interview between Dr. Duncan and myself, and 

 our substantial agreement as to the pathology of the case, and 

 its inevitable result. 



On the i6th of April the patient died comatose. For two or 

 three days before death the symptoms were very grave, includ- 

 ing intermitting strabismus, uncontrolable vomiting, slight con- 

 vulsive efforts of various groups of muscles, paralysis of the 

 sphincter ani, and sphincter vesicae, gradually increasing coma, 



* Turesseau: Clinical Medicine, Vol. I., p. 877. 



