Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

155/440 (page 137)

made in Ludwig's laboratoiy, witli regard to tlie condition of tlie lymphatic current under increased arterial pressure. I do not consider this comparison between the flow from an opened lymphatic and transudation from the capillaries to be admissible, for reasons given in the monograph already alladed to/ and which, to avoid prolixity, I will not again discuss. It is quite sufficient for me to point out that morphologically as well as chemically, the contents of the lymphatic trunks differ from transudations; that those contents cease to flow under circumstances which undoubtedly have no similar effect upon transudations ; and that all the lymph-channels in one portion of the body may be cut off without inducing oedema. The invariable and only cause of oedema is the insufficiency of the veins, or of the veins and lymphatics together, to carry away the transuded fluid. Therefore what is true of the contents of the lymphatic trunks does not apply as a matter of course to transuda- tion from the capillaries. In order to discover how transu- dations are affected, they themselves must be studied, and so far as this has been done, the result has always proved that augmented pressure is . invai-iably followed by increased transudation from the capillaries. Chabbas, acting under Griinhagen's direction, has found this to be correct with regard to the aqueous humour ^ which most certainly is to be considered as a transudation, and our manifold clinical ex- perience confirms the statement that real transudations (not exudations) rise and fall with corresponding variations of pressure. This statement, however, as a matter of course, does not exclude the possibility that other conditions may co-operate. And now to recapitulate my observations, I consider myself justified in concluding that there are no reasons whatever for relinquishing the theory that a transudation alone escapes from the glomerular vessels of the kidneys, in accordance with the laws of filtration. Secondly, that a secretion of the specific constituents of urine in a watery (concenbated) solution takes place in the convoluted uriniferous tubules, ' * Dio Albuininurie,' &c., pp. 28—30, and tlio foregoing translation, 29—31. ' Dogiel and Jesner's later investigations on this subject refer to the ultorations in the quantity of albumen.