354 CHYLE, LYMPH, TRANSUDATES AND EXUDATES. 



perhaps in the cerebrospinal fluid, and in those cases where an autolysis 

 has taken place in the liquid. 1 The non-inflammatory transudates do 

 not as a rule undergo spontaneous coagulation or do so only very slow- 

 ly. On the addition of blood or blood-serum they coagulate. Inflam- 

 matory exudates coagulate spontaneously, and PAIJKULL has shown 

 that these often contain nucleoprotein (or nucleoalbumin) . In inflam- 

 matory exudates a protein substance has been habitually observed which 

 is precipitated by acetic acid, but which does not occur in transudates, 

 or only in very small quantities. This substance, which has been observed 

 and studied by MOBITZ, STAEHELIN, UMBER, and RIVALTA, is claimed 

 by the first three observers to be free from phosphorus, while RIVALTA 

 considers it to be a phosphorized pseudoglobulin. UMBER calls it sero- 

 samucin, although it yields only very little reducing carbohydrate. 

 According to JOACHIM 2 it is only a part of the globulin, a view which can- 

 not be correct for all cases, v. HOLST 3 has so far substantiated UMBER'S 

 observation in that he has isolated a mucin substance from an ascitic 

 fluid in carcinoma of the stomach and the peritoneum, which seemed to 

 be identical with UMBER'S serosamucin, as well as with the synovial 

 mucin. There does not seem to be any doubt that in transudates and 

 exudates, different protein substances may occur under different cir- 

 cumstances, although the globulins form besides seralbumin the principal 

 mass of the protein bodies. Mucoid substances, which were first 

 observed by HAMMARSTEN in certain cases of ascites without complica- 

 tions with ovarial tumors, and which are cleavage products of a more 

 complicated substance, seem according to PAIJKULL 4 to be regular 

 constituents of transudates and are closely related to . the above-men- 

 tioned serosamucin. The occurrence of the above-mentioned substances 

 precipitable by acetic acid, the globulins (RIVALTA) and the nucleo- 

 proteins, in puncture fluids, has been recognized as of very great impor- 

 tance in the differential diagnosis between transudates and exudates. 

 There are numerous investigations on the relation between glob- 

 ulin and seralbumin, and JOACHIM has determined the relation between 

 euglobulin and the total globulin. No conclusive results can l>e drawn 

 from these determinations. The relation between globulin and seral- 

 bumin varies very much in different cases, but, as HOFFMANN and 



^Umber, Munch, med. Wochenschr., 1902, and Berlin, klin. Wochenschr., 1903. 

 In regard to the autolysis in transudates, see also Galdi, Biochem. Centralbl., 3; 

 Eppinger, Zeitschr. f. Heilkunde, 25, and Zak, Wien. klin. Wochenschr., 1905. 



2 Paijkull, 1. c.; Moritz, Munch, med. Wochenschr., 1903; Staehelin, ibid., 1902, 

 Umber, Zeitschr. f. klin. Med., 48; Rivalta, Biochem. Centralbl., 2 and 5; Joachim; 

 Pfliiger's Arch., 93. 



3 Zeitschr. f. physiol. Chem., 43. 



4 Hammarsten, ibid., 15; Paijkull, 1. c. 



