Cerebrospinal Fluid In Health And In Disease Third EditionPDF电子书下载

CHAPTER Ⅰ HISTORY OF CEREBROSPINAL FLUID 21

Knowledge of Existence of Cerebrospinal Fluid in Pathologic Conditions 21

Discovery of the Existence of Cerebrospinal Fluid in Normal Individuals 25

Investigations Concerning the Physiology of Cerebrospinal Fluid 28

Discovery of Methods of Removing Cerebrospinal Fluid From the Living 30

Modern Research on Cerebrospinal Fluid 38

CHAPTER Ⅱ ANATOMY OF THE STRUCTURES ASSOCIATED WITH THE CEREBROSPINAL FLUID 43

The Ventricles 43

The Chorioid Plexus 44

The Meninges 47

The Subarachnoid Spaces 48

The Cisterns 49

Communications 50

Pacchionian Bodies 52

CHAPTER Ⅲ PHYSIOLOGY OF THE CEREBROSPINAL FLUID 54

Rate of Formation 54

Circulation 54

Rate of Absorption 55

Channels of Absorption 57

Permeability 58

Function 61

Origin 63

CHAPTER Ⅳ NORMAL CEREBROSPINAL FLUID．PRESSURE 72

Type of Apparatus 73

Position of the Needle 80

Previous Withdrawal of Fluid 80

Age 81

Position of the Patient 81

Site of Puncture 82

Intracranial Arterial and Venous Pressures 83

The Queckenstedt Sign 84

Rate of Formation and Rate of Absorption 84

Brain Volume 85

Summary 85

CHAPTER Ⅴ NORMAL CEREBROSPINAL FLUID．PHYSICAL AND PHYSICOCHEMICAL PROPERTIES 88

Physical Properties 89

Amount 89

Color 89

Lack of Sediment 89

Physicochemical Properties 90

Specific Gravity 90

Conductivity 91

Surface Tension 91

Viscosity 91

Refractometric Index 91

Freezing Point 92

Spectroscopic Analysis 92

Crystallization 92

Reaction of Normal Cerebrospinal Fluid 95

Alkali Reserve 104

CHAPTER Ⅵ NORMAL CEREBROSPINAL FLUID．CHEMICAL PROPERTIES 108

Early Investigations 109

Recent Investigations 111

Inorganic Constituents 111

Total Solids 111

Calcium 112

Magnesium 113

Sodium and Potassium 114

Chlorides 114

Inorganic Phosphorus 115

Other Inorganic Substances 116

Organic Constituents 117

Organic Matter and Organic Index 117

Total Protein 118

Nitrogen 119

Sugar 120

Cholesterol 122

Lactic Acid 122

Cholin 122

Organic Phosphorus 122

Urobilin and Bilirubin 123

Other Organic Constituents 123

Comparison of Cerebrospinal Fluid and Blood Chemistry 123

CHAPTER Ⅶ NORMAL CEREBROSPINAL FLUID．BIOCHEMICAL PROPERTIES AND CYTOLOGY 133

Catalase 133

Amylase 133

Oxidase 134

Diastase 134

Proteolase 134

Lipase 134

Glycolytic Ferment 134

Opsonin 134

Alexin 134

Hemolysin 134

Toxicity 135

Antitoxins 135

Bactericidal Action 135

Cytology 135

Type of Cell 137

CHAPTER Ⅷ PATHOLOGIC CEREBROSPINAL FLUID．GENERAL CONSIDERATIONS 139

Infection of the Meninges 139

Irritation of the Meninges 144

Trauma and Other Factors 147

CHAPTER Ⅸ PATHOLOGIC CEREBROSPINAL FLUID．PHYSICAL AND PHYSICOCHEMICAL PROPERTIES 149

Physical Changes 149

Color 149

Increase in Amount of Obtainable Fluid 149

Pressure 150

Foam 150

Pellicle，Coagulum or Sediment 151

Physicochemical Changes 154

Spectrum Analysis 155

Crystallization 155

Turbidity 158

Protein Charges 159

The Colloidal Gold Reaction 163

Mastic Reaction 163

Benzoin Reaction 163

Other Colloidal Tests 164

Ninhydrin Reaction 164

Changes in the Reaction of the Cerebrospinal Fluid 164

Precipitation 173

Permeability of the Meninges 176

Bromide Test of Walter 177

Biologic Tests 178

CHAPTER Ⅹ PATHOLOGIC CEREBROSPINAL FLUID．CHEMICAL AND BIOCHEMICAL CHANGES 179

Chemical Changes 179

Inorganic Constituents 179

Chlorides 179

Calcium 180

Magnesium 180

Sodium and Potassium 180

Inorganic Phosphorus 181

Lead 181

Arsenic 181

Organic Constituents 182

Permanganate Reduction or Organic Index 182

Protein 182

Albumoses 184

Urea，Uric Acid and Creatininc 184

Sugar 185

Cholesterol 188

Lactic Acid 189

Cholin 189

Acetone 189

Bilirubin 189

Cytological Changes 190

Prognostic Value of Cytology of Cerebrospinal Fluid in Purulent Meningitis 194

Enzymes 194

Catalase 194

Diastase 195

Other Enzymes 195

Bacteriologic 195

Immunologic 197

Agglutination 197

Inhibition of Saponin Hemolysis 197

Hemolysin 198

Wassermann Reaction 198

Toxicity 199

CHAPTER Ⅺ RELATION OF CEREBROSPINAL FLUID TO VARIOUS FACTORS 202

Relation of Cerebrospinal Fluid to the Time of Day 202

Changes in Cerebrospinal Fluid With the Age of Fluid 202

Cerebrospinal Fluid From Different Loci 203

Postmortem Changes in Cerebrospinal Fluid 206

CHAPTER Ⅻ METHODS OF OBTAINING CEREBROSPINAL FLUID FROM THE LIVING BODY 209

Lumbar Puncture 209

Indications 210

Contraindications 214

Reactions Following Removal of Cerebrospinal Fluid 214

Technic of Lumbar Puncture 218

The Spinal Puncture Needle 223

Failure to Obtain Fluid 226

The Presence of Blood in the Fluid 229

Collection of the Fluid 229

Ventricular Puncture 231

Cistern Puncture 235

Indications 236

Technic 236

Failure and Untoward Effects 237

Special Methods 239

Combined Puncturd 239

Ventriculography 239

Myelography and Eneephalography 239

Lipiodol Injections 240

Orbital Puncture 242

Epidural Injections 242

Sacral Anesthesia 242

Spinal Anesthesia 243

CHAPTER ⅩⅢ METHODS OF EXAMINATION OF CEREBROSPINAL FLUID FOR DIAGNOSTIC PURPOSES 245

Physical 245

Color 245

Foam 246

Film or Pellicle 246

Pressure 247

Queckenstedt＇s Sign 248

Phenolsulphonephthalein Test for Determination of Type of Hydrocephalus 248

Chemical 249

Globulin Tests 249

RossJones 249

NonneApelt 250

Pandy 251

Noguchi 251

Kaplan 252

Weichbrodt＇s Reaction 252

Boltz Test 252

Braun-Husler Reaction 253

Alcohol Reaction 253

Takata-Ara Reaction 253

Taccone Test 253

Sulphosalicylic Acid-Mercurie Chloride Method 254

Relative Value of the Globulin Tests 254

The Permanganate Test 255

Boveri Test 256

Ninhydrin Reaction for Albumoses (Nobel-Kafka) 256

Quantitative Tests for Protein 257

Method of Nisal 257

Sugar 258

Chlorides 261

Physicochemical Methods 263

H-ion Concentration 263

Lange Gold Chloride Test 264

Mastic Test 269

Benzoin Test 271

Relative Value of Colloidal Reactions 271

Tests for Meningeal Permeability 272

Nitrate Test of Mestrezat 272

Uranin Test of Jervell 273

Cytologic Examination 273

The French Method of Cell Counting 273

Chamber Method of Cell Counting 274

Comparative Value of the Two Methods 276

Type of Cells 277

Bacteriologic 278

Culture Media 278

Direct Smear 279

Immunologic 279

Agglutination of Meningococei 279

Precipitation of Cerebrospinal Fluid With Antimentingococeus Serum 284

Guinea Pig Inoculation 284

Saponin Reaction 285

The Wassermann Reaction 286

Kahn Test 288

Peterman Microprecipitation Test 292

CHAPTER ⅩⅣ CEREBROSPINAL FLUID IN VARIOUS DISEASES 295

Infectious Meningitides 295

Tuberculous Meningitis 295

Meningococcus Meningitis 307

Staphylococcus Meningitis 309

Influenza Meningitis 309

Colon Meningitis 311

Typhoid Meningitis 311

Anthrax Meningitis 311

Rare Forms of Meningitis 311

Syphilis 312

General Paresis 315

Tabes Dorsalis 315

Syphilitie Meningitis 315

Other Diseases of the Central Nervous System 316

Tetanus 316

Huntington＇s Chorea 316

Epilepsy 316

Rabies 317

Herpes Zoster 317

Postdiphtheritie Paralysis 317

Alcoholic Psychoses 319

Manic-Depressive Psyenoses 319

Dementia Precox and Paranoia 319

Hemorrhage of the Brain 320

Skull Fracture 320

Pachymeningitis Hemorrhagiea Externa 320

Pachymeningitis Hermorrhagiea Interna 320

Cerebral Thrombosis 321

Encephalitis 321

Abscess of the Brain 322

Parasitic Cysts of the Brain 323

Tumor of the Brain 323

Tuberculoma 323

Froin＇s Syndrome (Massive Coagulation) 323

Acute Anterior Poliomyelitis 324

Multiple Sclerosis 330

Amyotrophic Lateral Sclerosis 330

Syringomyelia 330

Paralysis Agitans 330

Subacute Combined Degeneration of the Cord 330

Spinal Muscular Atrophy 330

Cerebral Arteriosclerosis 330

Other Degenerative Conditions 331

Acute Infectious Diseases Without Organic Involvement of the Central Nervous System 331

Meningism 331

Pneumonia 332

Mumps 333

Pertussis 334

Scarlet Fever 334

Typhoid 334

Meningitis Sympathiea 334

Acute Mastoiditis Otitis Media and Sinusitis 335

Lateral Sinus Thrombosis 335

Serum Meningitis 335

General and Metaboliec Diseases 336

Uremia 336

Diabetes Mellitus 336

Jaundice 336

Trichinosis 337

CHAPTER ⅩⅤ CEREBROSPINAL FLUID IN INFANTS AND CHILDREN 341

Cerebrospinal Fluid in Normal Newborn，in Infants and in Children 342

Normal Newborn 342

Normal Infants and Children 343

Cerebrospinal Fluid in Diseases Peculiar to Infancy and Childhood 345

Cerebral Hemorrhage of the Newborn 345

Hydrocephalus 345

Spina Bifida 346

Amaurotic Family Idiocy 346

Mongolian Idiocy 347

Little＇s Disease 347

Convulsions in Infancy 347

Spasmophilia 348

Alimentary Disturbances 349

Congenital Syphilis 349

Chorea of Sydenham 350

Meningitis 351

Meningitis of the Newborn 351

Meningitis in Infants and Children 351

Serous Meningitis 354

Pachymeningitis Hemorrhagiea Interna 354

CHAPTER ⅩⅥ INTRATHECAL TREATMENT 357

Intrathecal Treatment of Meningococcus Meningitis 357

Technic 359

Dosage 361

Agglutination 365

Untoward Effects of Serum 364

Intrathecal Treatment of Pneumococcus Meningitis 366

Intrathecal Treatment of Streptococcus Meningitis 367

Intrathecal Treatment of Tuberculous Meningitis 367

Intrathecal Treatment of Influenza Meningitis 367

Intrathecal Treatment of Acute Anterior Poliomyelitis 368

INtrathecal Treatment of Syphilis of The Nervous Syatem 368

Intrathecal Treatment of Tetanus 370

Intrathecal Treatment of Chorea 370

Spinal Drainage and Lavage 371

APPENDIX MONOGRAPHS ON CEREBROSPINAL FLUID 373