CHAPTER XIV 



RETROGRESSIVE CHANGES (Continued) 



Fatty, Amyloid, Hyaline, Colloid, and Glycogenic Infiltration 

 and Degeneration 



FATTY METAMORPHOSIS 



In 1847, ill the tirst 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 

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

 cessive accumulation of fat in the cells in the form of large drop- 

 lets, 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 

 dow^^ of the cell proteins, and hence the process was considered to 

 be a fatty degeneration 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 in- 

 volved. It will be impossible 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 litera- 

 ture, particularly those of Rosenfeld,^ and to the original articles 

 cited in the text. 



PHYSIOLOGICAL FORMATION OF FAT 



Concerning the normal formation of fat we may summarize the 

 evidence as follows : 



1 "Fat Formation," Erfrelmisse der Physiol.. Al)t.. 1, 1002 (1), ti.")l: ibid.. 190.3 

 (2), 50. Also see discussion in the Verh. Dent. Path. Oosell.. 1004 (Ti). .37-108, 

 and the review bv Leathes in his ''Prolilems in Animal ^Metabolism." IflOO, pp. 

 71—121, and "Tlie Fats," ^ionoGrraphs on Biochemistry, London, 1010; von Fiirth, 

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

 of role of li])ase in fat metabolism see Chap. iii. Other reviews of literature on 

 patholo£rical fat formation bv Christian. .Johns Hopkins ITosp. tiull.. IflOo (16), 

 1: Lohlein, Virchow's Arch.,' 190.5 (180), 1; Pratt. Johns TTopkins IJosp. Bull., 

 1904 (15), 301 (particular reference to heart) ; Wohlpemuth. JTandbucli d. Bio-- 

 chem., 1909, TIT (1), 150; :Ma?nus-Levv and Mever, ihid.. 1910, JV (1). 445; 

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

 Bercrmann, Handbuch d. Biochera., 1910. IV (2), 208. Later references of im- 

 portance cited in the text. 



397 



