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ARTICLE |

CONCENTRATION OF SERUM PROTEIN IN DIFFERENT TYPES OF EDEMA

HAROLD M. HAND, M.D.
Arch Intern Med (Chic). 1934;54(2):215-238. doi:10.1001/archinte.1934.00160140058004.
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In 1895 Starling1 first advanced his theory of the production of edema and the exchange of fluids between the blood and the tissue spaces. He showed that the colloid osmotic pressure of the serum was proportional to the concentration of protein in the serum. He advanced the theory that a decrease in the colloid osmotic pressure was responsible for the loss of fluid into the tissues and the production of edema. He contended that the crystalloids, though having a high osmotic pressure, have little influence on the exchange of water, because they pass through the walls of the vessels with the water, while the proteins, although having a much lower osmotic pressure, exert the principal influence because they do not pass through the walls of the vessels. Starling was unable to reduce the edema in the edematous leg of a dog by perfusion with Ringer's solution, but when perfusion

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