In a previous communication1 were published the results of lumbar puncture and drainage of the cerebrospinal canal as evidenced by three suggestive but eventually fatal cases. My conclusions, as stated at that time and based on the experience of these cases, were essentially as follows:
Probably several toxins exert an influence in uremia at different times and in different cases.
Other portions of the brain than the cortex are also affected by the causal influence in uremia.
Intracranial pressure is usually in evidence, either independently or in conjunction with toxic irritation and tissue destruction.
In cases in which the intracranial pressure is the main factor, lumbar puncture of itself may save life; it should constitute one of the routine measures in the treatment of uremia.
Transfusion of normal salt solution, except in cases presenting anuria or a markedly diminished secretion, is contraindicated.
Drainage of the spinal canal will not cure
WILLSON RN. THE RELIEF OF UREMIC HEMIPLEGIA AND OTHER UREMIC STATES BY LOWERING INTRACRANIAL PRESSURE.TEN CASES. JAMA. 1905;XLV(1):23–31. doi:10.1001/jama.1905.52510010023001g
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