532 



SEROUS AND SYNOVIAL MEMBRANES. 



exactly alike in this respect. The following 

 table exhibits four analyses, contrasted with 

 that of the serum of the blood : 



The difference in the amount of albumen 

 which these analyses exhibit is very striking ; 

 and the large quantity present in the latter 

 is especially remarkable as offering nearly 

 four times the quantity which is present in 

 the serum of the blood. The anomaly of an 

 unorganized liquid, derived from the blood, 

 possessing more of this important constituent 

 than the parent fluid, has been attributed by 

 Vogel to a reabsorption of the watery parts 

 subsequently to the effusion. The varying 

 methods of analysing these fluids leave less 

 room to remark quantitative differences of 

 their other constituents. The quantity of 

 salts seems, however, pretty constant ; al- 

 though the following analysis j exhibits a 

 singular increase in one of the most common 

 saline ingredients. It was taken from the 

 dropsical belly of a woman aged 40, and the 

 urine is stated to have contained about 6 

 parts in the 1000 of the same salt. 



Water 950 



Extractive, with, traces of albumen - 5'97 



Fat -----'- -84 



Almost pure chloride of sodium - 44 



1000-81 



The small number of analyses hitherto 

 made, and the incompleteness of the patho- 

 logical notice with which they are usually 

 accompanied, render it at present too early 

 to arrange the composition of these fluids in 

 any real connexion with the various morbid 

 states which have regulated their production. 

 But the possible cause of an excessive pre- 

 ponderance of albumen has been already 

 alluded to, and on the whole it seems likely 

 that the cases where this substance is of a 

 Jess remarkable, but still a considerable 

 amount, belong chiefly to the category of 

 dropsy from mechanical obstruction ; while 

 the dropsies of ana?mine, post-mortem trans- 

 udation, and the like, seem to be characterised 

 by the possession of a very small quantity of 

 albumen : thus the second analysis in the 

 table exhibits only three parts in the thousand ; 



* Eeduced from an analysis by Karl Frua. 

 Heller's Archiv., 1845, S. 363. The fluid was 

 found in the abdominal cavity. 



f An analysis by Vogel, from whose " Patholo- 

 gic " the remaining analyses by von Bibra, Dublanc, 

 and Lecanu, are quoted at second-hand. 



t Heller's Archiv fur Phys. und Path. Chemie, 

 1844, S. 47. 



and two or three others are given by the 

 same author, which have a very similar com- 

 position. In the serous fluids of the cerebral 

 ventricles, the quantity of albumen appears 

 still smaller, as is exemplified in the following 

 analysis by Berzelius.* 



Water 988 -3 



Chloride of sodium and potassium - 7-09 



Albumen _____ 1-66 



Lactate of soda, with alcohol extract - 2-32 



Soda '28 



Extractive, with traces of phosphates '35 



1000-00 



In respect of their diminished quantity of 

 albumen, it is difficult to avoid noticing their 

 approximation to the characters of the cerebro- 

 spinal fluid, the vitreous humor, and other 

 healthy effusions. 



The question that next suggests itself is, 

 " What relations do these fluids bear to the 

 serous membranes?" From a comparison of 

 the analyses quoted above, it is sufficiently 

 obvious that amid multiform phases of com- 

 position all these fluids preserve a close re- 

 semblance to the serum of the blood ; a feature 

 which sufficiently testifies to their origin and 

 import, and which refers their production to 

 the conditions of the blood, and their consi- 

 deration to the pathology of this fluid, rather 

 than to the serous membranes in contact 

 with which they are found. And the bearing 

 of this evidence is corroborated by several 

 other facts. In a vast majority of cases, as 

 above mentioned, their occurrence may be 

 directly traced to blood disorders ; either a 

 qualitative affection of this fluid, or a me- 

 chanical distention of its containing vessels, 

 a mutual dependence which tends still more 

 to allot them to the blood rather than to the 

 serous membranes. Again, instead of their 

 presenting the cellular form, in which the ele- 

 ments of secretion, morbid as well as healthy, 

 are usually involved, and which they might be 

 expected to assume were they essentially the 

 product of the cell-growing membrane, they 

 are devoid of all appearances of such organ- 

 ization. While in place of being peculiar 

 to these membranes, it is found that an iden- 

 tical effusion obtains in the areolar tissue ; 

 a structure which is alike destitute of their 

 membranous form and epithelial covering. 



Inflammatory or flbrinous effusions. A 

 large number of the fluids which are found 

 effused in the interior of the serous mem- 

 branes offer characters which essentially dis- 

 tinguish them from the dropsical effusions 

 above described. The first and most pro- 

 minent differences are those presented by 

 their appearance and chemical composition. In 

 addition to the albumen and salts which form 

 the main constituents of the serous effusions, 

 they also offer a greater or lesser quantity of 

 fibrine ; and as this substance retains its or- 

 dinary power of spontaneous coagulation, its 

 presence is readily recognized by the eye. 



* Simon's Chemie, Band ii. 581. The case is 

 mentioned as " Plydrocephalus." 



