CHAPTER XVI 



RETROGRESSIVE CHANGES (Continued) 



Fatty, Amyloid, Hyaline, Colloid, and Glycogenic Infiltration and 



Degeneration 



FATTY METAMORPHOSIS 



In 1847, in the first number of his Archiv, Virchow divided the 

 forms of fatty changes that may occur in pathological conditions 

 into two groups — "infiltration" and "degeneration" — -a division 

 that has since become classical. By infiltration he indicated the ex- 

 cessive accumulation of fat in the cells in the form of large droplets, 

 without destruction of the nucleus or irreparable damage to the cells, 

 and by the use of the term infiltration he implied his belief that the 

 fat entered the cell from without. When the fat remained in the form 

 of fine droplets and the cell became much disintegrated, Virchow 

 considered that the fat was derived from the breaking down of the cell 

 proteins, and hence the process was considered to be a fatty degenera- 

 tion of the protoplasm. Since that time scarcely any other subject 

 in pathology has been more warmly discussed than that of the origin 

 of the fat in fatty degeneration, and an appalling amount of literature 

 has accumulated concerning the questions involved. It will be im- 

 possible to give more than the essential facts that have been developed, 

 referring the reader for the full details of the discussion and evidence 

 to the numerous compilations of literature, particularly those of Rosen- 

 feld,' and to the original articles cited in the text. 



I "Fat Formation," Ergebnisse der Physiol., Abt. 1, 1902 (1), 651; ibid., 1903 

 (2), 50. Also see discussion in the Verh. Deut. Path. Gesell., 1904 (6), 37-108, 

 and the review by Leathes in his "Problems in Animal Metabolism," 1906, pp 

 71-121, and "The Fats " Monographs on Biochemistry, London, 1910; von Fiirth, 

 "Chemistry of Metabolism," Amer. Transl., New York. 1916. Concerning theor- 

 ies of role of lipase in fat metabolism see Chap. iii. Other reviews of literature on 

 pathological fat formation by Christian, Johns Hopkins Hosp. Bull, 1905 (16), 

 1; Lohlein, Virchow's Arch., 1905 (180). 1; Pratt, Johns Hopkins Hosp. Bull. 

 1904 (15;, 301 (particular reference to heart); Wohlgemuth, Handbuch d. Bio- 

 chem., 1909, III (1), 150; Magnus-Levy and Meyer, ibid., 1910, IV (1), 445; 

 Dietrich, Ergebnisse der Pathol., 1909, XIII (2), 283. Concerning Obesity see 

 V. Bergmann, Handbuch d. Biochem., 1910, IV (2), 208. Later references of im- 

 portance cited in the text. 



400 



