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358 CHYLE, LYMPH, TRANSUDATES AND EXUDATES.
conditions (ascitic fluid). The color, transparency, and consistency of
these may vary greatly.
In cachectic conditions or a hydrsemic condition of the blood the fluid
has little color, is milky, opalescent, watery, does not coagulate spon-
taneously, has a very low specific gravity, 1.006-1.010-1.015, and is
almost free from form-elements. The ascitic fluid in portal stagnation,
or in general venous congestion, has a low specific gravity and contains or-
dinarily less than 20 p. m. protein, although in certain cases the quantity
of protein may rise to 35 p. m. In carcinomatous peritonitis it may have a
cloudy, dirty-gray appearance, due to its richness in form-elements of
various kinds. The specific gravity is then higher, the quantity of solids
greater, and it often coagulates spontaneously. In inflammatory proc-
esses it is straw- or lemon-yellow in color, somewhat cloudy or reddish,
due to leucocytes and red blood-corpuscles, and from great richness in
leucocytes it may appear more like pus. It coagulates spontaneously
and may be relatively richer in solids. It contains regularly 30 p. m.
or more protein (although exceptions with less protein occur), and may
have a specific gravity of 1.030 or above. On account of the rupture
of a chylous vessel, the ascitic fluid may be rich in very finely emulsified
fat (chylous ascites). In such cases 3.86-10.30 p. m. fat has been
found in the ascitic fluid (Guinochet, Hay 1
), and even 17-43 p. m.
has been found by Minkowski.
As first shown by Gross, an ascitic fluid may have a chylous appearance
without the presence of fat, i.e., pseudochylous. The cause of the chylous
properties of a transudate is not known, although numerous investigators,
such as Gross, Bernert, Mosse, and Strauss, have studied the sub-
ject; several observations, however, seem to show that it is connected
with the amount of lecithin contained therein. In a case investigated
by H. Wolff 2
the oleic-acid ester of cholesterin was combined either
chemically or molecularly with the euglobulin.
By admixture of ascitic fluid with that from an ovarian cyst the
former may sometimes contain pseudomucin (see Chapter XII). There
are also cases in which the ascitic fluid contains mucoids which may be
precipitated by alcohol after removal of the proteins by coagulation at
boiling temperature. Such mucoids, which yield a reducing substance
on boiling with acids, have been found by Hammarsten in tuberculous
peritonitis and in cirrhosis hepatis syphilitica in men. According to the
investigations of Paijkull, these substances seem to occur often and
perhaps habitually in the ascitic fluids.
1
Guinochet, see Strauss, Arch, de Physiol., 18. See Maly’s Jahresber., 16, 475.
2
Gross, Arch. f. exp. Path. u. Pharm., 44; Bernert, ibid., 49; Mosse, Leyden’s
Festschrift, 1901; Strauss, cited in Biochem. Centralbl., 1, 437; Wolff, Hofmeister’s
Beitrage, 5.
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