The  limbs  become  relaxed,  and  feeble  or  powerless.  Sensibility  is  lessened
or  lost.     Reflex  action  disappears,  and  death  may  occur  from  asthenia,  or


INTERNAL    MENINGITIS.  199

from  paralysis  of  the  respiratory  muscles.  Toward  the  end  there  is  some-
times considerable  rise  of  temperature.  In  some  cases  the  symptoms  become
less  progressive  and  the  disease  passes  into  a  less  acute  stage;  the  pains
persist,  the  loss  of  power  continues  and  may  even  slowly  increase.  Death
may  occur,  after  weeks  of  suffering,  from  the  effects- of  bedsores  or  from
secondary  kidney  disease,  due  to  the  retention  of  urine,  and  facilitated  by
trophic  disturbance.  On  the  other  hand,  in  slight  cases,  the  signs  of
irritation  may  lessen  and  pass  away,  while  those  of  structural  damage,
paralysis  and  anaesthesia  may  remain,  and  to  these  may  be  added  muscular
atrophy  and  contractures,  from  the  secondary  consequences  of  the  lesions  of
the  nerve  roots.  Such  persistent  symptoms  vary  much  in  extent  and  degree,
according  to  the  position  and  intensity  of  the  morbid  process.  The  symptoms
of  damage  to  the  cord  may  slowly  increase,  in  consequence  of  the  spread  of
chronic  myelitis,  or  still  more  chronic  degeneration,  set  up  by  the  acute  mis-
chief.   In  very  slight  cases  the  symptoms  of  meningitis  may  pass  entirely  away.
