PRODUCTS, ADVENTITIOUS. 



97 



with fat in a peculiar form of atrophy * of their 

 proper texture, which is often attended with 

 fracture. The latter circumstance distinguishes 

 such cases from those of ordinary osteoma- 

 lacia, wherein (in addition to other characters 

 not belonging to the present head, as, for in- 

 stance, disappearance of their gelatin-element, 

 Miiller,) accumulation of free oil appears as 

 an important character. 



(m.) Adventitious Products. Numerous 

 adventitious products contain fat within their 

 proper substance. Thus fat is a very frequent 

 constituent of urinary calculi, and of various 

 concretions, for instance, the arterial species. 

 In deposits, (as the typhous, tuberculous, and 

 purulent,) it occurs occasionally in great abun- 

 dance in the granule and oil-globule forms ; 

 and it forms a constituent of no mean impor- 

 tance (though an accidental one) of various 

 growths. Thus in fibroma and osteoma the 

 total absence of fat is unusual ; and in cancer 

 fatty matter occurs with such constancy as 

 almost to take rank with its essential elements. 



(B.) Fatty matters excreted in the semi-fluid 

 or fluid state. (.) Fat does not exist natu- 

 rally in appreciable quantity in the urine ; in 

 certain states of disease, however, oily matter 

 is discharged in some quantities with the fluid. 

 Simon and others have discovered fat in the 

 urine of persons labouring under phthisis and 

 tabes mesenterica ; and it is commonly said to 

 be of most frequent occurrence in diseases at- 

 tended with rapid emaciation. We have our- 

 selves in vain sought for it in numerous cases 

 of phthisis at all stages, and consequently re- 

 gard its presence as by no means constant. 

 Dr. Elliotson relates the case of a female suf- 

 fering from biliary calculi who passed about 

 the third of an ounce of oil daily with her 

 urine-}- : such cases are, however, not to be 

 regarded without suspicion. Fat occurs, oc- 

 casionally at least, in considerable proportion 

 in the urine of females affected with puerperal 

 fever.;): Heller found the same principle in 

 three cases of herpes zoster. Fat also exists, 



* The frequent association of atrophy with fat- 

 deposition in various organs (Carswell, Gluge) is 

 as curious as it is positively established; but the 

 mode of connection of the two phenomena has not 

 been fully ascertained, and is probably not con- 

 stantly uniform. It would appear rational to sup- 

 pose that the fat-production acts most commonly as 

 the cause (mechanically) of the atrophy with which 

 it is found ; but (to go no further) in certain atro- 

 phies of the kidney, the latter is, if not the cause, 

 certainly the occasion of the former. It is a notable 

 fact that in the organ which undergoes the process 

 of senile atrophy to the highest amount namely, 

 the lung coexistent fat is not found; at least, we 

 have sought for it unsuccessfully with the micro- 

 scope ; it is true that INI. Guillot's mode of inves- 

 tigation might point out fat that had otherwise 

 eluded detection. Be this as it may, however, the 

 same difficulty in determining the relationship of 

 atrophy and other coexistent morbid changes (as, 

 for instance, of serum-accumulation in atrophy of 

 the convolutions of the brain in certain insane per- 

 sons) is met with, as in the case of fat-deposition. 



f Med. Chir. Trans, vol. xviii. 



J Bouchardat, Journ. des Counaiss. Me'dicales, 

 Aout, 1843. 



Simon's Chemistry, vol. ii. p. 320. 



VOL. IV. 



associated with albumen, in some cases of 

 Bright's disease, in saccharine diabetes, and 

 in the so-called chylous urine : and there are 

 three cases on record (by Canubio, Alibert, 

 and Graves) in which the fluid was actually 

 milky, containing fat and casein. 



(6.) The fa:ces sometimes contain oily and 

 tallowy-looking matters in large quantities. 

 The circumstances under which intestinal dis- 

 charge of this kind occurs, are not by any 

 means fully understood. Peculiar functional 

 derangements of the digestive process are suf- 

 ficient, independently of organic disease, to 

 produce discharge of the kind, whether per 

 annm or through the mouth.* The faeces in 

 diabetes mellitus are remarkable for their large 

 proportion of fat. Dr. Percy found this prin- 

 ciple amount to 16.16 per cent, of the dried 

 faces in a case where food of all kinds was 

 taken.t May the alleged fact that grape- 

 sugar is converted into butyric acid by bile, 

 be considered to explain (or at least to illus- 

 trate) the occurrence of fat in these faeces ? 

 Some of it is probably derived from non- 

 digested food. 



(f.) The saliva occasionally contains " ad- 

 ventitious fatty matter and fatty acid," accord- 

 ing to Dr. Wright J ; he found so much as 3.9 

 of these principles in 1000 parts of one variety 

 of morbid saliva. 



(rf.) The sweat is said to contain fat in the 

 colliquative hectic state ; but we know of no 

 analysis satisfactorily proving the point. 



(C.) Encysted fats. Fatty matters of dif- 

 ferent kinds occur in cysts. The chief varieties 

 of these are atheroma (from aBiipa, pnltis] ; 

 meliceris (from me/, honey, and cera, wax) ; 

 and steatoma (from oTtap, fat); so called re- 

 spectively from their pultaceous, honey-like, 

 and suety appearance. The most common 

 seats of atheromatous and meliceric cysts are 

 the scalp and eyelids , the new matter some- 

 times accumulates in the sebaceous follicles. 



One peculiarity of the fatty matter in meli- 

 ceris and atheroma appears to be the absence 

 of containing cells the fat is free. Miiller 

 hence presumes that the cyst is formed of the 

 thickened walls of an original single fat-cell, 

 apparently an unnecessary hypothesis. Be- 

 sides the fat, there is a granular matter of 

 albuminous nature in these masses. 



Analyzed by Valentin ||, the following was 

 found to be the composition of this encysted 

 fatty matter : 



Cholesterin 0.352 



Elain and oleate of soda 3.216 



Stearin 0.222 



Albumen and potass ; chloride "]_ , ^70 



of sodium and lime J 



Coagulated albumen 5.923 



Water , 88.715 



Steatomatous matter is most commonly ac- 

 cumulated in the ovaries, between the vagina 



* See the author's work on Cancer, p. 324. 



f Quoted in Simon, vol. ii. p. 378. 



t Loc. cit. 



See Simon, op. cit. vol. ii. p. 110. 



|1 Repertorium, 1838, p. 307. 



11 



