Serology of nervous and mental diseases / by D. M. Kaplan.

  • Kaplan, David Michael, 1876-
Date:
1914
Catalogue details

Licence: Public Domain Mark

Credit: Serology of nervous and mental diseases / by D. M. Kaplan. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    able to determine the cell count in a given spinal fluid satisfactorily it is better to perform another lumbar punc- ture about ten days later, and count the cells again, in case the previous counting gave a border-line result. In paretic individuals who are in their decline it is cus- tomary to find border-line counts; low cell counts are some- times seen in cord tumors and in cases of cerebrospinal lues of the endarteritic form. The majority of instances in which the pathologic increase is obtained are in tabes, particularly in those forms of the disease that yield to spe- cific treatment. To this cell count can also be added general paresis; in fact, this disease is the representative of the small-cell count pleocytosis. Pathologic increase in cells (15 to 60) is found in cases of untreated tabes. Properly treated cases of cerebrospinal syphilis of the gummatous and the meningitic types exhibit this degree of increase in their cell contents after appropriate therapy. The hyperlympho- cytic cell count is found in tabes and in the milder forms of cerebrospinal syphilis. The purulent meningitides show the highest cell counts, and it is in these cases that it is not infrequently impossible to count the cells because of their number. The acute forms of cerebrospinal syphilis have also their place in this form of cellular increase; I have observed a case in which the cells numbered 1680 per c.mm. The lowest of these counts are at times, although but rarely, found in tabes. The influence of therapy on the cell count in different conditions in which a pleocytosis exists will be the subject of a later section, in which, also, the other reac- tions, such as the Wassermann test, the globulin excess, and the Fehling reduction, will also be considered. A few remarks on the bacteriology of the cerebrospinal fluid: In order to secure an uncontaminated specimen for bacteriologic analysis, the fluid must be collected under strict aseptic precautions. Every utensil or instrument that may come in contact with the spinal fluid must previously have been sterilized. It is also essential, once the fluid begins to flow, to act as quickly as possible, as undue ex- posure to the air may contaminate the fluid and offset the resulting cultural work.