Progress in the successful management of otitic meningeal infections is dependent on very early diagnosis. The finding of the bacterial invaders in the cerebrospinal fluid comes too late to permit diagnosis at the stage of the invasion when therapy is effective. The inflammatory reaction produced by various causal agents brought to the parts through divers channels effects characteristic tissue reactions.
One of us (Dr. Kopetzky1), in a monograph published in 1912, called attention to the value of establishing early diagnosis in meningeal infections through an estimation of the chemical contents of the cerebrospinal fluid, and alluded to the significance of the abnormal absence of chemical elements normally present and to the presence of an excess of toxic substances and the products of brain metabolism, impeded in their removal from the cerebrospinal system by factors of intracranial pressure and stasis of the cerebrospinal fluid system.
KOPETZKY SJ, FISHBERG E. EARLY DIAGNOSIS IN MENINGITIS: CHEMICAL STUDIES OF THE SPINAL FLUID. Arch Otolaryngol. 1932;16(6):851–862. doi:10.1001/archotol.1932.00630040866008
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