. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. g symptom. Thepupils were ime\en and did not react; there was a slight conjuncti-vitis. The breathing was weak and catchy. Death supervenedwithin a few hours. These cases are not unusual in epidemics, andhere and there sporadic cases of this type occur. Another type of case is the more common form of the child in apparent health will suddenly complain of headache, fever,and begin to vomit. There may be a chill. The fever is generallyhigh, the pulse rapid. The headache is very sev
. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. g symptom. Thepupils were ime\en and did not react; there was a slight conjuncti-vitis. The breathing was weak and catchy. Death supervenedwithin a few hours. These cases are not unusual in epidemics, andhere and there sporadic cases of this type occur. Another type of case is the more common form of the child in apparent health will suddenly complain of headache, fever,and begin to vomit. There may be a chill. The fever is generallyhigh, the pulse rapid. The headache is very severe and is a constantleading s\Tnptom. There is also intense pain at the back of the neck,extending down the back. The child is irritable and restless, tossingabout, intolerant of light and sound. Any interference and touch onexamination of the surface of the body causes pain; in other words,there is hyperesthesia. After a few hours rigidity of the muscles at PLATE XI ^^-?-- : *,iT^;- ;^,.^^.-,.,__ ^^ph^^ |. ? ^?*~^:,. ^ ? 1 J i /^-??;. ?V- ?;?„- * ? . ? - -^.-M \ \ •?;3?v. Section of the Spinal Cord, showing the Exudate ow tlie Surface,Mofe Marked Posteriorly and Involving the Anterior and PosteriorNerve Roots. Epidemic cerebrospinal meningitis in an adult,death on the fifth day of the disease. MENINGITIS 339 the back of the neck appears, and this rigidity may increase to opis-thotonos; in some cases on the second day there may be repeatedconvulsions. When the disease is completely inaugurated the childlies in bed in a characteristic attitude, the lower extremities flexed,the arms flexed, the head slightly retracted. The children, for themost part, lie on the side. With the full onset of symptoms in some epidemics petechise appearwith ecchymoses over the whole surface. These petechise vary insize from a pinhead to large blotches resembling hemorrhages due totraumatism. Ecchymoses are seen especially on the extensor surfacesof the lower extremities. The patients complain of
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