Abstract
In 1917 Levinson 1 observed that spinal fluids from cases of epidemic meningitis immediately after withdrawal had a subnormal pH. This was in some instances further decreased when the fluids were permitted to stand at room temperature unstoppered. However, normal and tuberculous meningitic fluids when freshly drawn showed similar figures for pH, and the pH increased on standing, particularly in the tuberculous fluids. Levinson believed that the lowering of the pH of the spinal fluid in meningococcus meningitis was due to the accumulation of lactic acid in the fluid, but he presented no data to substantiate this explanation.
In the present communication, data are presented for the sugar and lactic acid of the spinal fluid of normals, miscellaneous pathological conditions and meningitis. Clausen's method was employed for the determination of the lactic acid, and the Folin-Wu procedure for the sugar.
Specimens of spinal fluid obtained from five normal adults, after a night's fast and rest, showed lactic acid concentration from 8 to 15 mg. per 100 cc. In twenty-one miscellaneous non-meningitic cases the lactic acid varied from 9 to 26 mg. per 100 cc. Fluids obtained from two chronic nephritics after convulsions gave figures of 22 to 23 mg., and from two cases of encephlitis lethargica 26 and 23 mg. Clinical improvement in the instances of encephalitis was accompanied by a fall in the spinal fluid lactic acid to 18 and 17 mg. respectively. Meningismus associated with broncho-pneumonia in three children gave normal figures for the spinal fluid lactic acid.
Meningococcus meningitis in the seven patients studied presented figures for the spinal fluid lactic acid varying from 23 to 77 mg. per 100 cc. In all instances there was observed a decrease in the sugar, and in some no sugar was found.
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