4 weeks later + — — 161 L. -(-
Second dose three weeks after serological test
1 week later -\- — — 92 L. +
Third dose one week after serological test
3 weeks later — ■ — — 71 L. -i-
Fourth dose one week later
2 weeks later — — — 16 L. -r
8 weeks Buy Nizagara Online later — — — 22 L. -f- Nizagara Online
Fifth dose right after serological test
3 weeks later — • ~ — 4 L. -i-
5. — Patient A.
Before therapy + — + 357 L. 8 P. +
0.6 salvarsan intravenously
1 week later + — -f- 309 L. +
3 weeks later 4- — -t- 188 L. 4-
Second dose salvarsan, after serological test
9 weeks later W-|- — W + 95 L. 4-
Third dose two weeks later
3 weeks later - — ■ — — ■ 41 L, 4-
6. — Patient D.
Before therapy + + -r 134 L. -f.
0.6 salvarsan
10 days later — — — 60 L, -f
6 weeks later — — — 26 L. 4-
Second dose immediately after serological test
2 weeks later — • — — 7 L. -I-
t months later W-t- — — 19 L. -i-
This table clearly shows that systematic sero-
logical studies during the treatment of a syph-
ilitic meningomyelitis Order Nizagara or a gummatous meningitis
serve a? indicators of the efficiency of treatment
and basis for prognosis. There is hard'y a clinical
sign that more emphatically demands specific medi-
cation than a high cell count and a positive Wasser-
mann reaction in the fluid. I consider Case i to
be an acute exudative syphilitic meningomyelitis,
in view of the serological finding and clinical signs.
As serological corroboration for this statement we
have the rather large number of polynuclear ele-
ments and the absence of the substance which re-
duces Fehling's solution. The Wassermann reac-
tion in the fluid decides the luetic nature of the
nen'ous disease. Cases like this one give great
satisfaction, for it can be safely predicted, in view
of the great pleoc}^osis and absence of copper re-
duction, that the mental and physical status will
be greatly improved by the treatment. The patient
under consideration improved marvelously after the
course of treatment scheduled. For a short time
Case II was considered to be general paresis, regard-
less of the laboratory diagnosis. For over six
months the clinical diagnosis remained as such and
the patient received the treatment outlined in the
table. It is over a year since the patient received
any drugs : he attends to his business and feels
iiuite well. Now his physician believes that the
368
KAPLAN: SEROLOGICAL ANALYSES IN NEUROLOGY.
condition wai5 most likely cerebrospinal syphilis and
not generaly paresis. It is not to be denied that
general paresis often shows remissions and inter-
missions in its clinical caurse, but the cases are
rare indeed where such improvement is as lasting
as in the case cited. It is my conviction that the
sporadic cures obtained in certain cases of general
paresis to be found in the literature of the pre-
serological days of neurology, were cases like the
one Buy Nizagara described above, cerebrospinal lues clinically re-
sembling general paresis.
Case Nizagara Tablets rii portrays the Plaut type of cerebrospinal
lues, with a negative W'assermann reaction in the
fluid and a positive one in the serum. This patient
was restored to good health, which, after a lapse
of two years, he still enjoyed. His serological status
became entirely normal, a condition to be obtained
but rarely in cerebrospinal syphilis ; for the cells, at
least, seldom become entirely normal in number.
Had this patient presented himself at another insti-
tution and given no information as to his previous
treatment it would have been rather difficult to cor-
roborate serologically the clinicians' diagnosis of
cerebrospinal lues. The fourth patient came to the
author to obtain relief from his gastric disturbances.
He was treated for two years for gastric catarrh
without obtaining any relief. The absence of
any abnormalities in his gastric chemistry, to-
gether with the presence of exaggerated knee
jerks and unequal pupils that reacted sluggishly,
suggested to me that the pains were girdle sensa-
tions, and a provisional diagnosis of cerebrospinal
syphilis was made. The serological study proved
that the contention was correct. After treatment
with salvarsan his active symptoms disappeared
and he was able to attend to his affairs. The
fifth patient, regardless of the gradual reduction
to negative, did not improve clinically. In Case
VI a marked improvement resulted from the treat-
ment and the patient still enjoys good health
after eighteen months. As can be observed in the
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