ON THE EQUILIBRIUM CONDITION BETWEEN BLOOD 

 SERUM AND SEROUS CAVITY FLUIDS. 



By ROBERT F. LOEB, DANA W. ATCHLEY, and WALTER W. PALMER. 



With the Assistance of Ethel M. Benedict. 



(From the Department of Medicine of the College of Physicians and Surgeons 

 of Columbia University, and the Presbyterian Hospital, New York.) 



(Received for publication, April 6, 1922.) 

 INTRODUCTION. 



There has been much speculation concerning the mechanism by 

 which fluid accumulates in the serous cavities of the body. The 

 presence of ascitic fluid in cirrhosis of the liver has been attributed to 

 compression of the portal circulation. In certain types of renal 

 disease, the retention of fluid has been attributed to some disturbance 

 of kidney function. Fluid accumulations in serous cavities, in in- 

 flammatory conditions, have been ascribed to an increased permea- 

 bility of the capillaries. Thus, it appears, that in the minds of in- 

 vestigators, these various types of edema are classified as unrelated 

 phenomena. 



We have made a preliminary study of several physicochemic al 

 properties of blood sera and edema fluids simultaneously obtained. 

 The cases studied include heart disease and nephritis with ascites, 

 hydrothorax, and subcutaneous edema; cirrhosis of the liver with 

 ascites; and tuberculous pleurisy with effusion. The results seem to 

 indicate that certain constant qualitative relationships exist between 

 blood serum and fluids in the serous cavities (peritoneal and pleural), 

 regardless of the nature of the fluids or the type of disease. 



EXPERIMENTAL. 



70 cc. of blood were removed from an arm vein and placed in large 

 centrifuge tubes under oil without exposure to the air. After clot- 

 ting and centrifugalization, the serum was removed. The patients 

 were tapped immediately after the removal of the blood and the ascitic 



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