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May 31, 1941


Author Affiliations

From the Department of Psychiatry, University of Cincinnati College of Medicine, and the Psychiatric Service of the Cincinnati General Hospital.

JAMA. 1941;116(22):2487-2488. doi:10.1001/jama.1941.02820220029007

Drainage of the cerebrospinal fluid by means of spinal puncture as a therapeutic measure in delirium tremens was introduced by Steinebach1 in 1915. In that same year Hoppe2 introduced this procedure in the United States; since then the treatment has become highly popular. Although it is now generally assumed that an increase in intracranial pressure occurs in delirium tremens and that drainage of the cerebrospinal fluid will relieve that tension, few data in support of this hypothesis can be found in the literature.

In a series of 18 cases, Steinebach found 14 patients (75 per cent) to have an increased pressure of the cerebrospinal fluid. However, this conclusion was based on his interpretation of any pressure above 150 mm. of water as abnormally increased, which criterion is not in accord with that generally employed in this country, in which the upper limit of normal is usually considered to

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