atient to breathe, and in other instances the
wind-pipe is itself opened from the outside in order to permit a
sufficient amount of air to enter the lungs to maintain life.

It is of the utmost importance that patients be kept in bed until all
danger of complications has passed. Death from heart-failure several
weeks after the diphtheria in the throat is well, is not an uncommon
result of the disease, and is especially prone to follow even the
slightest exertion. Patients under such circumstances have been known to
die from raising themselves up in the bed.

CEREBROSPINAL MENINGITIS.

Meningitis, or spotted fever, is one of the most terrible and fatal of
all diseases, every case proving fatal in some local epidemics.

Although the cause of the disease has been known for a number of years,
the exact method by which the germ that produces it spreads from man to
man was until quite recently entirely unrecognized, and even now it
cannot be said that the whole matter has been demonstrated.

_Character and Course of the Disease._--Cerebrospinal meningitis is
produced by a minute vegetable (bacterium), the _Micrococcus
intracellularis_. This germ does not appear to occur normally in any of
the lower animals, nor has it been found in the outer world, and is
therefore to be regarded as distinctly a human parasite. It is very
fortunately a germ of low vitality, as it develops only at about blood
heat, and when expelled from its normal dwelling-place in the human body
it dies very quickly.

The accompanying illustration shows how these bacteria appear under
the microscope; the drawing was made from fluid taken from the
spinal canal of a patient suffering from cerebrospinal meningitis.
These germs get within the skull and spinal canal, and produce
violent inflammation of the coverings of the brain and cord; these
membranes are called "meninges," hence the name "cerebrospinal
meningitis." Within a short time after their entrance pus is
produced, and the condition becomes practically one of abscess
around the brain and spinal cord.

In almost all cases the disease is preceded by a slight catarrhal
condition of the nose and throat, the symptoms being those of an
ordinary cold. The symptoms that point to the covering of the brain being
attacked come on with great suddenness; there is usually a chill,
followed by intense headache, vomiting, restlessness, with great dread of
noises a