CEREBROSPINAL MENINGITIS. 
549 
arachnoid membrane; the latter membrane has a blanched appear¬ 
ance. The inflammation is more strongly marked at the anterior 
cervical and lumbar regions of the cord and base of the brain than 
at other sections; (it is at parts of the body corresponding with 
these sections that we have the symptoms of paralysis from pres¬ 
sure most strongly marked during life.) The substance of the 
brain and the sections of the cord where the inflammation seems 
to be most intense, appear to be softened; it is reasonable to infer 
from certain symptoms that the inflammation extends to the nerve 
substance and produces changes in it, but this can only be decided 
by the microscope. The lung corresponding to the side the 
animal was lying on at the time of death is generally congested, 
but this appearance has no particular connection with this indi¬ 
vidual disease; a coagulum is sometimes found in the right cavi¬ 
ties of the heart; this appearance also has no direct pathological 
connection with this individual disease. 
These morbid appearances are all that are discovered, all the 
organs and viscera, with the exceptions noted, appearing to be 
normal; perhaps the morbid appearances would not be so marked 
if an examination was made of a patient dying soon after being 
attacked, as we have known a case to run its course to a fatal ter¬ 
mination in eighteen hours after the first symptom was noticed. 
This remark will lead us to the consideration of the duration of 
the disease in fatal cases. According to our experience the mini¬ 
mum being eighteen hours, the average the latter part of the 
third or beginning of the fourth day, the maximum about eight 
days, from the appearance of the first symptoms. These remarks 
apply to the disease in an epidemic form; in the isolated or spor¬ 
adic form as we have occasionally in cities, the cases are not as a 
rule as strongly marked in symptoms (though they may prove 
equally fatal in character) and are of longer average duration. 
Pathological character , or nature. The anatomical characters 
point to inflammation of the meninges (membrane) of the brain 
and spinal cord, perhaps the brain and spinal cord being impli¬ 
cated as well. But in view of the disease assuming an endemic 
or epidemic form, the inflammation must be looked upon as an 
effect of some pre-existing pathological condition of the blood; 
