A STUDY OF THE CEREBROSPINAL FLUID IN ACUTE POLIOMYELITIS

The spinal fluid in the cases of acute epidemic poliomyelitis examined was usually clear, colorless, and did not appear to be under any great increase of pressure. It showed changes in the number of cells present, or in the globulin content, or in both, in the majority of cases examined on the first few days after onset of symptoms. The number of cells was usually highest during the first week, and in one case reached the figure of 1,221 per cubic millimeter. The globulin reaction was usually most marked during the third week. The number of cells diminished rapidly and was above normal in only 32 per cent. of the cases in the third week. The increase in the globulin reaction persisted to the fourth week and might be present for a considerably longer period. The cell increase was due almost invariably to mononuclear cells of various types. The lymphocytic type of cell was the most common. A high polymorphonuclear count was noted in the very early stages. All the fluids reduced Fehling's solution. The examination of the spinal fluid may be of value in diagnosis in the preparalytic stages and in abortive cases. It is not of value in prognosis as to life or ultimate recovery.