GENUINE FATTY METAMORPHOSIS. 391 



"We have now compared a series of examples of fatty 

 degeneration, and may henceforth confine ourselves to 

 the consideration of genuine fatty metamorphosis, in 

 which the normal structure of the part is ultimately 

 destroyed, and the place of the histological elements is 

 gradually occupied by a purely emulsive mass, or, more 

 concisely, fatty debris. It makes no difference whether 

 it is a pus-cell, a connective-tissue-corpuscle, a nerve- or 

 muscular fibre, or a vessel which experiences the change ; 

 the result is always the same ; namely, milky debris, 

 an amorphous accumulation of fatty particles in a more 

 or less highly albuminous fluid. But though we hold to 

 the agreement of all cases of fatty metamorphosis in 

 this respect, it by no means, however, follows that the 

 importance of this change as a morbid process is in 

 every case the same. This you may at once infer from 

 the circumstance, that, whilst I have introduced this 

 process to your notice in the category of purely passive 

 disturbances, one of the very structures which we most 

 frequently find in it, the granule-globule, has been re- 

 garded as a specific element of inflammation. For 

 years an inflammatory globule [exudation corpuscle] 

 was looked upon as an essential phenomenon in the 

 process of inflammation, and in fact, the frequency with 

 which cells in a state of fatty degeneration are found in 

 inflamed parts, affords sufficient proof, that in the course 

 of inflammatory processes, which it is impossible we 

 should ever regard as simply passive processes, such 

 transformations must take place. It is therefore very 

 essential to find a means of distinguishing between the 

 two classes. This offers indeed in particular cases very 

 great difficulties, and according to my conviction the 

 only possible method by which clear notions upon the 

 subject can be obtained, consists in examining whether 

 the condition of fatty degeneration is a primary or se- 



