igi2] Martin H. Fischer 449 



Wolfgang Pauli and others can do this better. An edema does not 

 develop as long as the phosphates are capable of counteracting the 

 effect of the acids in the tissues or the lactic acid is changed to a 

 lactate. Edema comes on when this neutralization mechanism has 

 been exhausted. In his intense contemplation of the individual cell 

 Gies often overlooks the complex organism as a whole. When we 

 introduce acid into the body we reduce the total alkali content and 

 therefore the alkali content of every cell and tissue; although for a 

 number of reasons, not necessarily all are altered to the same degree. 

 The blood and lymph are not perpetual fountains of water, alkali 

 and salts, but are readily exhaustible. 



Fischer shows that alternate treatment of colloids with acids and 

 salins reduces the hydrophilic tendency of the colloids in the presence 

 of acid, bnt he does not discuss this Observation in its relation to 

 similar conditions in cells and tissues. 



The diffusion tendencies and effects in edematous tissues are 

 ignored. Does lactic acid accumulate in an edematous tissue as lactic 

 acid or in the form of lactates, or does it pass out of the tissue as acid 

 or as lactates ? What is the minimal concentration of lactic acid which 

 is able, in Solutions containing the physiological salins in their ordinary 

 proportions, to bring about swelling of any of the colloids or colloidal 

 masses which Fischer used in his experiments? Does this proportion 

 of lactic acid ever occur in edematous tissue? Do acid salts favor or 

 retard the tendency of lactic acid to increase the affinity of colloids 

 for water? (Page 306.) 



Sins of Omission. Some of these points are discussed in papers 

 that have appeared since my book on edema. 



Fischer did not consider the probable or possible bearing of definite 

 chemical relationships between the colloids and the acid in the case. 

 Are definite unions or relationships between tissue colloids and lactic 

 acid essential to the edematous manifestation of colloidal hydrophilia? 

 If so, do the tissue colloids and lactic acid form a hydrophilic part- 

 nership in the presence of such substances as di-sodium hydrogen 

 phosphate and sodium bicarbonate? (Page 307.) 



A discussion of this involves us in a discussion of the theory 

 of the colloidal State. Part of the phenomena here are purely 

 physical, as the adsorption phenomena. Others are chemical, as in 



