358 CHYLE, LYMPH, TRANSUDATES AND EXUDATES. 



conditions (ascitic fluid). The color, transparency, and consistency of 

 these may vary greatly. 



In cachectic conditions or a hydrsemic condition of the blood the fluid 

 has little color, is milky, opalescent, watery, does not coagulate spon- 

 taneously, has a very low specific gravity, 1.006-1.010-1.015, and is 

 almost free from form-elements. The ascitic fluid in portal stagnation, 

 or in general venous congestion, has a low specific gravity and contains or- 

 dinarily less than 20 p. m. protein, although in certain cases the quantity 

 of protein may rise to 35 p. m. In carcinomatous peritonitis it may have a 

 cloudy, dirty-gray appearance, due to its richness in form-elements of 

 various kinds. The specific gravity is then higher, the quantity of solids 

 greater, and it often coagulates spontaneously. In inflammatory proc- 

 esses it is straw- or lemon-yellow in color, somewhat cloudy or reddish, 

 due to leucocytes and red blood-corpuscles, and from great richness in 

 leucocytes it may appear more like pus. It coagulates spontaneously 

 and may be relatively richer in solids. It contains regularly 30 p. m. 

 or more protein (although exceptions with less protein occur), and may 

 have a specific gravity of 1.030 or above. On account of the rupture 

 of a chylous vessel, the ascitic fluid may be rich in very finely emulsified 

 fat (CHYLOUS ASCITES). In such cases 3.86-10.30 p. m. fat has been 

 found in the ascitic fluid (GUINOCHET, HAY x ), and even 17-43 p. m. 

 has been found by MINKOWSKI. 



As first shown by GROSS, an ascitic fluid may have a chylous appearance 

 without the presence of fat, i.e., pseudochylous. The cause of the chylous 

 properties of a transudate is not known, although numerous investigators, 

 such as GROSS, BERNERT, MOSSE, and STRAUSS, have studied the sub- 

 ject; several observations, however, seem to show that it is connected 

 with the amount of lecithin contained therein. In a case investigated 

 by H. WOLFF 2 the oleic-acid ester of cholesterin was combined either 

 chemically or molecularly with the euglobulin. 



By admixture of ascitic fluid with that from an ovarian cyst the 

 former may sometimes contain pseudomucin (see Chapter XII). There 

 are also cases in which the ascitic fluid contains mucoids which may be 

 precipitated by alcohol after removal of the proteins by coagulation at 

 boiling temperature. Such mucoids, which yield a reducing substance 

 on boiling with acids, have been found by HAMMARSTEN in tuberculous 

 peritonitis and in cirrhosis hepatis syphilitica in men. According to the 

 investigations of PAIJKULL, these substances seem to occur often and 

 perhaps habitually in the ascitic fluids. 



1 Guinochet, see Strauss, Arch, de Physiol., 18. See Maly's Jahresber., 16, 475. 



2 Gross, Arch. f. exp. Path. u. Pharm., 44; Bernert, ibid., 49; Mosse, Leyden's 

 Festschrift, 1901; Strauss, cited in Biochem. CentralbL, 1, 437; Wolff, Hofmeister's 

 Beitrage, 5. 



