340 CHYLE, LYMPH, TRANSUDATES AND EXUDATES. 



found in the ascitic fluid (GUINOCHET, HAY 1 ), and even 17-43 p. m. has 

 been found by MINKOWSKL 



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 the fluid from an ovarian cyst the 

 former may sometimes contain pseudomucin (see Chapter XIII). 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 sy philitica in men. According to the 

 investigations of PAIJKULL, these substances seem to occur often and per- 

 haps habitually in the ascitic fluids. 



As the quantity of protein in ascitic fluids is dependent upon the same 

 factors as in other transudates and exudates, it is sufficient to give the 

 following example of the composition, taken from BERNHEIM'S 3 treatise. 

 The results are expressed in 1000 parts of the fluid : 



Max. Min. Mean. 



Cirrhosis of the liver 34 . 5 5.6 9 . 6921 . 06 



Bright's disease 16.11 10.10 5.610.36 



Tuberculous and idiopathic peritonitis 55 . 8 18 . 72 30 . 7 37 . 95 



Carcinomatous peritonitis 54 . 20 27 . 00 35 . 1 58 . 96 



JOACHIM found the highest relative globulin amounts and lowest albumin 

 percentages in cirrhosis; in carcinoma, on the contrary, the lowest globulin and 

 the highest albumin. The values in cardiac stagnation stand between the cir- 

 rhosis and carcinoma percentages. 



Urea has also been found in ascitic fluids, sometimes only as traces, some- 

 times in larger quantities (4 p. m. in albuminuria), also uric acid, allantoin in 

 cirrhosis of the liver (MOSCATELLI), xanthine, creatine, cholesterin, sugar, diastatic 

 and proteolytic enzymes, and according to HAMBURGER 4 also a lipase. 



Hydrocele and Spermatocele Fluids. These fluids differ e'ssentially 

 from each other in various ways. The hydrocele fluids are generally 

 colored light or dark yellow, sometimes brownish with a shade of green. 



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. 



3 1. c. As it was impossible to derive mean figures from those given by Bernheim, 

 the author has given the maximum and minimum of the averages given by him. 

 4 Arch. f. (Anat. u.) Physiol., 1900, 433. 



