Absorption of Phenolsulphonephthalein. 65 



41 (1219) 



The absorption of phenolsulphonephthalein from the subarachnoid 

 space in diseases of the central nervous system. 



By Henry G. Mehrtens, M.D. and Howard F. West, M.D. 



(by invitation). 



[From the Division of Medicine, Stanford University Medical School, 

 San Francisco, Cal.] 



Dandy and Blackfan have shown that the injection of phe- 

 nolsulphonephthalein into the subarachnoid space in man is 

 harmless and in normal individuals appears in the urine in from 

 six to ten minutes. They also found in certain cases of hydro- 

 cephalus that there is a delay in the excretion of the dye. So far 

 as we know no determinations have been made of this delay in 

 other pathological conditions. 



A series of sixty-one patients, mostly with nervous diseases, 

 received injections of phenolsulphonephthalein after lumbar 

 puncture and the appearance time of the dye in the urine was 

 observed. These cases may be divided roughly into four groups, 

 as follows: 



I. Thirteen cases in which there was neither physical nor spinal 

 fluid evidence of central nervous disease, nor symptoms suggesting 

 organic nervous lesions. Appearance time was from four to 

 fourteen minutes — eleven appeared in ten minutes or under 

 — averaging nine minutes. 



II. Five cases with neither physical nor laboratory findings 

 positive, but with definite symptoms suggesting organic nervous 

 disease, as follows: Two patients having positive blood Wasser- 

 manns and symptoms of paresthesias, pain and mental disturbance, 

 one patient with aphasia, one with pains, nervousness, and loss 

 of sexual power, and one with dizziness and paresthesia. Ap- 

 pearance time was from thirteen to forty minutes, averaging 

 thirty minutes. 



III. Twelve cases having positive physical findings, but with 

 negative spinal fluids except for an occasional increase in pressure. 

 Appearance time fifteen to seventy minutes, averaging thirty-nine 

 minutes. 



