304 EDEMA 



special fats taken in the food, e. g., butter- fats (Straus 1 ). The 

 reaction is usually alkaline or neutral, and some specimens 

 coagulate spontaneously. Specific gravity varies from 1.007 

 to 1.040, the average being about 1.017. Perhaps the most 

 important characteristic is the variation produced by changes in 

 diet. 2 Zdarek 3 found in a chyle-cyst 2.7 percent, of fats, 

 7.2 per cent, of proteids, and 0.05 per cent, of sugar ; feed- 

 ing of fats increased their amount in the cyst and starvation 

 decreased it. 



Ascites adiposus is characterized by the absence of sugar 

 and by a higher percentage of fat, the maximum observed 

 being 6.4 per cent. In a case examined by Edwards the 

 composition was as follows: Specific gravity, 1.012; proteid, 

 2.7 per cent. ; fat, 6 per cent. ; diastatic ferment and sugar 

 absent. This form occurs principally as a result of fatty meta- 

 morphosis of cells, particularly in carcinomatous and tuberculous 

 exudates ; Edwards was able to show experimentally that a 

 transudate may change from serous to cellular, and later come 

 to contain fat. 



Pseudochylous effusions are also observed, not only in the 

 abdominal and thoracic cavities, but even in the fluid of the 

 edematous legs and scrotum ; these resemble chylous fluids in 

 being turbid or milky, but they contain no fat. 4 The turbidity 

 is apparently due chiefly to lecithin, which is largely combined 

 with the pseudoglobulin of the fluid (Joachim 5 ). Possibly in 

 some cases the turbidity is partly or largely (Poljakoif 6 ) due 

 to poorly dissolved proteids. Strauss 7 has noted the occurrence 

 of this form of ascites particularly in chronic parenchymatous 

 nephritis, but believes the turbidity has a local origin. Ham- 

 marsten has observed a similar turbidity due to mucoid sub- 

 stances, as also have Gouraud and Corset. 8 



1 Arch. Physiol. et Pathol., 1886 (Ser. 3, vol. 8), 367. 



2 A sample of the composition of 1 liter of chylous ascitic fluid is shown 

 by the analysis in the case studied by Comey and McKibben (loc. cit.) : 

 Specific gravity, 1.010 ; solids, 21 gm. ; proteids, 9.75 gm. ; urea, 1.28 gm. ; 

 fat, 1.45 gm. ; inorganic matter, 8 gm. ; peptone (?) and sugar, present; fibrino- 

 gen, mucin, nucleo-albumin, and uric acid absent. 



3 Zeit. f. Heilk.,1906 (27), 1. 



4 Literature, see Bernert, Arch. exp. Path. u. Pharm., 1902 (49), 32. 



5 Munch, med. Woch., 1903 (50), 1915 ; also Christen, Cent. f. inn. Med., 

 1905 (26), 329. 



6 Fortschr. d. Med., 1903 (21), 1081. 



7 Note to Poljakoffs article; also Biochem. Centr., 1903 (1), 437. 

 8 Compt. Eend. Soc. Biol., 1906 (60), 23. 



