Licence: Public Domain Mark
Credit: Physiological chemistry (Volume 2). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![nation of the patients, nor from the history of their cases, could I detect any evidence of an existing or previous hepatic affection. This circum- stance must remain unexplained till further investigations are instituted. I must not altogether omit to mention, that from the alcoholic extract of the liquor amnii, and still more from that of the vernix caseosa of an infant that had gone its full time, I obtained a substance which, although precipitable only by basic acetate of lead, gave no biliary reaction with sugar and sulphuric acid: the ammonia-salt of this acid crystallized under the microscope in broad plates. That bile-pigment passes into the transudations, both normal and morbid, in cases of icterus, was long ago inferred from the characteristic color of such fluids, and has subsequently been placed beyond a doubt by chemical experiments. It is, however, remarkable that in the two above-mentioned cases of hydrocele, in which resinous biliary acids were found, traces of bile-pigment Avere also present, besides a very large amount of cholesterin. Its presence might have been very easily esta- blished with certainty, but it was not rendered perceptible until a part of the albumen had been precipitated from the fluid by acetic acid, when, on boiling, there was formed a green coagulum, and the supernatant fluid appeared of a somewhat deep-green color. Heller has arrived at similar results in his investigation of various putrid, purulent, sanguineous hydrocele-fluids; but he also found uric acid, urea, margarate of soda, and glycocholate of soda in abundance. It has been already mentioned (in vol. i. p. 258) that sugar is found in the serous exudations in diabetes, in the same manner as bile-pigment in icterus. After the discovery of this substance in healthy blood, it might be expected that it would likewise occur in the ordinary transu- dations, but there is no direct proof that this is the case, since the quantities which we obtain for analysis are generally too small to allow of any accurate search for sugar. In a kilogramme and a half [or nearly three pints and a half] of the peritoneal transudation of a drunkard with granular liver (a quantity which would have been quite sufficient for the determination of sugar, if it had been present in the same proportion as in normal blood-serum), I sought in vain for this substance ; but after what has been already re- marked (see vol. i. p. 483), regarding the formation of sugar in the liver, it is probable that the production of sugar is interfered with in cases of hepatic disease, which might account for its not being found in this case. We have already spoken (in vol. i. p. 154) of the occurrence of urea in normal and excessive transudations. Since this substance has been found even in the aqueous humor as well as in the liquor amnii, and has also been detected by C. Schmidt1 in the fluid exudation in a case of chronic hydrocephalus in which no renal disease was present, we might fairly assume that it occurs in the circulating blood, and escapes through the walls of the capillaries in these parts with the water and other sub- stances which permeate easily, and is then found in the exudations in a quantity corresponding to the amount of urea in the blood ; indeed, if the functions of the lymphatics were disturbed, it might even accumu-](https://iiif.wellcomecollection.org/image/b21136300_0046.jp2/full/800%2C/0/default.jpg)
