Abstract
Dandy and Blackfan have shown that the injection of phenolsulphonephthalein 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 hydrocephalus 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 Wassermanns 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. Appearance 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.
IV. Thirty-one cases having both physical and laboratory evidence of central nervous system disease. Appearance time fourteen to eighty minutes, averaging forty-six minutes.
In a general way, delay in excretion ran parallel to the severity of the clinical symptoms, but the quantity eliminated has appeared to be more variable.
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