3o6 Fische/s Theory of Edema [Dec. 



power of exciting edema in a normal tissue; or of causing such 

 colloids as fibrin, when immersed in it, to swell; or of absorbing 

 more water than that attracted by an equal volume of similar juice 

 from nonnal tissue of the same kind? Does the minimal Propor- 

 tion of lactic acid which is capable of inducing edema in a living 

 tissue destroy the life of any of the cells or definitely impair normal 

 cellular activity? Does such a proportion of lactic acid remove 

 from its setting in protoplasm any basic factor of importance in the 

 essential intracellular coordinations? 



In Fischer's view the water of edema diffuses from the capil- 

 laries to the tissue Spaces and thence into the cells in response to the 

 attraction exerted for it there by intracellular colloids under the 

 influence of abnormal proportions of acid. Does the production of 

 lactic acid in an edematous tissue keep pace with the inflow and 

 accumulation of water? Does the water which accumulates in a 

 case of edema leave behind it all its former associates in lymph, 

 such as phosphate and bicarbonate, when it enters the edematous 

 field? Does edema result from the action of sodium di-hydrogen 

 (acid) phosphate, or of any other acid salt produced by combina- 

 tions of intracellular alkalin Compounds with any lactic acid that 

 may become available? Does such acid induce edema, or does it 

 combine with or affect protein in any way, in the presence of an 

 excess of alkalin material? 



Fischer demonstrated the striking power of small proportions 

 of electrolytes as agents which counteract the sweUing influence of 

 acids, even when the latter are present in large excesses. He does 

 not explain these effects although he emphasizes their importance 

 and their Utility. He shows that tartrate and phosphate anions are 

 particularly active in this respect, but he does not appear to consider 

 the probable tendency of phosphate in the tissues to interfere with 

 the swelling influence of such quantities of lactic acid as may be 

 presumed to occur there under pathological conditions. He fails 

 to indicate how much or how little the lactate arising from neutrali- 

 zations in such cases antagonizes the bloating influences of the lactic 

 acid which, let us assume, keeps on developing in an edematous 

 tissue. 



Fischer shows that alternate treatment of colloids with acids 



