232 



THE LIQUIDS IN DROPSIES. 



[BOOK i. 



Dropsy due to an altered relation between arterial and venous 

 pressure is aptly exemplified by the dropsy -in certain cases of heart 

 disease, or which is due to the pressure of an abdominal tumour, or a 

 cirrhosed liver, upon the inferior vena cava. In these cases the dropsy 

 is not general, but only affects the vascular area connected with the 

 obstructed veins. 



It was long ago pointed out by C. Schmidt that where dropsical 

 accumulations occur simultaneously in various regions as, for example, 

 in the subcutaneous connective tissue and in several serous sacs, 

 the composition of the extravasated liquid varies in the different situ- 

 ations in consequence of local peculiarities, so that if the liquids were 

 withdrawn and were to accumulate again, (the condition of the blood 

 remaining constant in the interval), the second accumulations would ex- 

 hibit the same absolute composition and relative differences as the first. 



The different dropsical fluids may be arranged in the following 

 order, according to their richness in proteids : 



(1) Pleuritic fluid : (2) Peritoneal fluid : (3) Cerebro-spinal fluid : 

 (4) Fluid of subcutaneous oedema. 



The quantitative differences in composition presented by fluids 

 removed at the same time from different serous cavities and from the 

 subcutaneous areolar tissue may be illustrated by quoting the two 

 following series of analyses. 



I. Composition of various dropsical fluids removed simultaneously from 

 the body of a person who had died of albuminuria (C. Schmidt 1 ). 



Fluid from 



Pleura. Peritoneum. 



Water in 1000 parts 

 Solid matters 

 Organic 

 Inorganic 



963-95 



36-05 



28-50 



7-55 



978-91 

 21-09 

 11-32 



9-77 



II. Composition of the dropsical liquid removed simultaneously from a 

 patient affected with albuminuria (Hoppe-Seyler 2 ). 



Fluid from 



Pleura. Per 

 Water in 1000 parts 

 Solids ^ 

 Albumin ,, 

 Ethereal Extract] 

 Alcoholic in 



Aqueous \- 1000 

 Inorganic salts parts. 

 Loss 



1 Schmidt, Zur diarakteristi'k der epid. Cholera, p. 116 et seq., quoted by Hoppe- 

 Seyler, Phys. Chemie, p. 602. 



2 Hoppe-Seyler, Yirchow's^rc/iiy, Vol. ix. (1856) p. 257. 



