File:Diseases of the nervous system - a text-book of neurology and psychiatry (1915) (14596364587).jpg

Identifier: diseasesofnervo00jell (find matches)
Title: Diseases of the nervous system : a text-book of neurology and psychiatry
Year: 1915 (1910s)
Authors: Jelliffe, Smith Ely, 1866-1945 White, William A. (William Alanson), 1870-1937
Subjects: Mental Disorders Nervous System Diseases
Publisher: Philadelphia : Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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ies it wouldappear, from the work of Hauptmann and Hossli, that paresis alonewill cause a positive result, but with larger quantities of cerebrospinalfluid (0.4 to 0.8 c.c), practically all forms of cerebrospinal syphilis willgive a positive reaction; tabes, cerebral syphilis, meningomyelitis, etc.(Hauptmann, Holtzmann, Swift and Ellis.) DIA GNOSIS—CEREBROSPINAL FLUID 515 Syphilis without nervous involvement usually gives a negativereaction, even when large quantities of the fluid are used. It must constantly be borne in mind in the diagnosis of syphilis ofthe nervous system that the reaction of the cerebrospinal fluid in theWassermann test is purely monosymptomatic. The positive or nega-tive results must always be interpreted by association with otherlaboratory and clinical tests. As Nonne has well said, the Wasser-mann reaction is only a symptom. Like other symptoms in a syndromeit may or may not be present without affecting the validity of thesyndrome from its diagnostic aspects.
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Fig. 252.—Lymphocytes in normal (left) and paretic (right) cerebrospinal fluid, (Kraepelin.) 3. Cytological Examination of the Cerebrospinal Fluid.—The tech-nique of puncture cannot be entered into here, but one point shouldbe borne in mind: the procedure is not always without danger. Itshould be done with care, the fluid being withdrawn very slowly, drop-wise in some cases, and the patient should rest in bed several hours,preferably both before and after the operation. One of the functionsof the cerebrospinal fluid is to maintain an equality in the intracerebralpressure, and any sudden alteration, such as is produced by the with-drawal of 5, 10, or 15 c.c. of the fluid, is apt to disturb such equilibrium.Headache, nausea, vomiting, dizziness, are among the unpleasanteffects in those who react badly. Such are few, but they exist, andcare is imperative. Some are helped by lying quiet, with foot of bed 516 SYPHILIS OF THE NERVOUS SYSTEM elevated and with aspirin, 10 grains, repeated

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