Until recent years, the early diagnosis of otogenic meningitis was of little practical significance, except inasmuch as it enabled the physician to prepare the friends of the patient for the fatal termination of a disease, which in its suddenness often comes as a lightning from a clear sky. But since surgical treatment has been employed in this disease, and not without success, the importance of an early diagnosis has increased appreciably inasmuch as it may indicate an operation to prevent this fatal result.
Before entering on the diagnosis of otogenic meningitis, a few facts as to the etiology may be mentioned.
Meningitis, which is according to all statistics the most frequent intracranial complication in suppurative otitis media, appears very rarely in infants under a year. It is not rare after the fortieth year, but older children and young people are those most frequently attacked.
It is generally assumed that otogenic meningitis is, in