Puncture of the cisterna magna is by no means a new procedure. In America, Ayer1 claimed that before 1920 there was no mention of cistern puncture in any of the literature. This was controverted by Westenhofer,2 who said that he performed it in 1905 and by Obregia,3 who claimed he used this method twenty-two times during 1908.
Up to October, 1923, Ayer and his co-workers had performed 1,985 cistern punctures without one fatality, and numerous other Americans, notably Ebaugh,4 Keegan and Riddell,5 Berger and Grossberg6 and McCusker7 reported similar results.
I present this method of cistern puncture as it applies to the syphilologist and the dermatologist as a diagnostic test in preference to lumbar puncture because of its clinical advantages, simplicity and lack of unpleasant sequelae.
On Oct. 6, 1927, Dr. Howard Fox invited Dr. Memmesheimer of Professor Hoffman's Dermatological Clinic at Bonn,
SPIEGEL L. THE TECHNIC OF CISTERN PUNCTURE (CISTERNA MAGNA). Arch Derm Syphilol. 1928;18(3):420–422. doi:10.1001/archderm.1928.02380150086011
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