EXTRACT XXIII. 



CEREBRO-SPINAL MENINGITIS. 



CEREBRO-SPINAL MENINGITIS is another disease of the 

 nervous system which may be considered with profit by 

 the light of the foregoing views. 



Sporadically or epidemically, simply or in connection 

 with other diseases, such as pneumonia, it seems to be 

 explicable to a larger and clearer extent than has been 

 possible hitherto. 



To begin with, it appears that we must regard this 

 disease as almost universally microbic in origin, reserving, 

 however, the possibility of the occurrence of non-microbic 

 cases. 



The disease being diagnosed to be cerebro-spinal menin- 

 gitis, and consequently microbic, and it being believed 

 to be due to the presence of a pneumococcus, diplococcus, 

 or what may more truly be described in this case as a 

 neurococcus^ it behoves us to find out how it has come 

 here, how it gives rise to the disease, why it is accom- 

 panied sometimes by certain diseases, such as pneumonia, 

 and why it is followed by its peculiar sequels and fre- 

 quently, or generally, fatal termination. 



Aerial convection, it would seem to us, is the most 

 likely method of its communication, most probably on 

 the lines described as those followed in the dissemination 

 of epidemic influenza ; that is, the spores of the neuro- 

 coccus are suspended in the atmosphere or other medium 

 and find an entrance into the cerebro-spinal cavity through 

 the nasal mucosa and the peri- and endo-neural canals of 



