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XXII. OBSERVATIONS ON THE MINUTE ANATOMY OF FATTY DEGK- 



NERATION OF THE LIVER.* 



By William Bowman, Esq., F.R.S., Demonstrator of Anatomy in King's 

 College, London ; and Assistant Surgeon to King's College Hospital. 



FATTY degeneration of the liver is found almost exclusively in phthi- 

 sical subjects. Louis met with it in forty out of one hundred and 

 twenty cases. The organ is always enlarged in a degree proportioned, 

 cceteris paribus, to the quantity of fat it contains. It is altered to a buff 

 colour, resembling that of fallen leaves. In consistence it is nearly na- 

 tural ; and when sliced the knife is rendered greasy, and minute glo- 

 bules of fat appear, mingled with the blood. It has also an unctuous 

 feel, greases paper, and readily inflames. This deposit of fat is never 

 collected into masses, but is equally diffused throughout the whole 

 viscus. It is remarkable that it occasions no obstruction to the portal 

 circulation, as is clear, from its being always unattended with ascites. 

 It never, indeed, gives rise to any symptoms (beyond those of mere en- 

 largement) from which its existence might be suspected during life. 

 Thus much is already known of the disease. 



In examining under the microscope, a short time since, a specimen of 

 this disease, taken from the body of a patient of Dr. Budd, in the 

 King's College Hospital, I observed an interesting fact, denoting the 

 seat of the fatty accumulation, which, with Dr. Budd's concurrence, I 

 am desirous of communicating. 



To make clear my meaning, I shall premise a very few words on the 

 minute structure of the lobules of the liver. Mr. Kiernan has well 

 described the vascular element of these minute representatives of the 

 organ. It consists of a capillary plexus intervening between the portal 

 and hepatic veins. The diameter of the capillaries in this plexus is 

 very large, being nearly twice that of a blood globule ; while the di- 

 ameter of the capillaries in most other textures is the same as that of 

 the blood globule, and in some (as muscle) even less, so that the blood 

 globules only pass along by undergoing elongation. This large size of 

 the capillaries of the liver, probably, has reference to the deficiency of 

 propelling power in the portal circulation. This portal hepatic plexus 

 may be termed solid, as it is extended in all directions, and presents 



* From the Lancet of January 22nd, 1842. 

 VOL. n. K 



