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PLEURAL FLUID. 357
in globulin. The ordinary statement that pericardial fluids are richer
in fibrinogen than other transudates is hardly based on sufficient proof.
In a case of chylopericardium, which was probably due to the rupture
of a chylous vessel, or caused by a capillary exudation of chyle because
of stoppage, Hasebroek l
found in 1000 parts of the fluid 103.61 parts
solids, 73.79 parts proteins, 10.77 parts fat, 3.34 parts cholesterin, 1.77
parts lecithin, and 9.34 parts salts.
The pleural fluid occurs under physiological conditions in such small
quantities that a chemical analysis of it cannot be made. Under patho-
logical conditions this fluid may show very variable properties. In
certain cases it is nearly serous, in others again sero-fibrinous, and in others
similar to pus. There is a corresponding variation in the specific gravity
and the properties in general. If a pus-like exudate is kept enclosed for
a long time in the pleural cavity, a more or less complete maceration
and solution of the pus-corpuscles is found to take place. The ejected
yellowish-brown or greenish fluid may then be as rich in solids as the
blood-serum; and an abundant flocculent precipitate of a nucleoalbumin
or nuceloprotein (the pyrin of early writers) may be obtained on the
addition of acetic acid. This precipitate is soluble with difficulty in
an excess of acetic acid.
Numerous analyses, by many investigators,2
of the quantitative
composition of pleural fluids under pathological conditions have been
published. From these analyses we learn that in hydrothorax the
specific gravity is lower and the quantity of protein less than in pleuritis.
In the first case the specific gravity is generally less than 1.015, and the
quantity of protein 10-30 p. m. In acute pleuritis the specific gravity
is generally higher than 1.020, and the quantity of protein 30-65 p. m.
The quantity of fibrinogen, which in hydrothorax is about 0.1 p. m.,
may amount to more than 1 p. m. in pleuritis. In pleurisy with an
abundant accumulation of pus, the specific gravity may rise even to 1.030
according to the observations of Hammarsten. The quantity of solids
is often 60-70 p. m., and may be even more than 90-100 p. m. (Ham-
marsten). Mucoid substances have also been detected in pleural fluids
by Paijkull. Cases of chylous pleurisy are also known; in such a
case M£hu 3
found 17.93 p. m. fat and cholesterin in the fluid.
The quantity of peritoneal fluid is very small under physiological
conditions. The investigations refer only to the fluid under diseased
1
Zeitschr. f. physiol. Chem., 12.
2
See the works of M6hu, Runeberg, F. Hoffmann, Reuss, all of which are cited in
Bernheim’s paper in Virchow’s Arch., 131, 274. See also Paijkull, 1. c, and Halli-
burton’s Text-book, 346; Joachim, 1. c.
1
Arch. gen. de meYl., 1886, 2, cited from Maly’s Jahresber., 16.
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