1912] Martin H. Fischer 455 



colloidal coördinations in cells, in response to various prevailing influ- 

 ences in incipient edema? (Page 310.) 



I do not understand this. 



Does it foUow, because acids increase colloidal hydrophilia and 

 because lactic acid production is increased by suboxidation in tissues 

 as edema is there inaugurated, that the edema is caused or initiated by 

 the resultant lactic acid? (Page 310.) 



A question in logic. This could be answered correctly by either 

 yes or no. 



Have the possible influences of hydrolases been duly considered? 

 Is it improbable or impossible that such enzymes are even more im- 

 portant factors in the development of edema than the acid which is 

 produced and to which Fischer attributes the whole hydrops? 

 (Page 310.) 



Ferments have been considered. Whether they are as impor- 

 tant as the acid or more so, or whether acids and ferments act 

 together, cannot yet be said, for quantitative studies of the subject 

 were lacking when I wrote on edema, and are still lacking. When 

 they have been made — and work has been progressing on this sub- 

 ject for a year past in our laboratory — the answer will be easy. 



May not enzymes of this kind — aided perhaps by organic acids or 

 acid salts or both — cause such changes in the normal intracellular 

 colloidal coördinations and in the colloids themselves as to result in 

 increasing the total affinity for water by the parts involved ? ( Page 310.) 



Certainly, and I have said so repeatedly in my various books 

 and papers. 



Are the hydrostatic phenomena of certain edemas clarified by 

 Fischer's conception of directive colloidal hydrophilia? (Page 310.) 



I think so. Body position influences the circulation, which in 

 turn influences the oxygen supply to a part, etc., as I have previously 

 pointed out. 



Does his theory account for the great diversity in composition of 

 edematous fluids ? Repeated severe hemorrhage, on a free diet, is fol- 

 lowed by the urinary excretion of lactic acid in exceptional quantities 

 but there is no visible anasarca. Why not? 



