1. That in acute diffuse purulent meningitis we have to deal with a very fatal disease. 2. There are two types of infection, one, the fulminating or fatal, the other a less virulent but often fatal type. The recoveries fall into the latter group. 3. Early diagnosis and treatment are essential. 4. The most successful line of treatment lies in complete eradication of the primary focus of infection, local drainage, frequent lumbar punctures and intravenous therapy. 5. In labyrinthine cases of meningitis, very early diagnosis is imperative as the spread of the meningitis is rapid owing to its anatomical position, and translabyrinthine drainage of the infected cerebro- spinal fluid is the line of attack par excellence. 6. When the drainage is free, natural lavage should be encouraged by therapeutic measures. 7. The meningitis may be masked by the more prominent symptoms of the infecting process and, inversely, meningitis may simulate almost any intracranial complication of suppurative otitis media. 8. Lumbar puncture is the surest guide to diagnosis and is a most useful adjunct to treatment. 9. In every case operative measures should be tried, whatever the state of the patient: inactivity means certain death.