CEREBEITIS. 



501 



The differences between cerebral and meningeal diseases are 

 arranged as follows by Aitken, and as, to some extent, they may 

 prove useful in diagnosis, I take the liberty of quoting them : — 



CEREBRAL DISEASE. 



1. From the outset, or from a 

 very early stage of development, 

 there is loss of some one or more 

 of the proper nervous functions, 

 such as paralysis, anaesthesia, loss 

 of memory. 



2. Cerebral disease is not com- 

 monly attended by high-marked 

 exaggeration of function, such as 

 furious delirium, convulsions, in- 

 tense hyper£esthesia, or tenderness. 



3. Little vascular excitement at- 

 tends cerebral disease, nor is there 

 frequently any highly marked 

 general disturbance. 



4. Paralj'sis and anaesthesia, 

 losses of volition, ideation, per- 

 ception, and the like, characterise 

 cerebral disease. 



MENINGEAL DISEASE. 

 1. It is not till some time after 

 the detection of signs of disease 

 that diminution or loss of nervous 

 function takes jjlace. 



2. The subsequent diminution 

 or loss of nervous function which 

 succeeds the prolonged existence 

 of " head symptoms " is generally 

 preceded in cases of meningeal 

 disease by extremely severe excite- 

 ment or exaggeration of functions, 

 such as pain, tenderness, furious 

 delhium, or convulsions. 



3. In meningeal affections there 

 is usually much local vascular ex- 

 citement, with general disturbance. 



4. Sj^asms, or convulsions, pain, 

 and delirium are the general fea- 

 tures of meningeal disease. 



In all the three cases of cerebral abscess mentioned, there was 

 the absence of the above-mentioned indications of meningeal 

 disease ; and indeed the post mortem of the two fatal ones proved 

 this, and even the automatic movements of the limbs of the 

 third case clearly proved that volition was to a great extent 

 destroyed. 



In each of the brains examined, the abscesses were symme- 

 trical, situated in the anterior lobes of each hemisphere, and were 

 seen, after the removal of the dura mater, as two bulging 

 prominences, measuring about an inch in diameter, which, when 

 opened, gave exit to a thick, whitish pus, of good consistence 

 and free from smell. The walls of the abscesses consisted of the 



