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SPINAL FLUID CELL COUNT AND ENCAPSULATION OF BRAIN ABSCESS:  AN ATTEMPT TO CORRELATE THESE FACTORS, AND TO DETERMINE THE OPTIMAL TIME FOR DRAINAGE

HENRY W. WOLTMAN, M.D.
JAMA. 1933;100(10):720-722. doi:10.1001/jama.1933.02740100014005.
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In every case of abscess of the brain a twofold responsibility is thrown on physicians. First, the condition must be recognized, if possible, when it exists; mistakes are brought home at necropsy and one learns to do better. Second, the right thing must be done at the right time; this is much more difficult; of blunders one is often unaware, and unwittingly they are laid to the will of God. In a valuable paper on this subject, Grant1 stated: "Drainage of a brain abscess before encapsulation has occurred has been uniformly disastrous in our experience.... Only two patients died because operation was delayed too long."

I should like to dwell briefly on this question of the optimal time for drainage of an abscess of the brain, which was called to my attention by Adson2 and by Lillie,3 and to raise the question whether the cell count of

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