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51
EPIDEMIC CEREBROSPINAL MENINGITIS.
On March 12th, 1907, epidemic cerebro-spinai meningitis
(cerebrospinal fever) became a compulsorily notifiable infectious
disease throughout the administrative County of London, in
accordance with the provisions of Section 56 of the Public
Health (London) Act, 1891. This disease had taken on epidemic
proportions in Belfast aud Glasgow, and it was thought advisable
to make it notifiable throughout London, so as to prevent it
being introduced and spreading there. Up to the end of 1907
a total of 153 cases have been notified as having occurred
throughout the County, and of these 13 belong to Lambeth
Borough.
The disease is "an acute, epidemic disease, characterised by
profound disturbance of the central nervous system, indicated
by the onset chiefly of shivering, intense headache or vertigo, or
both, and persistent vomiting; subsequently by delirium, often
violent, alternating with somnolent, or a state of apathy or
stupor; an acutely painful condition with spasm—sometimes
tetanoid—of certain groups of muscles, especially the posterior
muscles of the neck, occasioning retraction of the head; and an
increased sensitiveness of the surface of the body. Throughout
the disease there is marked depression of the vital powers, not
unfrequently collapse; and in its course an eruption of vesicles,
petechice, or purpuric spots, or mottling of the skin, is apt to
occur. If the disease tends to recovery, the symptoms gradually
subside without any critical phenomena, and convalescence is
protracted ; if to a fatal termination, death is almost invariably
preceded by coma. After death the enveloping membranes of
the brain and spinal cord are found in a morbid state, of which
the most notable signs are engorgement of the blood vessels,
usually excessive, and an effusion of sero-purulent matter into