Ill 



IS CHOLINE PRESENT IN THE CEREBROSPINAL FLUID OF 

 EPILEPTICS ? By S. Kajiura, Imperial Japanese Navy. (From 

 the Physiological Laboratory, King's College, London.) (With 

 one Plate.) 



{Received for publication 30th July 1 908. ) 



In their investigations on the presence of choline in cerebro-spinal fluid 

 and blood, Halliburton and Mott pointed out that it was only present 

 in organic diseases of the nervous system, and that this was a fact of 

 diagnostic value in distinguishing diseases where there is an actual 

 breakdown of nervous material from those which are merely functional.^ 

 Although these observers, and those who immediately followed them, 

 employed as their principal chemical test the formation of crystals of 

 the choline platino-chloride — a test which it has since been shown is not 

 absolutely conclusive by itself — nevertheless the absence of choline can 

 be inferred when this test gives negative results. 



On the other hand, it has been contended by Donath ^ that choline is 

 generally"^ ^3«gH!d in the cerebro-spinal fluid in cases of epilepsy ; and he 

 relies for the detection of choline upon the fact that the crystals of th^ 

 platinum compound of choline are doubly refracting, and can thus easily 

 be distinguished from platinum compounds of potassium and ammonium 

 chloride, which under the ordinary microscope are liable to be mistaken for 

 those of the choline salt. 



In his Oliver-Sharpey lectures,'* Professor Halliburton said: "This 

 requires confirmation. Granting that the diagnosis of epilepsy in 

 Donath's cases was correct, it appears necessary to remove epilepsy from 

 the list of functional diseases, if the existence of choline in the fluids of 

 such cases is a fact." 



The research of which this paper is the outcome was undertaken with 

 the view of ascertaining whether or not Donath is correct in his state- 

 ments. The difiiculty of demonstrating the presence of choline when mixed 

 with potassium and ammonium salts, as always happens when one is 

 dealing with physiological fluids, has been overcome by the introduction of 

 the periodide test by O. Rosenheim,* and it appeared necessary to 

 investigate the question by means of this characteristic and trustworthy 



* See fully Halliburton, Ergebn. d. Pliysiologie, iv., pp. 72-74, 1906. 

 ^ Joum. of Physiol., xxxiii., p. 211, 1905-6. 



3 British Medical Journal, May 4, 1907. 



* Joum. of Physiol., xxxiii., p. 221, 1906; xxxv., p. 445, 1907. 



VOL. I., NO. 4. — 1908. 20 



