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352 CHYLE, LYMPH, TKANSUDATES AND EXUDATES.
tion in the cells, bodies of high molecular weight are split into a number
of smaller molecules, which latter, either directly, if they leave the cells
and pass into the tissue-fluid, or indirectly, when they remain in the cells,
produce an increase in the osmotic tension within the cells, and in this
way cause a taking up of water from the fluid, and must therefore increase
the osmotic pressure of the tissue-fluids. As the cells can by synthesis
build up highly complex constituents from simple molecules, and as the
chief products of catabolism are carbon dioxide and water, it is difficult
to explain these intricate conditions. Still, irrespective of whatever
view, a change in one or the other direction in the osmotic pressure
upon both sides of the capillary wall must be produced thereby. Whether
this and other physico-chemical processes are alone sufficient to explain
the lymph formation (Cohnstein, Ellinger) remains an open and
disputed question. 1
H. TRANSUDATES AND EXUDATES.
The serous membranes are normally kept moistened by liquids whose
quantity is sufficient only in a few instances, as in the pericardial cavity
and the subarachnoidal space, for a complete chemical analysis to be
made of them. Under diseased conditions an abundant transudation
may take place from the blood into the serous cavities, into the sub-
cutaneous tissues, or under the epidermis; and in this way pathological
transudates are formed. Such true transudates, which are similar to lymph,
are generally poor in form-elements and leucocytes, and yield only very
little or almost no fibrin, while the inflammatory transudates, the so-called
exudates, are generally rich in leucocytes and yield proportionally more
fibrin. As a rule, the richer a transudate is in leucocytes the closer it
stands to pus, while a diminished quantity of leucocytes renders it more
nearly like a real transudate or lymph.
It is ordinarily accepted that filtration is of the greatest importance
in the formation of transudates and exudates. The facts coincide with
this view that all these fluids contain the salts and extractive bodies
occurring in the blood-plasma in about the same quantity as the blood-
plasma, while the amount of proteins is habitually smaller. While the
different fluids belonging to this group have about the same quantities
of salts and extractive bodies, they differ from one another chiefly in
containing differing quantities of protein and form-elements, as well as
varying quantities of transformation and decomposition products of
these latter—changed blood-eoloring matters, cholesterin, etc. The
x
On this question see Ellinger, "Die Bildung der Lymphe," Ergebnisse der Phys-
iologic, I, Abt. 1, 355, and Asher, Biochem. Centralbl., 4, pp. 1 and 45.
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