362 EDEMA 



simple chemicals enter the normal spinal fluid but very httle,^- ex- 

 cept perhaps alcohol. ^''^ According to Rosenbloom'*'* there is no crea- 

 tin or creatinine. It contains normally from 2 to 4 mg. of amino-N 

 per 100 c.c, or about half that in the blood, without definite changes 

 in syphilis. ^^ There is almost the same amount of urea as in the 

 serum of the same person, i. e., 20" to 42 mg. per 100 c.c.*® In uremia 

 the non-protein constituents of the spinal fluid increase with those of 

 the blood, but to a less degree. Substances giving the ninhydrin 

 test appear in meningitis,'*^ but Rosenberg states that even with the 

 highest indicanemia"*^ no indican is found in the spinal fluid. Sugar 

 is present in from 0.07 to 0.085 per cent, and is not modified signifi- 

 cantly in mental diseases;*^ it is reduced in meningitis but increased in 

 uremia.^" There is only a very small amount of diastase, not bearing 

 any constant relation to the cell count. '^^ 



Xanthochromia. — In cases of retention of spinal fluid, usually in a 

 lumbar cul-de-sac, it may assume a yellow color although free from 

 blood pigment, containing much globulin and coagulating spontane- 

 ously (Froin's syndrome) . The color is apparently due to concentra- 

 tion of plasma held for some time in the spinal canal and may be 

 from bilirubin. ^^ Most usually this condition accompanies tumor of 

 the spinal cord.^^ 



Wound secretions obtained from large aseptic wounds, mostly amputation 

 stumps, have been studied by Lieblein.'''' The reaction is generally alkaline, 

 globulin and albumin abundant, but fibrinogen scanty, total nitrogen being less 

 than that of the blood and decreasing from day to day; the proportion of albumin 

 increases and globulin decreases as healing progresses. Occasionally albumoses 

 were found, but only on the first day in aseptic wounds; if found later, they gener- 

 ally were antecedent to suppuration (concerning suppuration see "Inflammation, " 

 Chap. xi). 



Blister fluid is generally rich in solids and proteins (40-65 p. m.). In a burn 

 blister Morner^^ found 50.31 p.m. proteins, among which were 11.59 p. ni. globulin 

 and but 0.11 p. m. fibrin; also a substance reducing copper oxide, but not pyro- 

 catechin. By refractometric determinations the amount of protein in blister 

 fluids is in direct proportion to the amount in the blood. ^'' Antibodies of all 



" See Rotky, Zeit. klin. Med., 1912 (75), 494. 



" Schottmiillerand Schumm, Neurol. Zbl., 1912 (31), 1020. 



" Biochem. Bull., 1916 (5), 22. 



« Ellis, elal, .Jour. Amer. Med. Assoc, 1915 (64), 126. 



« Ellis and Cullen, Jour. Biol. Chem., 1915 (20) 511. 



^^ Nobel, Miinch. med. Woch., 1915 (62), 1355, 1786. 



^» Berl. kl. Woch., 1916 (53), 1314. 



^' Weston Jour. Med. Res., 1916 (35), 199; Kraus and Corneille, Jour. Lab. 

 Clin. Med., 1916 (1), 685. 



" Leopold and Bernhard, Amer. Jour. Dis. Chil., 1917 (13), 34. Discussion of 

 chemistry of spinal fluid in children. 



" Jicsclike and Pincussohn, Deut. med. Wochs., 1917 (43), 8; Katakura, Kyoto 

 Jour. Med. Sci., 1916 (13), 1. 



" Bauer and Spiegel, Deut. Arch. klin. Med., 1919 (129), 18. 



6» Review by Sprunt and Walker, Bull. Johns Hop. IIosp., 1917 (28), 80; Elsberg 

 and Rochfort, Jour. Amer. Med. Assoc, 1917 (68), 1S02. 



" Beit. klin. Chir., 1902 (35), 43. 



" Hammarsten, "Physiological Chemistry." 



59 Engel and Orszag, Zeit. klin. Med., 1909 (67), 175. 



