344 Dr. Thomson, Mr. Hill, and Dr. Halliburton. 



appear to have heen fully established before the present instance. 

 However, considerable research into the literature of the subject has 

 shown that there are several cases recorded in which, though no history 

 of injury existed, the flow of fluid from the nose was of such a character 

 that they must have been similar to the present case, although in the 

 majority of instances the true nature of the fluid escaped observation. 



Many of these patients exhibited cerebral symptoms in the course 

 of the disease, and some ultimately died from inflammation of the cere- 

 bral meninges, which had probably spread from the nose through some 

 opening in the bony lamina that normally separates the cranial and 

 nasal cavities. The full clinical details of this rare case and of the 

 similar ones just referred to are, however, reserved for publication else- 

 where. The present paper is concerned only with the composition of 

 the fluid and the variations it presents under different circumstances. 



Characters of the Fluid. 



Our opportunities for examining the fluid chemically have been fairly 

 frequent. The fluid was always collected in sterilised glass vessels, 

 and the examination made as soon as possible by one of us (W. D. H.) 

 at King's College, London. 



The fluid is perfectly clear and colourless, looking like water ; its re- 

 action is faintly alkaline; its specific gravity is about 1005. On micro- 

 scopic examination it shows no cells or other deposit. It gives no 

 precipitate with acetic acid. It contains a trace of proteid, coagulable 

 by heat, but the quantity is too small to give more than an opalescence. 

 In another portion of the fluid it was ascertained that this proteid is 

 precipitable by saturation with magnesium sulphate ; it is therefore a 

 globulin. Albumin and other proteids are absent. 



The fluid contains a substance which reduces Fehling's solution. 

 A portion of the fluid was treated with excess of acidified alcohol ; the 

 proteid so precipitated was filtered off. The filtrate was evaporated to 

 dryness over a water bath ; the dry residue was taken up with alcohol, 

 filtered, and again evaporated to dryness. Part was evaporated to 

 dryness on a glass slide; the residue examined microscopically was 

 seen to contain the needle-like crystals, occurring singly and in bundles, 

 similar to those previously described and figured by one of us 

 (W. D. H)* as obtainable from cerebro-spinal fluid. The residue had 

 also the characteristic pungent taste of pyrocatechin. 



The remainder of the dry residue was dissolved in water and filtered. 

 The filtrate reduces Fehling's solution well, but it does not ferment 

 with yeast, nor does it give any osazone crystals on treatment with 

 phenylhydrazine hydrochloride and sodium acetate. Control experi- 

 ments with a weak solution of dextrose, which gave about the same 

 * ' Journ. of Physiol.,' vol. 10, p. 248. 



