372 LECTURE XV. 



oak-leaf with its ribs and indentations before one ; the 

 ramifications of the branches of the portal vein correspond 

 to the ribs, the fatty zone to the sub- 

 stance of the leaf. The more abun- 

 dant the infiltration, the broader does 

 the fatty zone become, and there are 

 cases in which the fat fills the whole 

 of the acini up the central (intralobu- 

 lar) hepatic vein (Fig. 110, h) and 

 every single cell is crammed full of 

 fat. In rare cases it certainly happens, that we find just 

 the reverse, and that the fat lies around the central 

 vein ; these are cases which are probably to be explained 

 by supposing that the fat is already in process of excre- 

 tion and only the last cells still retain a little of it. Only 

 we must take care not to confound with this condition a 

 kind of fatty, necrobiotic atrophy which occurs particu- 

 larly in chronic cyanosis.* 



If now we consider the process in detail, we find that 

 the manner in which the hepatic cells fill themselves, en- 

 tirely corresponds to that, in which an epithelial cell in 

 the intestine becomes filled with fat. At first we find 

 fat-granules widely scattered, and indeed very small. 

 They become more numerous, more closely aggregated, 

 and after a time larger ; at the same time the cells be- 



Fig. 110. The adjoining halves of two hepatic acini, p. A branch of the portal 

 vein with.braches^)' p", corresponding to the interlobular veins. h, h. Transverse 

 sections of the intralobular, or hepatic, vein. a. The pigment zone, b the amyloid 

 zone, e the fat zone. 20 diameters. 



* Cyanosis (chronic) is here used to express the general venous congestion which 

 is consequent upon chronic affections of the lungs and heart. " Since (as the Au- 

 thor says in a MS. note) it has become known that cyanosis, even when produced 

 by congenital malformation of the heart, does not arise from a commingling of 

 arterial and venous blood, but from an obstruction to the venous circulation,' it has 

 seemed reasonable to designate every more general hyperaemia, due to such ob- 

 struction, by the same term." " Acute cyanosis," he adds, " occurs in acute affec- 

 tions of the lungs, as for example, in pertussis." TR. 



