362 EDEMA 



that even with the hig'liest indieanemia '^"^ no indicaii is found in the 

 spinal fluid. Su<iar is present in from 0.07 to 0.085 per cent, and is 

 not modified sig'uificantly in mental diseases.^^'" Tliere is only a very 

 small amount of diastase, not bearing any constant relation to the cell 

 count. ^^^ 



Wound secretions obtained from lar<'P aseptie wounds, mostly amputation 

 stumps, liavc been studied by Lieblein.i''' Tlie reaction is generally alkaline, 

 jrlobulin and alb\imin abundant, but tibrinoaen scanty, total nitr()ii:en beiu'i less 

 than that of tlie blood and decreasino- from day to day; the proportion of albumin 

 increases and trloluilin decreases as liealino: ])rou:resses. Occasionally albumoses 

 were found, but only (m the first day in asejjtic wounds: if found later, thev 

 ffenerallv were antecedent to suppuration (concerning suppuration see ''Inflam- 

 mation,"' (hap. X.) . 



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

 blister i^b'irner i" found 50.31 p.m. proteins, among which were 11.50 p. m. globulin 

 and but 0.11 p. m. fibrin; also a substance reducing copper oxide, but no pyro- 

 catechin. By refractometric determinations the amount of protein in blister 

 fluids is in "dirwt pro])ortion to tlie amount in the blood. i" Antiljodies of all 

 sorts seem to pass readily into blister fluids,is although tlie complement-fixation 

 reaction is not so strong as with the blood. isa 



Chylous Effusions.^' — Fat may be present in effusions in sufficient 

 quantity to cause a milky appearance, either from escape of chyle 

 from a ruptured or obstructed thoracic duct, or throuoh fatty degen- 

 eration of the cells in the effusion or the lining of the walls of the 

 cavity. The former are designated as chylous, the others as chyli- 

 foDii or adipose fluids, but it is ^lot always easy to distinguish be- 

 tween them. The composition of the fluids in true chylous exudates 

 will vary according to the food taken and the amount of fat the food 

 contains, and will resemble the composition of chyle, except to the 

 extent that it is modified by the effusion or absorption going on in the 

 cavity. They are characterized by strong bactericidal powers as evi- 

 denced by lack of putrefaction after long standing. 



Analyses of human chyle are scanty. Panzer 20 found 00.29-04.5.3 per cent, 

 water ;' 5.47-0.71 per cent, solids; 0.80-1.04 per cent, inoraanic salts; 2.1(5 per 

 cent, coagulable protein; 0.50 per cent, ether-soluble material; also diastatic en- 

 zyme, soaps, and occasionally traces of cholesterol, lecithin, and sugar. Carlier.-i 

 in a specimen from a child, obtained very similar results, excejit tluit tlie salts 

 were much less a])undant. The proteins and fats vary greatly witli the did : thus 

 Sollmann -- found variations in the jiroteins from 1.S5 to (i.o per cent. 



i4eBerl. kl. Wocli.. 1016 (53), 1314. 



i4f Weston, Jcnir. Aled. I'es.. lOKi (35), 100; Kraus and Corneille. .Tour. Lab. 

 Clin. ^Fed., 1016 (1), 685. 



i-*« lycsclike and Pincussohn. Deu(. nicd. Woclis., 1017 (43), S. 



ir. T?eit.. klin. C'liir., 1002 (35), 43. 



Ki Ilammarsten, .Amer. ed., 1004. p. 224. 



17 En gel and Ors/ag, Zeit. klin. :Med., 1000 (67), 175. 



i« p:isenberg. Dent. med. Woch., 1000 (35), (il3. 



isaBusclike and Zimmcrmann. Med. Klinik, 1013 (0), 1082. 



in Literature bv (iandin, Krgeb. inn. ]\1e<l., 1013 (12), 218. 



20 Zeit. phvsiol. Chem.. 1000 (30), 113. 



21 British 'iMed. Jour.. 1002 (ii), 175. 



22 Amer. .Tour. Ph\sinl., 10(17 (17). 4S7 : see also Ilainill. Jour. Pliysiol.. 1006 

 (35), 151. 



