SPINAL MENINGITIS, an inflamma tion of the meninges, the membranes covering the spinal cord. The mem branes are three in number: the pia mater, which is in contact with the sub stance of the cord; the dura mater, which serves as a lining to the spinal canal; and the araehnoid, a webbed structure between the pia mater and the dura mater. An inflammation af fecting the meninges of both the brain and the cord is called cerebrospinal meningitis. In spinal meningitis all three membranes are usually involved. Acute spinal meningitis is often caused by sunstroke, exposure to cold, and in jury to the spine, and is occasionally a complication in cases of scarlatina, typhoid fever and pneumonia. The pre liminary symptoms include pain, chill, fever, vomiting and a general sense of disarrangement. The shooting pains in the region of the cord are rendered more acute when the back is touched or moved, and the pain is transmitted to those parts of the body with which the cold is immediately connected, and in extreme cases the paroxysms may lead to a chronic bending of the spinal col umn. After a period of fever lasting some days a condition of paralysis super venes which may result in death from exhaustion. Where the patient recovers convalescence is usually protracted over several months, but where the illness is long drawn out complications in the renal and vesical regions may lead to a fatal issue. The pia mater in these
cases becomes congested and reddish with the accompaniment of hemorrhages. There is an issue of matter varying in color from gray to green on the surface of the pia, with congestion of the spinal fluid. Inflammation may pass from one membrane to another, as well as to the substance of the spinal cord, and free action may be prevented to such an ex tent that the membranes may be held together. The malady may be acute or chronic, and the chronic differs from the acute chiefly in the fact that the proc cesses are prolonged, and there is an absence of fever. In acute cases, com plete rest in bed is the first requisite, care being taken that there is no pres sure on the affected parts. The bowels should be kept clean, the spine should be cupped, and ice afterward applied. Where the pain is great suitable drugs may be administered to give relief. Re course may be added to external coun ter-irritants to assuage the pain in the spine. In chronic and prolonged cases cold douches and such treatment as will relieve the inflammation will greatly help the patient.