Roles of colloidal molecules in Starling's hypothesis and in returning interstitial fluid to the vasa recta

To begin to understand the role of colloidal molecules, a simple question requires an answer: How do the solutes alter water in an aqueous solution? Hulett's answer deserves attention, namely, the water in the solution at temperature and external pressure applied to solution (T,pe1) is altered in the same way that pure water is altered by reducing the pressure applied to it by the osmotic pressure of the water at a free surface of the solution. It is nonsense to relate the lower chemical potential of water in a solution to a lower fugacity or to a lower activity of the water in the solution, since these terms have no physical meaning. It is also incorrect to attribute the lower chemical potential of the water to a lower concentration of water in the solution. Both claims are derived from the teachings of G. N. Lewis and are erroneous. Textbook accounts of the flux of fluid to and from capillaries in the kidney and other tissues are inadequate, if not in error, as they are based on these bogus claims. An understanding of the process by which colloidal proteins in plasma affect the flux of nearly protein-free fluid across the capillary endothelium must start with insights derived from the teachings of G. Hulett and H. Dixon. The main points are 1) colloidal molecules can exert a pressure against a membrane that reflects them and, thereby, displace a distensible membrane; 2) they can alter the internal tension of the fluid through which they diffuse when there is a concentration gradient of the molecules; and 3) only by these means can they influence the flux of plasma fluid across the capillary endothelium. However, the process is complex, since both the hydrostatic pressure and protein concentrations of fluids inside and outside the capillary vary with both position and time as plasma flows through the capillary.