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 fortified in 1578, and in 1685 Vauban made it one of the strongest places on the French frontier, but the fortifications were razed in 1748 by the treaty of Aix-la-Chapelle.

MENINGITIS (from Gr. , a membrane), a term in medicine applied to inflammation affecting the membranes of the brain (cerebral meningitis) or spinal cord (spinal meningitis) or both.

Tubercular cerebral meningitis (or Acute Hydrocephalus) is a disease due to inflammation of the meninges of the brain produced by the presence of a tubercle bacillus. This disease is most common in children under ten years of age, but may affect adults. The tubercular constitution is an important factor in this malady. In numerous cases it is manifestly connected with bad hygienic conditions, with insufficient or improper feeding, or with over exercise of the mental powers, all of which will doubtless more readily exert their influence where an inherited liability. exists, and the same may be said regarding its occasional occurrence as one of the after consequences of certain of the diseases of childhood, especially measles and whooping-cough.

In what is known as suppurative, or simple acute meningitis (non-tubercular), the disease arises from various causes, and the symptoms are similar to those described above.

In posterior-basic meningitis, inflammation of the membranes investing the posterior basic spinal cord, the chief symptoms are fever, with severe pain in the back or loins shooting downwards into the limbs (which are the seat of frequent painful involuntary startings), accompanied with a feeling of tightness round the body.

Cerebro-spinal fever or epidemic cerebro-spinal meningitis, popularly called “spotted fever,” is an infectious disease occurring sporadically or in epidemics, and due to the diplococcus intracellularis discovered by Weichselbaum in 1887. This disease was not recognized until the 19th century. It was first described at Geneva in 1805 and small outbreaks followed in Paris (1814), Metz and Genoa (1815), and Westphalia (1822), but in the United States there was a widespread epidemic, including New England and spreading as far as Kentucky and Ohio. Fresh outbreaks in Europe took place between 1837 and 1850. In 1837 it prevailed in the south of France chiefly amongst troops in garrison, and fresh outbreaks continued throughout France in 1846 with epidemics in Algiers, Italy and Sicily. In Great Britain it first showed itself in the Irish workhouses ip 1846, where it was known as “the black death” or “malignant purpuric fever.” After 1866 except for sporadic cases it disappeared from Great Britain, but small outbreaks took place in 1885 to 1900 in Dublin. In 1905 there was an extensive epidemic in New York, followed by an outbreak in Scotland in 1906, and in Scotland and Ireland in 1907–1908. The registrar-general’s returns for 1907 give 1018 deaths in Scotland due to the disease, of which 711 were at Glasgow and 148 at Edinburgh. In the same year Belfast was visited by a severe epidemic, 495 deaths out of the total death-rate of 631 taking place in that district.