=Symptomatology.= Meningitis is generally sudden in onset and ushered in by a rigor, frequently of a most intense character. Headache is always a marked feature, commonly diffuse, but sometimes localized to the region primarily and mainly affected. The headache is intense and exacerbations are marked, the patient crying out in his agony. There is great mental irritability and all attempts at clinical examination are strenuously resisted. After the initial rigor the temperature remains high, with occasional remissions during the early hours of the morning. Vomiting may be frequent and violent, but, according to my observations, this has not been a conspicuous feature. The pulse-rate is increased, whilst, in the early stages, the volume is full and the tension high. The skin is burning hot and dry, except during the post-rigor periods when sweating predominates. The face is flushed, often turgid, and the eyes are bright. General restlessness is a marked feature. The more _localizing_ features may be arranged in three groups: intellectual, motor, and sensory. =Intellectual symptoms.= The condition of the patient is one of great restlessness, increasing sometimes to actual violence and mania. Attendants are usually required to restrain his movements, and, tossing about in bed, crying out in his pain, muttering and wandering in his delirium, he offers a typical clinical picture of cerebral irritation. =Motor symptoms.= The motor symptoms vary according to the region mainly involved, cortex or base. In the _former_ case, excitation results in twitchings and convulsions of the regions supplied by the cortical areas involved. Convulsions may be general or confined to a certain group of muscles, the former condition usually present in children, the latter more often observed in adults and occasionally partaking of the Jacksonian type. Convulsions may be associated with contractures of the limbs, the flexors mainly affected in such a manner that an attitude of general flexion may be assumed. The patient appears to suffer pain when attempts are made to straighten the limbs. In any case, such attempts are resisted. Implication of the _base of the brain_. This is evidenced by symptoms sufficiently definite. Thus, the following symptoms may be observed:-- _Optic neuritis._ _Myosis and squints_, from involvement of the third, fourth, and sixth nerves. _Trismus_, from implication of the third division of the fifth nerve. _Facial paralysis_, from implication of the seventh nerve. _Deafness_, from involvement of the eighth nerve. _Dysphagia and dyspnœa_, from involvement of the ninth and tenth nerves. _Rigidity of the neck and torticollis_, from involvement of the eleventh nerve. _Retraction of the head and neck_, from involvement of the posterior divisions of the upper cervical nerves.