CYTODIAGNOSIS AND PARASYPHILITIC DISEASE 361 



enter the needle 2/5 of an inch to the right of this point, pushing the needle inward 

 and upward. Collect the material in a sterile test-tube. Make cultures on blood- 

 serum and then centrifugalize and examine the sediment as for pleural fluids. 



In general terms it may be stated that: 



1. A lymphocytosis indicates a tuberculous process. 



2. An abundance of polymorphonaclear and eosinophilic leukocytes 

 indicates a meningococcic, streptococcic, influenza or pneumococcic 

 infection. 



When the case is one of meningism there are very few. cells. In poliomyelitis 

 there is a cell increase of which 90% may be lymphocytes. 



A method of examination considered by neurologists as of differential diagnostic 

 value is to count the number of cells in a cubic millimeter of the cerebrospinal fluid. 

 The technic is to use a gentian- violet- tinged 3% solution of acetic acid. This is 

 drawn up to the mark 0.5, and the cerebrospinal fluid is then sucked up to n. After 

 mixing, the cell count is made with the haemocytometer. Normally we have only 

 one or two cells per cubic millimeter, but in tabes or general paresis this is increased 

 to 50 or 100 cells (greatest at onset of disease). 



The test for globulins as showing parasyphilitic disease is taken up under Tre- 

 ponema pallidum. The technic of the Wassermann test with cerebrospinal fluid 

 is discussed under that test. Any excess of urea in the cerebrospinal fluid is a sure 

 sign of renal inadequacy. 



Trypanosomiasis gives a cellular increase very similar to syphilis. 



In the work of the French Sleeping Sickness Commission five cells per cubic 

 millimeter was taken as normal. 



