scholarly journals STUDIES IN EDEMA

1910 ◽  
Vol 12 (3) ◽  
pp. 288-310 ◽  
Author(s):  
Moyer S. Fleisher ◽  
Leo Loeb

1. Adrenalin injected intraperitoneally increases the rapidity of absorption of fluid from the peritoneal cavity, independently of whether the solution to be absorbed is hypotonic or hypertonic or is approximately isotonic with the blood serum. The intravenous injection of adrenalin also increases the absorption of fluid, but not so markedly as does the intraperitoneal injection. 2. Adrenalin injected either intraperitoneally or intravenously increases the quantity of sodium chloride absorbed. The relative absorption of sodium chloride—the movement from the peritoneal cavity of sodium chloride, as compared with the movement of water—is slightly increased when 0.85 per cent. of sodium chloride solution and adrenalin are injected intraperitoneally; but it is diminished when adrenalin is injected intravenously, or when 1.5 per cent. sodium chloride solution and adrenalin are injected. When distilled water has been injected intraperitoneally, adrenalin decreases the relative amount of sodium chloride in the peritoneal fluid—a fact that is evidently related to the increased elimination of sodium chloride through the kidneys under the influence of adrenalin. 3. When 0.85 per cent. sodium chloride solution is injected into the peritoneal cavity, the blood becomes diluted after two hours and a half. When adrenalin is also injected, the dilution of the blood is less marked, in spite of the increased absorption under the influence of adrenalin. When distilled water is injected into the peritoneal cavity, the blood is diluted equally in control and adrenalin experiments. When 1.5 per cent. sodium chloride solution is injected, the dilution of the blood is very slight, and in adrenalin experiments it is the same as in control experiments or very slightly greater than in control experiments. 4. The increase of absorption from the peritoneal cavity caused by the injection of adrenalin is not due to the increased diuresis caused by the injection of this substance. 5. The injection of adrenalin causes a temporary increase in the osmotic pressure of the blood, which gradually returns to normal. Under certain conditions, after the injection of adrenalin, there is a tendency toward maintaining the higher osmotic pressure of the blood serum, even up to the end of the experiment. We have reason to believe that this increase in the osmotic pressure of the blood is the main factor in increasing the absorption of fluid from the peritoneal cavity. 6. In experiments in which 0.85 per cent. sodium chloride solution has been injected intraperitoneally, either with or without adrenalin, there exists a tendency of the peritoneal fluid to attain a greater osmotic pressure than the blood serum, in spite of the fact that the injected fluid is slightly hypotonic as compared with the blood serum. We note a similar condition in cases of general edema in man, in which the osmotic pressure of the ascitic fluid is greater than that of the other edematous fluids, or even that of the blood serum. There exists, therefore, a mechanism that causes the passage of osmotically active substances from the blood or from the tissues into the peritoneal cavity, and that causes the osmotic pressure of the peritoneal fluid to become higher than that of the blood. It follows from our experiments that this mechanism, which causes the ascites in edematous persons to have such a high osmotic pressure, is not dependent upon certain pathological changes in the lining membranes or upon other pathological conditions, but exists already in normal animals. 7. The addition of 1.22 per cent. calcium chloride solution to 0.83 per cent. sodium chloride solution, in such proportions as we used in our infusion experiments, in which we determined the transudation into the peritoneal cavity, delays the absorption of fluid from the peritoneal cavity but very slightly. Therefore, calcium chloride increases directly the transudation into the peritoneal cavity and does not cause an increase in the amount of fluid in the peritoneal cavity merely by inhibiting the absorption. 8. It follows that adrenalin does not increase the amount of peritoneal transudate found after the intravenous infusion of large quantities of sodium chloride solution, to which adrenalin has been added, by delaying the absorption from the peritoneal cavity. The increased amounts of peritoneal fluid must be due to increased transudation into the peritoneal cavity; and the adrenalin, in view of its marked effect on absorption from the peritoneal cavity, must increase the movement of fluid into the peritoneal cavity much more strongly than could be assumed from the figures obtained in the infusion experiments.

1910 ◽  
Vol 12 (4) ◽  
pp. 487-509 ◽  
Author(s):  
Moyer S. Fleisher ◽  
Leo Loeb

1. In the experiments recorded in this paper the influence of the osmotic pressure of the blood upon absorption of fluid from the peritoneal cavity becomes apparent. Nephrectomy, removal of the adrenals, and other operations increase the osmotic pressure of the blood and increase the absorption of fluid from the peritoneal cavity. On the other hand, ether narcosis, at the period at which we tested its influence, causes neither an increase of osmotic pressure of the blood nor an increase in the absorption of fluid from the peritoneal cavity. 2. The increased osmotic pressure and increased absorption of fluid in nephrectomized animals is to a great extent not a specific effect of the removal of the kidneys, but approximately the same conditions can be observed after incisions of the skin and muscles. 3. After poisoning with uranium nitrate and in cases of peritonitis, complicating factors come into play, and under such conditions the absorption from the peritoneal cavity is not increased, notwithstanding the higher osmotic pressure of the blood. 4. In conditions in which the osmotic pressure of the blood is very high before the injection of sodium chloride solution into the peritoneal cavity (nephrectomized rabbits or rabbits injected with uranium nitrate three days previously), adrenalin causes no increase, or only a very slight one, in the absorption of peritoneal fluid. On the other hand, one day after the injection of uranium nitrate the osmotic pressure of the blood is only slightly increased before the injection of the sodium chloride solution into the peritoneal cavity, and here adrenalin causes a marked increase in absorption of fluid from the peritoneal cavity. 5. In animals injected with uranium nitrate the retention of sodium chloride and other osmotically active substances in the blood is not entirely due to interference with the functions of the kidney. This retention may be explained either by an inability of the tissues to bind the sodium chloride and other osmotically active substances or to a diminished permeability of the blood vessels for such substances. 6. While in nephrectornized animals the elimination of sodium chloride from the peritoneal cavity and also from the blood is increased, in animals injected with uranium nitrate such an elimination is diminished. This increase in the sodium chloride content of the peritoneal fluid in animals treated with uranium nitrate is accompanied by a decrease in the diffusion of other osmotically active substances into the peritoneal cavity. 7. While in nephrectomized animals and in animals injected with uranium nitrate one day previously, adrenalin causes a diminution of the fluid retained in the blood-vessels similar to the diminution noted in normal animals, adrenalin no longer exerts such an effect at a later stage of the uranium nitrate poisoning. At this period after the administration of uranium nitrate, the retention of fluid in the blood vessels is apparently equal in experiments with and without the injection of adrenalin, and following the absorption of fluid from the peritoneal cavity, the retention of fluid in the blood vessels in the uranium nitrate animals is increased comparatively to a greater extent than in normal animals. 8. Our experiments show a marked difference in the distribution of fluid and of osmotically active substances in nephrectomized animals and in animals injected with uranium nitrate. This difference may explain the much greater liability to the development of edema in animals injected with uranium nitrate.


1909 ◽  
Vol 11 (2) ◽  
pp. 291-313 ◽  
Author(s):  
Moyer S. Fleisher ◽  
Daniel M. Hoyt ◽  
Leo Loeb

1. The secretion of urine and the elimination of fluid through the intestinal canal which are caused by the intravenous injection of solution of 0.85 per cent. sodium chloride are decreased by the addition of calcium chloride to the sodium chloride solution. The secretion of urine is more markedly inhibited than is the elimination of fluid through the intestines. 2. In contradistinction to the decreased elimination of fluid through the kidneys and intestines, addition of calcium chloride to the sodium chloride solution increases markedly the transudation of fluid into the peritoneal cavity. To a certain degree the urine and ascites may be said to increase in an inverse proportion. 3. Although calcium chloride inhibits both absorption from and secretion into the intestines it seems to decrease the secretion more markedly than the absorption. 4. The action of calcium chloride in increasing the ascitic fluid is a double one: first, by diminishing the amount of urine secreted: secondly, by increasing the ascites independently of its action on the kidneys. The latter may be a direct action on the endothelial cells of the peritoneal cavity: this, however, must be determined by further investigations. 5. Addition of calcium chloride to the infused fluids increases the tendency to the occurrence of edema of the lungs. 6. Infusion of large quantities of fluid into animals dilutes the blood, but this dilution seems to be carried only to a certain degree— about 30 per cent.—and to be independent of the chemical character of the solution and of the function of the kidneys. 7. The presence or absence of the kidneys has a marked influence on the intestinal and ascitic fluids. When the averages of ascitic and intestinal fluids per 1,000 c.c. of retained fluid in non-nephrectomized animals and these fluids per 1,000 c.c. of infused fluid in nephrectomized animals are compared, more fluid is found in the case of the nephrectomized animals. This fact can only be explained in part by the shorter time necessary for the same amount of fluid to be retained in the case of the nephrectomized animals. Nephrectomy causes an increase of the ascites and the intestinal fluids through a mechanism which will have to be investigated by means of further experiments.


1925 ◽  
Vol 41 (6) ◽  
pp. 707-718 ◽  
Author(s):  
Russell L. Haden ◽  
Thomas G. Orr

Chemical changes are reported occurring in the blood of animals with obstruction of the jejunum, in which distilled water or sodium chloride solutions were introduced directly into the lumen of the intestine below the point of obstruction. Distilled water given daily from the beginning of the obstruction, had no influence on the development or course of the toxemia. 1 and 2 per cent salt solutions prevented a toxemia in uncomplicated cases. One animal so treated lived 30 days. Distilled water, given after the onset of toxemia, did not alter the progress or outcome of the toxemia. 10 per cent sodium chloride solution, administered after the onset of toxemia, controlled it in most cases for a long period. Hydrochloric acid had no effect on the course of the toxemia.


1910 ◽  
Vol 12 (4) ◽  
pp. 510-532 ◽  
Author(s):  
Moyer S. Fleisher ◽  
Leo Loeb

I. In normal animals the injection of caffeine slightly diminishes the absorption of fluid from the peritoneal cavity, in spite of the fact that the amount of fluid and sodium chloride eliminated through the kidneys is markedly increased. The lessened absorption of fluid is due to a slight lowering of the osmotic pressure of the blood. II. In nephrectomized animals caffeine increases the absorption of fluid from the peritoneal cavity; the increase in absorption is greater in nephrectomized animals which received caffeine than in nephrectomized animals which did not receive this substance, and it is due to additive increase in the osmotic pressure of the blood. In a similar manner, caffeine increases the absorption of fluid from the peritoneal cavity in animals in which, instead of nephrectomy, other operations, not directly affecting the kidneys, had been performed. In this case also the increase in absorption is presumably preceded by and due to an increase in the osmotic pressure of the blood. III. In animals injected with uranium nitrate three days previously, caffeine diminishes the absorption of fluid from the peritoneal cavity, notwithstanding the high osmotic pressure of the blood which we observe in such animals. This agrees with the results of our previous experiments in which we found that in animals injected with uranium nitrate the absorption of fluid is not increased in spite of the rise of the osmotic pressure of the blood. IV. At the time of the conclusion of the absorption experiments, the amount of fluid retained in the vessels was found to be diminished in each series in which caffeine was used. Only in certain cases can this be due to the increased amount of fluid leaving the blood vessels through the kidneys; in other cases it can only be due to a movement of water from the blood vessels into the tissues caused by the injection of caffeine. V. In normal animals, in nephrectomized animals and in animals in which an operation not directly affecting the kidneys had been performed, caffeine causes an absolute and relative increase in the elimination of sodium chloride from the peritoneal fluid, as a result of which the remaining peritoneal fluid shows a lessened content of sodium chloride. Caffeine causes also a decrease in the sodium chloride content of the blood. We see, therefore, that under the influence of caffeine a greater amount of sodium chloride is eliminated from the body fluids into the tissues or through the kidneys. The factors which cause the sodium chloride to leave the body fluids are probably primarily responsible for the diuresis which takes place after administration of caffeine. In the case of caffeine and other similar substances the diuresis is, therefore, in all probability not due primarily to a specific action of the kidney, but to conditions which affect the distribution of sodium chloride in the body. VI. The distribution coefficient of other osmotically active substances differs from that of sodium chloride. These other substances have a tendency to move into the body fluids in increased quantities under the influence of caffeine. VII. Summarizing all experiments in which we studied the absorption from the peritoneal cavity, we may state that changes in the osmotic pressure of the blood represent the principal factor in explaining the variations in the rate of absorption of fluid from the peritoneal cavity. VIII. There exists no direct relation between an increase in the rate of absorption of fluid from the peritoneal cavity and an increase in the amount of urine secreted. If it should be found that even at a period following the injection of caffeine, later than that at which we have studied the absorption, a rise of the osmotic pressure of the blood does not appear, then we may state that the diminution in the amount of edema in the body cavities resulting from the administration of caffeine is entirely due to an inhibition of the production of edema and not to an increased absorption of fluid from the serous body cavities.


2014 ◽  
Vol 692 ◽  
pp. 84-89 ◽  
Author(s):  
Xiao Li ◽  
Yu Wen Guo ◽  
Jiu Li Ruan ◽  
Qi Qiao ◽  
Jian Qiang Zhang

This research established a density separation system by using sorting media such as calcium chloride solution (CaCl2), sodium chloride solution (NaCl) and ethyl alcohol solution (C2H5OH) to study the density separation experiment involving nine different waste plastics. The results showed that PVC(or POM or PET), PC, PA6, PS(or ABS), HDPE and PP could be progressively separated from their mixtures by CaCl2(1.3005g/mL), NaCl (1.1604g/mL), NaCl (1.0861g/mL), tap water (0.9969g/mL) and C2H5OH(0.9039g/mL) with a 100% of sorting rate, respectively.


1908 ◽  
Vol 10 (4) ◽  
pp. 484-489 ◽  
Author(s):  
Percy M. Dawson ◽  
Lemuel W. Gorham

On the basis of these facts we feel justified in making the following assertion: Under normal conditions and during various procedures (namely, stimulation of the vagus centrally and peripherally, of the saphenus nerve centrally, and of the annulus Vieussentis, intravenous transfusion of 0.7 per cent. sodium chloride solution, intra-arterial transfusion of strong carbonate, bleeding and asphyxia) the pulse pressure is a reliable index of the systolic output.


1929 ◽  
Vol 49 (4) ◽  
pp. 525-530
Author(s):  
Thomas G. Orr ◽  
Russell L. Haden

1. In experimentally produced general peritonitis drainage of the gut by ileostomy 6 inches above the cecum has no beneficial effect. 2. Animals with experimentally produced general peritonitis treated with ileostomy plus 1 per cent sodium chloride solution live three times as long as those not given the salt solution.


1927 ◽  
Vol 46 (6) ◽  
pp. 963-977 ◽  
Author(s):  
Takuji Shionoya

1. Distilled water dialyzes through the collodion tube and causes hemolysis. Clotting of the hemolyzed blood in the collodion tube occurs later. 2. Bile salts accelerate the appearance and development of white thrombi in the heparinized animal. The masses of white thrombi are very loose, soft, fragile and easily broken into clumps of platelets. They are poor in fibrin or the fibrin is abnormal, since they have less retractility than those obtained from the use of physiologic sodium chloride solution or calcium chloride or serum. Despite the increase in number and size of white thrombi, normal clotting does not occur. 3. When the collodion tube is surrounded by 1 or 2 per cent d-glucose solution, tiny and numerous white thrombi appear as radiating figures. The masses of white thrombi are rather loose and fragile. The clotting time of the heparinized blood does not appear to be shortened. 4. When a 1 to 2 per cent solution of calcium chloride is used as the dialyzing fluid outside the collodion tube, or when it is injected into the circulation, the formation of white thrombi is accelerated. They grow very rapidly. In spite of the action of heparin, the white thrombi formed are not so fragile as when bile salts are placed outside of the collodion tube. Fibrin seems to form easily. Obstruction of venous cannula takes place speedily and if the clots in the cannula are not removed, the white thrombi in the collodion tube remain small and become red by sedimentation of red cells. 5. Intravenous use of 10 per cent solution of magnesium sulfate without heparin retards the coagulation of circulating blood and permits the blood to flow through the extracorporeal loop from three to four times as long as normal. The formation of white thrombi, as well as red, is retarded. Magnesium sulfate (1 per cent) in physiologic sodium chloride solution placed outside the collodion tube markedly retards the formation of white and red thrombi in the heparinized animal. Magnesium sulfate (10 per cent), 50 mg. for each kilo of body weight each hour, administered intravascularly in the heparinized animal definitely prevents the first stages of thrombosis, and consequently prevents clotting. 6. It is possible by the combined use of adequate amounts of magnesium sulfate and of heparin intravenously to prevent all stages of thrombus formation for from 1 to 3 hours.


1909 ◽  
Vol 11 (3) ◽  
pp. 480-488
Author(s):  
Moyer S. Fleisher ◽  
Leo Loeb

1. Animals in which experimental myocarditis has been produced and winch are infused with sodium chloride solutions show a marked decrease in the amount of the secretion of urine. This decrease is even more pronounced than that produced when calcium chloride is added to sodium chloride solution. The intestinal fluid which is markedly decreased, and the peritoneal transudate which is increased by calcium chloride are, on the other hand, not markedly influenced by myocarditic lesions. We may, therefore, conclude that calcium chloride does not exert its specific effect on the quantity of peritoneal fluid through a lowering of blood pressure. 2. Each of the three factors, namely, calcium chloride, adrenalin and myocarditic lesions affects the elimination of fluid through the kidneys, through the mucosa of the small intestine and through the endothelial lining of the peritoneal cavity in a specific way. The conditions influencing the elimination of fluids through these three surfaces seem, therefore, to be different in each case and characteristic for the cells lining these surfaces.


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