deg. F.; the pulse from 40 or
50 per minute quickly reaches 120 and over. There are muscular
twitchings all over the body, possibly associated with convulsions and
tetanic seizures, and these are followed by coma and speedy death"
(Macewen).

Spontaneous evacuation of a temporal abscess may take place through
the middle ear.

#Cerebellar Abscess.#--Next to the temporal lobe, the cerebellum is
the most common seat of abscess. Cerebellar abscess is usually due to
spread of infection from a thrombosed sigmoid sinus, either directly
from a sub-dural abscess formed in relation to the walls of the sinus,
or by extension of the thrombotic process along the cerebellar veins.
While the abscess is small, it may give rise to few symptoms, and the
patient may be able to go about, but as it increases in size serious
symptoms develop. There may be nystagmus, and the patient suffers from
vertigo, and is unable to co-ordinate his movements. If he attempts to
walk, he reels from side to side; even when sitting up in bed, he may
feel giddy and tend to fall, usually towards the side opposite to that
on which the abscess is situated. The head and neck are retracted, the
pulse is slow and weak, and the temperature subnormal. There is
frequent yawning, and the speech is slow, syllabic, and jerky. There
may be optic neuritis and blindness. There is sometimes unilateral or
even bilateral spastic paralysis of the limbs from pressure on the
medulla oblongata. The respiration may assume the Cheyne-Stokes
character, occasionally being interrupted for a few minutes, while the
heart continues to beat vigorously. This arrest of respiration is
especially liable to occur during anaesthesia.

_Treatment._--The abscess having been localised, the skull must be
opened and the pus removed.

#Abscess from causes other than Middle Ear Disease.#--From the _nasal
passages_, infection may spread to the interior of the skull directly
through the walls of the frontal, ethmoidal, or sphenoidal air
sinuses, or indirectly by way of the veins, and give rise to a
cerebral abscess, usually in the frontal lobe. The symptoms are
similar to those of abscess following middle ear disease, but focal
symptoms are seldom present. When the abscess is on the left side,
apraxia and motor aphasia may be present. Spontaneous evacuation may
take place by the abscess bursting into the nose through the
cribriform plate.

The treatment consists in trephining through the frontal b