360 EDEMA 



acute suppurative meningeal inflammation (Jacob). ^^ There is nor- 

 mally in the adult from 60 to 150 cc, and Frazier estimates that from 

 360 to 720 cc. is secreted daily. HalHburton gives the following analyses 

 of pathological accumulations of such fluids : 



Table VI (Spina bifida) 



Case 1 Case 2 Case 3 



Water 989.75 989.877 991.658 



Solids 10.25 10.123 8.342 



Proteias 0.842 1.602 0.199 



Salts 1 Q .^^ / 0.631 3.C28 



Extractives/ ^■^'^^ \7.89f 5.115 



The percentage of solids in spina bifida is thus a little higher than 

 in normal meningeal fluids. In hydrocephalus the percentage of solids 

 is rather greater, as seen in Table VII. 



Table VII (Hydrocephalus; 



Case 1 Case 2 Case 3 



Water 986.78 984.59 980.77 



Solids 13.22 15.41 19.23 



Proteins and extractives 3.74 6.49 11.35 



Salts 9.48 8.92 7.88 



Normal cei'ebrospinal fluid seems to be h3'pertonic to the serum of 

 the same animaP^ and slightly more alkaline than the blood. ^^ In 

 meningitis the alkalinity is often lowered. ^^ The alkaU reserve is 

 nearly constant in systemic diseases, except diabetes (McClendon),'° 

 and is practically the same as that of the blood. By gas chain meas- 

 urements Levinson-i found the spinal fluid almost neutral (pH = 

 7.4-7.6); in epidemic meningitis it is 7.3-7.4. According to Fuchs 

 and Rosenthal-- the average freezing-point of the cerebrospinal fluid 

 is lowered about the same in all diseases (A = —0.52° to 0.54°) ex- 

 cept in tuberculous meningitis, where it is much less (average —0.43°). 

 The amount of potassium is about the same as in the blood, -^ and not 

 increased in degenerative diseases of the central nervous system;-* 

 after death the amount is much increased by post-mortem changes. 

 Calcium is almost constant at 5 mg. per 100 cc, or about one-half 

 as much as in the plasma." In diseases associated with destruction 

 of brain tissue, such as general paralysis and epilepsy,-^ choline or some 



'^ Brit. Med. Jour. 1912 Oct. 26. 



»' Ravaut, Presse rnod., 1900 (8;, 128; Zanier, Cent. f. Fhysiol., 1896 (10), 353. 

 •8 Hurwitz and Tranter, Arch. Int. Med., 1916 (17), 828. 

 >» Levinson, Arch. Pediatrics, 1916 (33), 241. 

 2" Jour. Amer. Med. Assoc, 1918 (70), 977. 

 2> .jour. Infect. Dis., 1917 (21), 556. 

 " Wion. mcd. Presse, 1904 ^45), 2081 and 2135. 

 "Myers, Jour. Biol. Cheni., 1909 (6), 115, literature. 

 "^ Rosenbloom and Andrews, Arch. Int. Med., 1914 (14;, 536. 

 "Halverson and Borfreini, Jour. Biol. Chem., 1917 (29), 337. 

 2* Concerning si)inai fluid in cpilcp.sy see Larkin and Cornwall (Jour. Lab. 

 Clin. Med., 1919 (4), 352. 



