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August 19, 1933


JAMA. 1933;101(8):622. doi:10.1001/jama.1933.02740330054029

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To the Editor:  —In The Journal, July 29, an article by Drs. Kubie and Retan describes with meticulous detail the newest procedure for dealing with infections of the central nervous system. This in principle and effect is "lavage" of the perivascular and perineuronal spaces of the cerebrospinal parenchyma, which is induced by the introduction of large amounts of hypotonic salt solution into the circulation, and, as the result of differences in osmotic tension thus created, a large amount of this fluid ultimately finds its way into the ventriculosubarachnoid spaces of the brain and cord. It is then drained off through a lumbar interspace, with a lumbar puncture needle. The conception and execution of the therapeutic procedures is, as far as I am aware, original with the authors, and they deserve commendation for this notable contribution to the therapy of infections of the central nervous system.I have had the opportunity

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