1. 1. In otogenic meningitis, the particular bacteria invading the central nervous system play in themselves a relatively small rôle; the tissue reactions and the clinical signs are almost similar, irrespective of the nature and kind of invading microorganism. 2. 2. Clinical evidence stresses the fact that the symptomatology is divisible into two groups of clinical signs: those due to increased intracranial pressure, and those due to toxicity, including the terminal sepsis from bacterial activity. Where the predominating symptoms are those of pressure, if this can be relieved, cure will not necessarily follow unless the other factors incidental to the lesion have been mastered. If the intracranial pressure is abated, time is gained to carry on measures to combat the other factors. If the intracranial pressure remains high and mounts, then death intervenes before the other factors in the case can be handled. 3. 3. Drainage of the central nervous system does not answer the problem presented in meningitis. The problem is more in keeping the brain tissue alive to outlast the infection. The important step to accomplish this is to keep the cerebrospinal fluid circulating. Any procedure or any technique which stops this circulation defeats one of the objects in view. Brain cells naturally function best, and their by-products of cerebral cell metabolism are most easily neutralized, when they are kept bathed in a cerebrospinal fluid, the chemistry of which is as near normal as possible. The deposit of plastic exudate, which impedes cerebrospinal circulation, is to be lessened to the greatest possible degree. This is best accomplished by the administration of small whole blood direct transfusions, which are begun as early as possible in the course of the disease and continued until all meningeal symptoms have disappeared. 4. 4. Chemotherapy, in the form of sulfanilamide, has demonstrated distinct value. It may be given by mouth, injected intramuscularly, or in a combination of both means. During its administration, repeated tests for methemoglobin should be taken. Combined with the blood transfusions, the dangers from the reactions to the drug are lessened. 5. 5. No evidence is as yet at hand that medical treatment alone suffices to give a reasonable assurance of obtaining consecutive recoveries. It is therefore absolutely necessary that every possible bone focus be thoroughly removed as soon as its presence is diagnosed. Additionally, the breaking of the contiguity of structure of the skeletal dural veins—a frequent route for meningeal invasion—gives another factor toward obtaining recovery. In diagnosis, the clinical picture alone is insufficient to furnish the clinician with specific diagnostic data. In general terms, it may suffice to establish a clinical diagnosis of otogenic meningitis, but since an exact determination of the phase which the given case presents is highly desirable—so as to institute intelligent remedial therapy —data which furnish the basis for this determination must be sought. Clues are to be found in repeated spinal tap examinations, and in comparisons of the fluid contents with those of the circulating blood. In fluid examination, its physical properties, the pressure under which it is obtained, its cytology, its bacteriology, and lastly its chemistry are exceedingly important. 6. 6. With these newer conceptions of otogenic meningitis, more recoveries are being reported, and we meet meningeal infections with more confidence because we are better able to combat them. With this hopeful note on the future additional developments in therapy, let me, for the present, leave the problems presented by otogenic meningitis.