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December 1917


Am J Dis Child. 1917;14(6):424-443. doi:10.1001/archpedi.1917.01910120029002

In a recent communication a series of cases of internal hydrocephalus was presented and subdivided into two apparently distinct anatomic varieties—obstructive hydrocephalus and communicating hydrocephalus. These two groups were sharply differentiated by an anatomic difference, demonstrated by the introduction of a neutral solution of phenolsulphonephthalein into the cerebral ventricles and almost immediately testing for its presence in the spinal fluid. In the obstructive type, this solution introduced into the ventricles failed to appear in the spinal fluid; in the communicating type it appeared promptly in the spinal fluid.

Clinically, the two varieties appeared identical, and it was only by this test that hydrocephalus could be subdivided. The growth of the head seemed about equally rapid, the etiology was equally obscure, and either variety might be congenital or acquired.

By an estimation of the amount of phenolsulphonephthalein excreted by the kidneys following the intraventricular and intraspinal introduction, a quantitative

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