Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case historiesSouthard, Elmer Ernest
Science
Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case histories
Southard, Elmer Ernest
Neurosyphilis
1. Does the “paretic” gold sol reaction mean general paresis? In
connection with this general question, a brief summary of the
significance of the gold sol reaction in this group may be made.
(1) Fluids from cases of general paresis in the vast majority of
cases will give a strong and fairly characteristic reaction,
especially if more than one sample is tested. (2) Very rarely
general paresis fluid will give a reaction weaker than the
characteristic one. (3) Fluids from cases of syphilitic
involvement of the central nervous system other than general
paresis often give a weaker reaction than the paretic, but in a
fairly high percentage of cases give the same reaction as the
paretics. (4) Non-syphilitic cases may give the same reaction as
the paretics; these cases are usually chronic inflammatory
conditions of the central nervous system. (5) When a syphilitic
fluid does not give the strong “paretic reaction” it is
presumptive evidence that the case is not general paresis, and
this test offers a very valuable differential diagnostic aid
between general paresis, tabes, and cerebrospinal syphilis. (6)
The term “syphilitic zone” is a misnomer, as non-syphilitic as
well as syphilitic cases give reactions in this zone, but no fluid
of a case with syphilitic central nervous system disease has given
a reaction out of this zone, so that the finding may be used
negatively; and any fluid giving a reaction outside of this zone
may be considered non-syphilitic. (7) Mild reactions may occur
without any evident significance, while a reaction of no greater
strength may mean marked inflammatory reaction. (8) Tuberculous
meningitis, brain tumor, and purulent meningitis fluids
characteristically, though not invariably, give reactions in
higher dilutions than syphilitic fluids. (9) The unsupplemented
gold sol test is insufficient evidence on which to make any
diagnosis, but used in conjunction with the W. R., chemical and
cytological examinations, it offers much information, aiding in
the differential diagnosis of general paresis, cerebrospinal
syphilis, tabes dorsalis, brain tumor, tuberculous meningitis, and
purulent meningitis. (10) We believe that no cerebrospinal fluid
examination is complete for clinical purposes without the gold sol
test.
=FREQUENT SYMPTOMS IN DIFFUSE AND VASCULAR NEUROSYPHILIS=
=(“CEREBRAL” AND “CEREBROSPINAL SYPHILIS”)=
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