in alcoholism, in peripheral neuritis, in hysteria,
and in two cases of anterior [>oliomyelitis. In
igo2 Joft'roy and Mercier studied the s|)inal fluid
of the insane by means of this method. They
found Clomipramine Anafranil the cell count normal in ten cases of dementia
pr.Tcox and in seventeen of alcoholic Clomipramine 50 Mg psycliosis. In
general paresis the cells were always in excess, and
these authors believed that they could exclude this
diagnosis where the cell content of the spinal fluid
was normal. The method of Widal. Sicard. and
Ravaut was cumbersome and tedious, as well as
inaccurate. The number Clomipramine Hydrochloride of cells was estimated by
counting the cells ol)served on a smear after cen-
trifugalization. In\estigators soon attempted to
simplify the technic and to make it as ready of
application a-; is blood examination. Kraemer used
the ordinary Thoma-Zeiss blood counting chamber. '
and in eleven cases of general paresis he found that
the number of cells ranged between five and forty-
five to each c. mm. Merzbacher considered fifteen
cells to each c. mm. the upper limit for cells in
ncirmal fluids.
He fo-.nid a cell increase in 100 per cent, of gen-
eral jiaretics and that among these sixty-five per
cent, Anafranil Clomipramine showed globulin excess. According to Park-
inson, the number of cells in the fluids of paretics
tends to lessen in the stages of decline and to in-
crease during the lucid intervals. Undoubtedlv the
best method of estimating the cells in the spinal
fluid is that with the chamber devised by Fuchs and
Rosenthal. This chamber, which is larger than the
Thoma-Zeiss blood chamber, has the advantage of
reducing errors to a minimum, this being the
method used on fluids reported in this article.
The appearance in iix)6 of the work of Wasser-
mann, Xeisser. and Bruck on the serodiagnostic re-
action in syphilis opened a new field for spinal fluid
research. This reaction, now so widely known as
the Wassermann reaction, has been e.xtensively
studied by many workers, and while it is not ac-
cepted as specific, its practical utility is now a!;ove
(|uestion. It was ascertained at a very early date
that this serodiagnostic reaction Clomipramine 50mg need not neces-
sarily be present in every patient who had come
in contact with syphilis, and also, that there are
disease^ other than syphilis capable of giving this
reaction. Boa? and Hauge found it in scarlet
fever, Bruck and Gessner in lepra, Kaplan in
scleroderma and in certain jaundiced sera, Hartoch
and JakimofT in trypanosomiasis. From the very
beginning attempts were made to produce an
e(|ually sensitive test nf less complexity, chiefly by
-M. Stern. Bauer. Tchernogouboff. von Dungern
and Xoguchi. Zeissler's "Auswertungs Methode"
with serum, and later Hauptmann's application of
the method to spinal fluids, were designed to make Clomipramine Hydrochloride Tablets
the test more sensitive. Working with sera from
general paresis patients. Muirhead Clomipramine Buy obtained sev-
enty-six per cent, of positive Wassermann reac-
tions. The most comprehensive exposition of the
serology of nervous diseases is to be found in the
work (if Plant and of Xonne. Buy Clomipramine Online The former estab-
lished a definite serological picture for cerebro-
spinal syphilis, finding a positive Wassermann re-
action in the serum and a negative result in the
spinal fluid in the majority of instance?.
Hauptmann, with the use of his "Auswertungs
Methode," obtained almost 100 per cent, of positive
results, working with spinal fluids from patients
suffering from cerebrospinal syphilis. This work
and Xonne's article, appearing in the September,
igii. issue of the Dctttsclir /.citschrift fiir .\'er-
-icuhcUkuiidc. being in line with the work carried
on by myself, will receive more detailed consid-
eration. It is my opinion that the use of larger
quantities of spinal fluid, as advocated by Haui^t-
mann, may in some instances be responsible for a
nonspecific inhibition. It is a well known fact that
there are conditions other than lues capable of giv-
ing a positive Wassermann result ; it seems to me
that these nonspecific results could be reduced to a
minimum if it were not for the fear that some sero-
logical workers possess of missing a Clomipramine Tablets positive Was-
sermann reaction on a >yphilitic patient. Regard-
less of this, suspicion should be aroused when the
laboratory begins to Clomipramine 25mg claim infallibility of methods
and results. Of the forty-four cases analyzed by
Hauptmann only two were admitted to have been
benefited by previous therapy. The fact that about
twenty per cent, of fluids were absolutely free from
a pleocytosis did not seem to affect the value of
the method in the least, although Hauptmann's
chief, Xonne, strongly emphasized the importance
of an increase Clomipramine 20mg in the cell content in fluids from all
patients with true paraliietic affections of the nerv-
ous system. ( See above mentioned article, jjage
203.) In about four per cent, of this material
Hauptmann was unable to obtain a positive result
on the fluids. From the arguments that follow une
carries away the impression that a negative Was-
sermann reaction was unexpected and undesirable.
The attitude of the "Auswertungs Methode" ad-
vocate becomes apparent when the following state-
ment is analyzed: "Xot until larger quantities of
fluid were utilized could a positive Wassermann
reaction be obtained." The critically inclined
worker is fully justified in asking what the factors
were that prompted Hauptmann to look for a posi-
tive Buy Clomipramine result and to make use of larger quantities of
fluid in Clomipramine For Ocd a given case. Evidently, the reason why a
negative Wassermann residt was not desirable was
because the author possessed data suggestive of
neurological lues. This will in a measure account
for the positive Wassermann reactions obtained in
some patients who undoubtedly had received suf-
ficient treatment to negative the fluid serology, and
will also explain why he did not in one instance
find a serological picture similar to those described
by Plant. It is important to remember that cerebro-
spinal lues is invariably accompanied Clomipramine 10 Mg by a pleocy-
tosis. A few Clomipramine Ocd exceptions are to be obtained in the
endarteritic form of this disease and in those pa-
tients with general paresis who survived a very
persistent and strenuous antiluetic treatment.
Hauptmann entirely ignores the importance of a
pleocjtosis and on page 260 of his article states
with considerable emphasis that "now we are en-
abled to detect syphilis of the nervous apparatus
without the help of the other three tests (cell count,
protein excess, serum Wassermann)".
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