A View on the Starting Mechanism of Pleural a. Abdominal Fluid at Times Suffering from Liver Disturbances

By mentioning 5 cases of liver patients who have been accompanied by not only ascites but also pleural fluid, the starting mechanism for ascites has been examined. Now, in order to start ascites, such factors as portal vein congestion, portal vein hypertension, colloidchemical change of blood as well as of ascites, hindrance against water metabolism regulator etc. may be pondered on, yet these alone cannot explain the starting mechanism for those five cases. Rather, as in every case, ascites has started violently immediately after those symptoms suggestive of some infection have appeared, and ascites was a transsudat from the beginning of accumulation, but contains comparatively great amount of protein; as these facts being recognizable, it can be identified that the principal factor was serous inflammation, as H. Eppinger declared. That is to say, at the same time certain kind of toxine so influenced the liver that it has given rise to serous hepatitis, and by injuring portal vein, augmenting its permeability, which, in turn, urged the lay-up of ascites. Furthermore, 3 cases have been studied that were accompanied with pleural fluid as to the factor to start pleural fluid, and so it has been concluded that even on this occasion the like factor in case of ascites should be thought as its starting mechanism too.