PLEURAL FLUID. 357 



in globulin. The ordinary statement that pericardial fluids are richer 

 in fibrinogen than other transudates is hardly based on sufficient proof. 

 In a case of chylopericardium, which was probably due to the rupture 

 of a chylous vessel, or caused by a capillary exudation of chyle because 

 of stoppage, HASEBROEK l found in 1000 parts of the fluid 103.61 parts 

 solids, 73.79 parts proteins, 10.77 parts fat, 3.34 parts cholesterin, 1.77 

 parts lecithin, and 9.34 parts salts. 



The pleural fluid occurs under physiological conditions in such small 

 quantities that a chemical analysis of it cannot be made. Under patho- 

 logical conditions this fluid may show very variable properties. In 

 certain cases it is nearly serous, in others again sero-fibrinous, and in others 

 similar to pus. There is a corresponding variation in the specific gravity 

 and the properties in general. If a pus-like exudate is kept enclosed for 

 a long time in the pleural cavity, a more or less complete maceration 

 and solution of the pus-corpuscles is found to take place. The ejected 

 yellowish-brown or greenish fluid may then be as rich in solids as the 

 blood-serum; and an abundant flocculent precipitate of a nucleoalbumin 

 or nuceloprotein (the pyrin.of early writers) may be obtained on the 

 addition of acetic acid. This precipitate is soluble with difficulty in 

 an excess of acetic acid. 



Numerous analyses, by many investigators, 2 of the quantitative 

 composition of pleural fluids under pathological conditions have been 

 published. From these analyses we learn that in hydrothorax the 

 specific gravity is lower and the quantity of protein less than in pleuritis. 

 In the first case the specific gravity is generally less than 1.015, and the 

 quantity of protein 10-30 p. m. In acute pleuritis the specific gravity 

 is generally higher than 1.020, and the quantity of protein 30-65 p. m. 

 The quantity of fibrinogen, which in hydrothorax is about 0.1 p. m., 

 may amount to more than 1 p. m. in pleuritis. In pleurisy with an 

 abundant accumulation of pus, the specific gravity may rise even to 1.030 

 according to the observations of HAMMARSTEN. The quantity of solids 

 is often 60-70 p. m., and may be even more than 90-100 p. m. (HAM- 

 MARSTEN). Mucoid substances have also been detected in pleural fluids 

 by PAIJKULL. Cases of chylous pleurisy are also known; in such a 

 case MEHU 3 found 17.93 p. m. fat and cholesterin in the fluid. 



The quantity of peritoneal fluid is very small under physiological 

 conditions. The investigations refer only to the fluid under diseased 



1 Zeitschr. f. physiol. Chem., 12. 



2 See the works of Me"hu, Runeberg, F. Hoffmann, Reuss, all of which are cited in 

 Bernheim's paper in Virchow's Arch., 131, 274. See also Paijkull, 1. c., and Halli- 

 burton's Text-book, 346; Joachim, 1. c. 



3 Arch. ge"n. de med., 1886, 2, cited from Maly's Jahresber., 16. 



