PATHOLOGICAL FAT ACCUMULATION 403 



or there may be no increase in the total amount of fat, but the invisi- 

 ble fat becomes visible through autolysis of the cell proteins. Thus, 

 Bainbridge and Lcathes '® found that after ligation of the hepatic 

 artery there is a marked fatty degeneration of the liver, without an 

 increase in the amount of fat according to analysis. (3) Finally, of 

 course, both factors may occur together. Of these various forms, in 

 only the first would the chemist consider the organ "fatty," although 

 from a morphological standpoint the second form is entitled to rank 

 as a true "fatty degeneration," and the form that will occur seems 

 not to depend upon the cause of the cell injury, but ratlier upon the 

 organ under consideration. In a study of the relation of the morpho- 

 logical to the chemical changes Rosenfeld ^^ arrived at the following 

 results : 



Normal human hearts contain, on an average, 15.4 per cent, of lip- 

 ins ; the hearts showing fatty degeneration contain 20.7 per cent, on an 

 average.^"" The pancreas, which normally contains 15.8-17.4 per cent., 

 also contains an increased amount when showing fatty degeneration. 

 The liver, however, takes on by far the greatest amount of fat after 

 "steatogenetio" poisons,-" and the microscopic picture usually gives a 

 very good approximation of the amount of lipins it contains.^°^ Ap- 

 parently in these organs any excessive fat above the normal is obsei'va- 

 ble microscopically, although the normal lipin content is not, and only 

 in these three organs could Rosenfeld find an actual increase in fat 

 after poisoning- with phosphorus, etc. It would seem, on the other 

 hand, that there is not often a real increase in the fat content of the 

 "fatty" kidney.-^ Normal spleen contains 14.2 per cent, of lipins, 



isBiochem. Jour., 1906 (2), 25. 



i9Berl. klin. Woch., 1904 (41), 587. 



19a The amount of phospho-lipins in the heart is usually nearly constant, but 

 alimentary fat may accumulate in the myocardium under certain conditions. 

 See Wegelin, Berl.'klin. Woch., 1913 (50), 2125; Bullard, Amer. .Tour. Anat., 

 1916 (19), 1. 



20 In fatty livers in phosphorus-poisoning the amount of fat may reach 75 per 

 cent, of the dry weight. Accompanying the fat increase arc increase in, water 

 and a relative or absolute decrease in proteins, probably due to cell autolysis. 

 In acute yellow atrophy a similar decrease in protein occurs, but without an in- 

 crease in fat. (See v. Starck, Deut. Arch. klin. Med., 1884 (35), 481.) 



20a See Helly (Beitr. path. Anat., 1914 (60), 1) who examined 100 human 

 livers Avhich showed all variations in microscopic fat content, and chemically 

 from 7.36 to 74.43 per cent, of lipins (dry weight). He found tliat there was 

 usually a good correspondence between microscopic appearance and analytic re- 

 sults, altho some marked and unexplained discrepancies were observed. Gener- 

 ally the fat content was from 10 to 30 per cent, of the dry weight, with 19 to 

 21 per cent, the most common figures. When there is much fat present in the 

 liver the fat content of the bile is increased (Le Count and Long, Jour. Exp. 

 Med.. 1914 (19), 234). 



21 This is contradicted by Landsteiner and ^lucha (Cent. f. Path., 1904 (15),. 

 752) and by Lohlein (Virchow's Arch., 1905 (180), 1) and Bosenthal (Deut. 

 Arch. klin. INIed., 1903 (78), 94), but is supported bv Orgler {ibid., 1904 (176), 

 413), and Dietrich, Verb. Deut. Path. Gesell., 1907 (11), 10. See also the later 

 studies by Rosenfeld on the effects of various steatoffenic poisons on different 

 organs, in Arch. f. Exp. Path. u. Pharm., 1906 (55), 179 and 344. It is probable 

 that the truth lies between tlie opposing views, namely, the kidney may under 



