ins with vomiting and soon becomes so violent
that older children constantly cry aloud and lament, while the smaller
ones put their little hands up to their head, pull their hair and ears
and restlessly roll about on the pillow.

These expressions of pain last as long as children retain consciousness,
a particular part of the head is not commonly pointed out, but asked
about it the majority point to the forehead. With small children
automatic movements are noticed that also seem to refer to headache, and
which consist in rapidly placing the hand on the head and then drawing
it back.

The larger children complain of _pains in the bowels_, especially in the
region of the stomach, which remarkably often, though not regularly,
become more intense by pressing and may become so violent that the
children cry out aloud with pain, when the stomach or other portion of
the abdomen is but slightly touched. But these pains do not last as long
as the headache, they often stop suddenly, at times return.

The shape of the _abdomen_ is extraordinarily characteristic. In the
beginning nothing remarkable can be noticed, but after the symptoms of
acute hydrocephalus, vomiting, constipation, etc., have lasted for some
time, the abdomen gradually decreases in size, becomes wrinkled and
collapses until it finally assumes a scaphoid shape and by slight
pressure the large iliac artery can be felt on the spinal column.

This contraction of the abdomen is attendant in every case of
tuberculous meningitis.

If the large _fontanel_ on the head is not yet closed, the same will
gradually bulge out as the disease progresses.

The _mental activity_ suffers premature derangements, such as have been
fully mentioned in the description of the precursory symptoms. The most
striking is the confused, staring look, the peevish and surly behavior,
and again in other cases the extreme indifference toward otherwise
well-liked persons and things. Later on actual delirium sets in, but
generally of a quiet nature.

A very common symptom is a loud, plaintive outcry, that is repeated at
longer or shorter intervals. Children often cry out at partly regular
intervals during a whole night; these cries are always accompanied by a
loud sigh. These symptoms of excitement being extremely tormenting and
depressing for the sympathizing relatives, fortunately last no longer
than 6-8 days at the most, and are succeeded by a deep _stupor_.

If the children have once beco