426 



LANGE'S PARESIS TEST 



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. 



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. 



Miller gives the following table as to pleocytosis: 



AVERAGE INCIDENCE OF LYMPHOCYTOSIS IN THE SPINAL FLUID 

 (Plaut, Rehm and Schottmuller) 



Colloidal Gold Test (Lange's). It is now generally accepted that 

 this test is more diagnostic of general paresis than any other single 

 test. The color changes in the first five tubes (i-io; 1-160) are so 

 constant that the term "paretic curve" is applied to such findings. 

 Of less diagnostic value are the so-called cerebrospinal lues curves 

 where the color changes, though of less intensity than the paretic ones, 

 are most marked in the third, fourth, fifth and sixth tubes (1-40 to 1-320). 

 In various types of meningitis, other than luetic, the color changes are 

 at times more marked in the tubes with the higher dilutions of spinal 

 fluids (from 1-320 to 1-2560). 



The paretic curve of the colloidal gold test generally runs parallel with a spinal 

 fluid Wassermann and globulin increase. This agreement does not exist at all con- 

 stantly for positive blood-serum Wassermann tests and increased cell counts. 



It may be stated that this test is of more importance in paresis than any single one 

 of the four reactions of Nonne, viz. (a) blood-serum Wassermann (b) spinal fluid 

 Wassermann (c) globulin increase and (d) increased cell count of spinal fluid (pleo- 

 cytosis). Of course, all of these tests should be carried out. 





