The case which I here report illustrates the extreme difficulty of making a diagnosis in the early stages of tuberculous meningitis. As stated editorially in a recent issue of The Journal, it is perfectly possible to have a primary tuberculous meningitis, synovitis, or osteomyelitis, with no other tuberculous lesion existing in any other part of the body, and it is in support of this statement that I report the following case. This child was sick two weeks before the symptoms were clear enough to make a positive diagnosis.
—Alexander A., aged 3% years, had never been sick previously and was the picture of health. One paternal grandmother and one paternal uncle had died of tuberculosis. His parents were both living and healthy and being intelligent people had taken particular care in regard to his diet, exercise in the open air, etc., so that he was apparently as normal and