In 1919 Wegeforth, Ayer and Essick described the direct puncture of cisterna cerebello-medullaris. Without knowledge and independent of this Karl Eskuchen recommended in 1923 to tap the cistern after touching the squama occipitalis before. His proceeding found general resonance. It is less dangerous and practicable without much experience. Originally there were numerous diagnostical, therapeutical and scientific indications for the suboccipital puncture. Most of them are out of date. Still, it is the only practicable alternative when the lumbal puncture was with no purpose.