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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    OTHER TESTS OF CEREBROSPINAL FLUID Tests with Fehling’s solution were made on 111 fluids to determine the diagnostic value of the presence of a reducing substance. The results were so inconstant that no reliance could be placed on this test in differ- entiating between tuberculous and other forms of acute meningitis. The results are embodied in the following table: Form of meningitis Reduction No Reduction Total Tuberculous 24 26 50 Meningococcus 3 29 32 Pneumococcus 2 2 4 Streptococcus 1 1 Normal fluids 23 1 24 These findings suggest that a reduction in normal fluids is the rule, and yet there is reduction in so many cases of tuberculous meningitis that the test is of no value in diagnosis. The globulin test of Noguchi has been used only recently. It con- sists of a precipitation of an excess of globulin by means of a solution of butyric acid in normal salt solution, and the addition of a sodium hydrate solution. Seventeen cases of meningitis—eight tuberculous, five meningo- coccus and four influenza—all gave typical positive reactions. Of twenty- two normal fluids tested, all but two gave a negative reaction. Of the two apparently normal fluids giving a positive test, one was from an acute case of enterocolitis with toxemia and a temperature of 107 F. The cere- brospinal fluid, which was clear, was injected into a guinea-pig and ten weeks later no evidence of tuberculosis or other disease could be found. The other fluid was also from a case of colitis, the autopsy in which showed no meningeal lesion. This test appears to be of great value in differentiating normal from abnormal fluid.