ON THE BALANCE OF THE VITAL ECONOMY. 439 



alteration in many of them at an advanced period of life ; this consists in the 

 conversion of their albuminous or gelatinous materials into fat, thus con- 

 stituting what is known as fatty degeneration. That this change is not due 

 to the removal of the normal components of the tissues, and the substitution 

 of newly-deposited fatty matter in their place, but is (in most cases at least) 

 the result of a real conversion of the one class of substances into the other, 

 may now be considered as well ascertained. 1 And there are certain facts 

 which indicate that this kind of degeneration is a part of the regular series 

 of processes, by which tissues that have served their purpose in the economy 

 are prepared for being removed by absorption ; one of the most remarkable 

 being the observations of Virchow 2 and Kiliau 3 with regard to the fatty 

 degeneration of the muscular tissue of the uterus after parturition, and quite 

 analogous phenomena are observed in muscles the motor nerves of which 

 have been divided. 4 So, as Mr. Paget has pointed out, the fibrinous and 

 corpuscular products of inflammation are often brought into a state fit for ab- 

 sorption, by passing through this intermediate stage ; the fibrinous substances 

 being observed to be dotted by granules which are recognized as oil-parti- 

 cles by their peculiar shining black-edged appearance, and at the same time 

 losing its toughness and elasticity, and being no longer rendered transparent 

 by acetic acid ; whilst the lymph-cells present a similar increase of shining 

 black-edged particles like minute oil-drops, which accumulate until they 

 nearly fill the cell-cavity, their nuclei at the same time gradually fading and 

 disappearing. 5 Thus, then, if the fat, which is one of the products of this 

 retrograde metamorphosis, be absorbed as fast as it is formed, and the effete 

 tissue be replaced by a new production (as seems to be the case with Mus- 

 cles in a state of healthy activity), there is no appearance of degeneration, 

 and the nutrition is kept up to its normal standard. So if, from the advance 

 of age, or from the insufficient exercise of the muscles, their nutrition take 

 place less rapidly than their waste, whilst the products of their degeneration 

 are still removed, simple atrophy is the result. If, on the other hand, the 

 general conditions being similar, the fat produced in degeneration be not 

 absorbed, but remain in the tissue, an obvious "fatty degeneration" is the 

 result. This seems most likely to happen either (I) when the fat is thus 

 produced in such excessive amount, that the ordinary rate of its absorption 

 (corresponding with that of its elimination by the combustive process) does 

 not provide for its removal ; which will occur when a large amount of tissue 

 is undergoing degeneration at once, as in the case of the uterus after partu- 

 rition ; or (2) when the blood, being already highly charged with respiratory 

 material, is indisposed to receive an additional amount of fat ; and it is 

 probably in part from this cause, that the habitual presence of Alcohol in 

 the blood strongly predisposes to fatty degeneration, as is proved by the very 

 large proportion of intemperate individuals among the subjects of the more 



Hancltield Jones's Articles in the Brit, and Jb'or. Moa.-unir. Jtsev., vol. xi, p. dz<, ana 

 vol. xii, p. 30. In this country, a substantial description of the importance of the 

 fatty degenerations was given, upwards of a quarter of a century ago, by Gulliver 

 (Trims. "Med.-Chir. Soc., 1843, vol. xxvi, and Edin. Med. and Burg. Journ., July, 



1 For an excellent account of the whole subject of Fatty Degeneration, see Dr. 

 Handtield Jones's Articles in the Brit, and For. Med.-Chir. Key., vol. xi, p. 327, and 

 vol. 



fatty 



(Tr 



1843, p. 158), who thus early proved that these degenerations are a most frequent 



cause of the decay of the tissues, especially of aneurism of the arteries, and of that 



spontaneous bursting of their small branches, which is the proximate cause of the 



most frequent form of apoplexy in the brain. 



2 Verhandlungen der Gesellschaft fur Geburtshiilfe, Berlin, vol. iii, p. 17. 



3 Henle and Pfeuffers Zeitschrift, vol. ix, p. 1. 



4 See Erb, Centralblatt, 1868, p. 115; Bizzozero and Golgi, Strieker's Jahrbucher, 

 1873, p. 125. 



5 See Mr. Paget's Lectures on Surgical Pathology, vol. i, p. 374. 



