By fractional lumbar puncture is understood the removal of liquor cerebrospinalis in a number of separate portions. It is a diagnostic procedure which the author of this book has elaborated and discussed in the minutest detail from observations on seventy-three patients, covering a period of four years.
The method is simple enough. The patient is placed in the right lateral prone position on a table the head end of which is elevated 30 cm., the knees being drawn up in the usual manner.
The puncture is made with 1.2 mm. and 1.5 mm. (external diameter) needles, respectively, for children and adults. The interspaces utilized are not mentioned, but presumably are the third and fourth lumbar. The liquor is collected in six portions of from 2 to 3 cc. or 3 to 4 cc. and immediately stoppered. The cells are then stained in the diluted fluid with a solution containing methyl