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JAMA. 1935;105(17):1333-1340. doi:10.1001/jama.1935.02760430023007.
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In 1931 I published an article on the treatment of infections of the central nervous system by forced spinal drainage, describing cases of poliomyelitis, acute encephalitis, septic meningitis and syphilitic meningitis. These cases were treated by spinal drainage coincident with the intravenous injection of hypotonic solution. These were the first cases treated by this method to be described in the medical literature.

The term "forced spinal drainage" has led to some misconception as to the essential factor involved in this treatment. The term suggests that drainage of the spinal fluid is essential. If this were true, the amount of spinal fluid produced in a certain case would have some relation to the therapeutic result. This has not occurred. I have therefore suggested the term, "forced perivascular drainage," to emphasize better one of the chief factors.

THE PHYSIOLOGIC BASIS OF THE TREATMENT  Starling1 in 1909 published his studies on the


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