Cerebrospinal Fever (The Black Sickness (popular name in Dublin)—Spotted Fever).— This fever is due to an organism, the meningo coccus, and may occur in an epidemic form. It is rare after forty years of age, and is not un common among you n g ch ildren. The symptoms are due to inflammation of the membranes of the brain (p. 136) and spinal marrow.
Symptoms.—The disease may begin with feverishness, headache, pains in the back and limbs, and feelings of illness lasting for a few hours or a couple of days before any serious disease is feared. Usually, however, the attack is sudden, coming on with collapse and insensi bility or with severe shiverings (rigors), intense headache and dizziness, excessive pain in the back of the neck and along the spine, constant vomiting, pain in the stomach and cramping of the muscles of the legs. The fever is not necessarily great, but the patient is restless and delirious or drowsy. The skin is over sensitive, so that slight touches give rise to complaints of pain. One marked symptom is a stiffening of the muscles of the head and back, so that the patient's head and neck are arched back. A rash of blebs (herpes) appears on the
lips. Purple spots (petechice) come out about the second day, in severe cases within the first twenty-four hours. They appear first on the legs. Purple blotches also appear over the body in very severe cases. Death may occur from collapse within a few hours of the attack, or from the first to the seventh day, the patient passing into stupor and from it to death. Death may not occur for several weeks, and may then be due to complications. Paralysis is a common complication, and so also are affections of eyes, ears, and joints.
Even in favourable cases the illness lasts from two to six weeks, the extreme weakness that results being a cause of the delay.
Treatment.—If the attack begins with col lapse, it must at first be met with the application of heat to the limbs and over the heart, and the administration of small quantities of stimulants. Mustard plasters over the chest and back are also recommended. When this stage is over, the intense pains in the head and back are relieved by ice bags on the back of the head and along the spine.