. The diseases of infancy and childhood . icles andsubarachnoid space. In infants a rough way of estimating the pres-sure is through the tenseness of the anterior fonta-nels, and in all children the force with which thefirst few drops of fluid escape from the canula. Indications for Lumbar Puncture.—Lumbar punc-ture is performed for diagnostic and therapeuticpurposes in all cases in which there are symptomswhich very closely simulate meningitis, or inwhich we think meningitis is actually present. I have also performed lumbar puncture re-cently for the relief of symptoms of so-called men-ingism
. The diseases of infancy and childhood . icles andsubarachnoid space. In infants a rough way of estimating the pres-sure is through the tenseness of the anterior fonta-nels, and in all children the force with which thefirst few drops of fluid escape from the canula. Indications for Lumbar Puncture.—Lumbar punc-ture is performed for diagnostic and therapeuticpurposes in all cases in which there are symptomswhich very closely simulate meningitis, or inwhich we think meningitis is actually present. I have also performed lumbar puncture re-cently for the relief of symptoms of so-called men-ingism, knowing that no meningitis was present. Lumbar puncture is performed as a therapeutic procedure incases of meningism, to relieve pressure, or at times in the conditionof status epilepticus; in all forms of meningitis; and as a therapeuticprocedure in chronic hydrocephalus. It has recently been advanced by the otologists as exceedinglyuseful in cases where meningitis is suspected as an extension frominflammation of the ear The Quincke noodle forlumbar puncture. 78 INFANCY AND CHILDHOOD. The decision to perform lumbar puncture in private practice isnot always easy on account of the dread with which the laity regardall procedures of this nature. In pneumonia where there may be a suspicion of pneumococcusmeningitis and where there are signs of increased cerebral pressure asevinced by cerebral symptoms, the persistence of such symptoms mayjustify the physician in performing lumbar puncture. Indefinite cerebral symptoms such as headache, restlessness, andconvulsions of a general or transitory nature are not indications forlumbar puncture. On the other hand, even very mild cases of meningitis, with indefi-nite sopor, muscular weakness, delayed reflexes at the knee, markedemaciation, and fever without even marked rigidity of the neck, mayjustify the procedure of lumbar puncture on the ground that if ameningitis is present we should endeavor to give the patient thebenef
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectchildren, bookyear191
