The constant presence of the tubercle bacillus in the cerebrospinal fluid of tuberculous meningitis : with a study of the cerebrospinal fluid in other forms of acute meningitis / Josephine Hemenway.

  • Holt, L. Emmett (Luther Emmett), 1855-1924.
Date:
1911
Catalogue details

Licence: In copyright

Credit: The constant presence of the tubercle bacillus in the cerebrospinal fluid of tuberculous meningitis : with a study of the cerebrospinal fluid in other forms of acute meningitis / Josephine Hemenway. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    THE CONSTANT PRESENCE OF TUBERCLE BACILLI IN THE CEREBROSPINAL FLUID OF TUBERCU- LOUS MENINGITIS WITH OBSERVATIONS ON THE CEREBROSPINAL FLUID IN OTHER FORMS OF ACUTE MENINGITIS * JOSEPHINE HEMENWAY, M.D. NEW YORK A systematic effort has been made since March, 1906, in the labora- tory of the Babies’ Hospital, to determine the presence of tubercle bacilli in the cerebrospinal fluid in cases of tuberculous meningitis. One hun- dred and thirty-eight patients have been admitted to the wards of the hospital since that time, but fluids for examination were obtained from 137 only. In all but two, tubercle bacilli were demonstrated in the cere- brospinal fluid. The technic which was followed in demonstrating the bacilli has given such satisfactory results that it is herewith given in detail. TECHNIC The cerebrospinal fluid is collected in several test tubes, allowing about 20 c.c. to a tube. The last fluid withdrawn after the child has been raised to the sitting posture is considered the most important, as the bacilli are usually found more readily in this. Care must be taken not to shake the tubes. It has been found that a fibrin coagulmn, the so-called “film,” forms more often in tubes which have not been agitated. The fibrin coagulum is at first Very delicate and friable. It forms with greater regularity and becomes firmer in fluids which have been placed in the incubator over night. After ten hours it is usually so firm that the entire film can be removed with a platinum loop. It is then carefully spread with fine needles on a glass slide. This is stained by the carbol- fuchsin Gabbett method. Bacilli were found with comparative ease in every case in which the film formed. In several cases in which the question of immediate diagnosis was extremely important, there was a sufficient coagulum after the fluid had stood three hours to enable one to find the bacilli. In about 4 per cent, of the fluids examined this coagulum did not form at all. One of the following devices was then used: The sides of the test tubes were scraped with a platinum loop and any material From the Laboratory of The Babies’ Hospital, New York.