Dr. Webber's Essay on Cerebro-Spinal Meningitis
Boston Medical and Surgical Journal
a population of 16,000, 450 were attacked, and of these 45 cases were fatal. " The invasion of the disease was in many instances sudden, while in others certain prodromes existed. In some the commencement of the attack was indicated merely by slight disturbance of the cerebral functions, with a little rigidity of the muscles at the back of the neck, and vomiting; these symptoms, perhaps, yielded to treatment in two or three days. In many, however, the headache, particularly frontal or
... but sometimes general, was most intense from the commencement of the attack; the head being thrown back, and so retained by the rigidity of the muscles, for perhaps several (in some many) days ; extreme anxiety and restlessness for the greater part of the time, frequently with spasms or convulsions, or both; pulse not always disturbed in a degree corresponding -with the gravity of the other symptoms ; injection of the adnatae, with high febrile movement, only taking place in a very limited number. Vomiting and costiveness, in the early period of the attack, have been among the most constant symptoms ; and it has been observed that after the vomiting had ceased for several days, during which the patients seemed likely to do well, this and the other acute symptoms have recurred, followed by a fatal termination. The absence of thirst throughout was among the most remarkable circumstances accompanying the attack."