CEREBRO-SPINAL MENINGITIS 423 



passes through the canal in the temporal bone. This may be the result of 

 disease of that bone, or of some effusion into the sheath of the nerve from 

 inflammatory conditions. 



Injury to the nerve after leaving the canal is the more common cause, 

 such as blows beneath the ear when rolling, or being cast, or from other 

 causes. Pressure from tumours or abscesses, or inflammatory swelling in 

 its course, will also produce it. 



Symptoms. Where a nerve is paralysed the angle of the mouth on 

 the sound side is drawn upward, while that on the paralysed side is 

 lowered. The lips hang loose and pendulous, the eye cannot be closed, the 

 nostril of the affected side cannot be dilated, the cheek is flaccid and has 

 lost its firmness to the touch. In feeding, the patient seizes his food with 

 the teeth instead of gathering it up with his lips. In drinking, the mouth 

 is pushed into the water for some distance, and during mastication food 

 falls from the mouth on the paralysed side. 



Treatment. When due to abscess or inflammatory swelling hot 

 fomentations and poultices should be applied to the affected part. 



If possible the abscess should be laid open and emptied, so as to remove 

 the pressure on the nerve. This should be followed by iron tonics and nux 

 vomica to restore the lost power to the muscles, and, if necessary, the 

 application and repetition of iodine blisters. Where a tumour or inflam- 

 matory swelling exists, a purgative followed by iodide of potassium in 

 full doses should be given. 



CEREBRO-SPINAL MENINGITIS 



A fatal affection among horses implicating the spinal and cerebral 

 membranes appears to have been known for a long period in various parts 

 of the world. In the United States of America cerebro-spinal meningitis 

 is recorded to have been investigated in 1850. In Germany it was known 

 in 1865, and in Egypt ten years later. About the year 1881 a fatal form 

 of paralysis attracted notice in this country, and Professor Axe described 

 outbreaks which occurred almost simultaneously in Essex, London, and 

 Norfolk. A peculiarity of the disease at the time was its limitation to 

 certain parts of the year, the majority of cases occurring between the end 

 of February and the beginning of May. Mares seemed to be more sus- 

 ceptible to the affection than horses, and animals of all ages were attackec 

 Climatic conditions did not appear to have any marked influence on t 

 progress of the malady. When it was first recognized in 1881 the weather 

 was cold and wet, but since then cases have been observed in the 

 part of the summer during hot bright weather. 



