In normal cerebrospinal fluid the cells range from 0 to 3 per cubic mm. and are lympho-mononuclear in type. No neutrophilic granulocytes are seen, their appearance thus meaning a pathological condition, even when cell count remains normal. The foregoing paper deals with such peculiar sign. It was found in the following conditions: 1) brain softening in its acute period; 2) protracted insulinshock during Sakel's therapy; 3) status epilepticus in convulsionpatients; 4) cerebral concussion, even with otherwise normal liquor; 5) brain tumors; 6) mental confusion of the toxic or toxi-infectious groups, and 7) several acute conditions interfering with the brains functions. The above sign of neutrophilic granulocytosis in spite of normal cell counting bespeaks the impact on the brain of local circulatory disturbances, no matter the underlying condition. The latter may be cerebral edema through compression or venous stasis, as well as congestive states in general, or toxi-infectious diseases. Moreover, it may be the only cerebrospinàl fluid change disclosing the brain damage. As for the prognosis, this sign holds its value since it points to the local circulatory situation at the cerebral level, irrespective of the patient's general conditions.
