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August 7, 1926


JAMA. 1926;87(6):377-379. doi:10.1001/jama.1926.02680060001001

At the risk of being elementary and pedantic, I wish to emphasize certain fundamental principles in diagnosis wherein the examination of the cerebrospinal fluid is of importance. The excuse for such a summary is to be found on every hand, from the query of a writer in a recent number of The Journal, who wishes an answer as to when lumbar puncture is indicated, to the case in which you and I have obtained unusual findings which we cannot easily interpret. Nor do the text-books on fluid diagnosis always clarify the situation, for, on turning to the description of the fluid in brain tumor, we read: "In tumors of the brain, the amount of cerebrospinal fluid may or may not be increased.... The cells are usually increased.... The globulin as a rule is not increased but may be slightly increased.... The Lange test may show changes." True, but not very

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