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Article
March 3, 1917

VALUE OF SPINAL PUNCTURE IN ETIOLOGIC DIAGNOSIS OF CARDIOVASCULAR DISEASES

JAMA. 1917;LXVIII(9):691-692. doi:10.1001/jama.1917.04270030023007
Abstract

The examination of spinal fluid in cardiovascular diseases was suggested to me by the finding of a positive spinal fluid Wassermann test in a man, aged 54, who had an aortic aneurysm, a bilateral optic neuritis and unequal pupils, and a negative blood Wassermann test. The spinal fluid showed also positive Nonne and Noguchi tests and a high cell count, consisting mainly of lymphocytes. These evidences of meningeal irritation or inflammation, as they undoubtedly are, were first described by Ravaut, and are now accepted without controversy. Yet no attempt has been made heretofore to arrive at an etiologic diagnosis of cardiovascular diseases by resorting to an examination of the spinal fluid in cases in which the blood Wassermann test has been found negative.

As Cabot1 has shown, the etiologic factors in the production of these diseases may be grouped under four headings: (1) nephritis; (2) toxic conditions, such as

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