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To the Editor:
In The Journal of July 26, 1913, p. 265, Dr. M. J. Karpas states that "in tumor of the brain of non-luetic genesis the fluid is free from pathologic findings." I may say without going into the literature for quotations that a number of cases of non-luetic brain tumors have been reported in which the spinal fluid showed a positive result from Noguchi's modification of the Wassermann test and increased cell-count. I have had two such cases myself. In one of these cases in which I had originally made a diagnosis of brain tumor I revised the same to cerebrosyphilis on the basis of the laboratory report. The necropsy showed non-specific tumor at the pontocerebellar angle. Therefore, that the spinal fluid may in cases of non-specific brain tumor show increased cell-count and positive Noguchi test appears to me as a matter of very considerable clinical importance.
Diller T. Cerebrospinal Fluid in Brain Tumors. JAMA. 1913;61(9):703. doi:10.1001/jama.1913.04350090071024