FATTY LIVER. 37! 



(Fig. 109) ; instead of a villus, invested externally with 

 epithelial cells, imagine a canal clothed on the inside with 

 epithelium. The delicate cylindrical epithelium in the 

 gall-bladder has the same striated border as that in the 

 intestine (Fig. 14), and the fat is seen in the same way to 

 penetrate into it from without, to pursue its course down- 

 wards and after a time to pass into the wall of the gall- 

 bladder. The same may be said of the biliary passages 

 (duct, biliferi, hepat., cystic., choledoch.), which are also 

 provided with cylindrical epithelium of a similar struc- 

 ture. I have watched the same process also in young 

 sucking animals after digestion, and there it is easy to 

 convince oneself that the fat, which for a time is con- 

 tained in the hepatic cells, is manifestly excreted from 

 them into the biliary ducts, but that in the course of 

 these ducts the fat is reabsorbed and thus a second time 

 returns into the circulation. 



Such an intermediate interchange of matter as this, 

 where the fat passes from the intestine into the blood, 

 from the blood into the liver, from the liver into the bile, 

 and thence again into the lymphatics, or into the capilla- 

 ries which conduct the blood back to the hepatic veins and 

 to the heart, presupposes of course, just as absorption in 

 the intestines does, that the conveyance back again must 

 take place under favourable circumstances ; if any dis- 

 turbing cause arises, a retention will of course ensue, and 

 the place of the fine granules will gradually be occupied 

 by large drops. But this is the mode of proceeding as 

 it can really be traced in the fatty liver. 



Upon studying a fatty liver, it is generally seen that 

 the fat is first deposited in that zone of the acini which is 

 immediately contiguous to the capillaries into which the 

 branches of the portal vein break up (Fig, 110. c, c). 

 When sections of the organ are carefully examined with 

 the naked eye, it looks in many parts as if one had an 



