294 Kajiura 



disposal was very small. The quantity, however, was too small to enable 

 me to complete the series of tests by the application of the periodide 

 reaction to the platinum compound. This was also the case in No. 11. 



In view of these two positive results, a closer investigation of them 

 appeared necessary, for it seemed improbable that they were cases of 

 simple epilepsy ; the notes which Dr Batten kindly forwarded confirmed 

 this view. 



Case 9 was a child (F. L. R.) one year old, with congenital mental 

 defect, with chorea and epilepsy culminating in status epilepticus. 

 Her symptoms while in the hospital appear to have been very 

 obscure, and the diagnosis of meningitis and later of encephalitis 

 was made. The fluid removed by lumbar puncture contained 

 excess of lymphocytes. She was still in the hospital when I last 

 heard of her. 

 Case 10 was also a child (L. H.) ten years of age, who had had fre- 

 quent fits since she was eighteen months old. It did not appear, 

 however, to be a simple case of epilepsy, for there was also 

 considerable mental defect, though the cause of the latter is 

 uncertain. 

 In case 9 the clinical evidence is quite clear that something more than 

 a functional disorder was present. In case 10 the clinical evidence is not 

 so clear, although it was evidently recognised as something more than 

 a simple case of epilepsy. The finding of choline in both cases is there- 

 fore not unexpected, and these are just the cases where the choline test 

 should come to the assistance of the clinical observer, in pointing to the 

 probability that an organic lesion is at the root of the malady. 



It now remains to explain how it is that Donath's method gave 

 always a positive result, although choline could not be detected by the 

 periodide test. 



In the first place, Donath's method always gives positive results, not 

 only in cases of epilepsy, but also in normal cerebro-spinal fluid, or in the 

 cerebro-spinal fluid of every disease in which I have had the opportunity of 

 examining it. 



These results are shown in Table III., p. 295. 



In cases 12 and 13 the fluid was normal, and in case 16 the fluid was 

 also approximately normal. 



Negative results (by the periodide test) in cases of meningitis were 

 previously noted by Rosenheim;^ inflammation of the meninges does not 

 necessarily cause any noteworthy change in the underlying cerebral matter. 

 Yet, as the table shows, all cases gave a positive result when subjected to 

 Donath's test. 



As it seemed possible, as mentioned before, that the obtaining of 

 anisotropic crystals may indicate the presence of other organic bases, I 

 collected the platinum precipitates of several cases (which gave a positive 

 1 Journ. of Physiol., xixv., p. 467, 1907, 



