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April 1, 1905


JAMA. 1905;XLIV(13):997-1002. doi:10.1001/jama.1905.92500400001001

By the term meningitis is understood inflammation of the pia arachnoid, the investing membrane of the brain and spinal cord. Considered as a single membrane, it consists of a serous surface (arachnoid) forming one side of the subdural space and beneath this a loose connective tissue, the pia mater, which carries the blood vessels for the brain and cord. The brain, covered by this membrane, projects into the subdural space as the heart projects into the pericardial cavity. In addition to the vessels, there are numerous lymphatics, which are situated in the adventitial sheaths of the veins and arteries and which are continued with these vessels into the brain. They are true lymphatic vessels with an endothelial lining; they are thin-walled, and, when distended, communicate freely with the tissue spaces. There are no lymphatics in the tissue of the brain itself, nor have lymph spaces, similar to the spaces

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