Diseases of the nervous system .. . r not found or existonly in very small quantities in the cerebrospinal fluid; the hemolysins and alexinsare also absent. The secretion of the fluid is composed of selected materials, as is proven by thefact that it contains more potassium salts than the blood serum (A. Schmidt), andthat ferrocyanid does not pass from the blood, and iodin only very slowly, into thecerebrospinal fluid (Cavazzani). Sicard never saw iodin and methylene-blue pass intothe normal cerebrospinal fluid. According to Widal and Monod the same conditionoccurs in tabes, paralysis, and inf
Diseases of the nervous system .. . r not found or existonly in very small quantities in the cerebrospinal fluid; the hemolysins and alexinsare also absent. The secretion of the fluid is composed of selected materials, as is proven by thefact that it contains more potassium salts than the blood serum (A. Schmidt), andthat ferrocyanid does not pass from the blood, and iodin only very slowly, into thecerebrospinal fluid (Cavazzani). Sicard never saw iodin and methylene-blue pass intothe normal cerebrospinal fluid. According to Widal and Monod the same conditionoccurs in tabes, paralysis, and inflammation due to the meningococci, Avhile in tuber-culous meningitis iodin passes from the blood to the fluid. In uremia, in tuberculous meningitis, and in enteric fever, the fluid may have atoxic effect (Dircksen). As a guide in diagnosis the pressure and the amount of albumin in thefluid should be measured with each lumbar puncture, and it should be micro-scopically examined for cellular elements and microbes. 236 LUMBAR PUNCTURE. Fig. 129 a. (11) Method of Performing Lumbar Puncture.—The patient should be placed upon his left side near the edge of the bed, the body inclined a little forward, the chinas nearly as possi-ble approaching theknees, the operatorsitting beside thebed; the needleshould be intro-duced between thethird and fifthlumbar vertebralarches. When thedural sac is reachedand the fluid be-gins to flow fromthe cannula, themandrin should beremoved and a hol-low metal coneshould be closelyattached to the needle and this again to a narrow rubber tube with a glass tube at its end. As soon as fluid appears, the glass tube is held to such a height that the fluid column is in equilibrium, when its vertical position from the point of opening will show the existing pres-sure; after this has been noted (naturally taking into account the previously mentioned secondary in-fluences) the glass tube is lowered (10 to 20 mm.) below the height of pressure so that the fluid may
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