354 '^^^ Fungus Disease of India. [part ii. 



been able to trace such degenerative changes onwards. That the degeneration is 

 essentially one of the fatty tissues, is not only evident from the nature of its ultimate 

 prodvicts, but from the localisation of the primary foci of the deceased action. These 

 foci are invariably situated in localities abounding in fat, in the subcutaneous adipose 

 tissue, in the sub-fascial or inter-muscular connective tissue, and in the cancellated 

 tissue of bones and specially in spongy bones abounding in fatty matter. 



The degenerative process appears to consist in a gradual condensation and inspis- 

 sation of the contents of the fat cells, with a coincident diminution and disappearance 

 of the vascular supply of the lobes and lobules of the adipose tissue and an ultimate 

 solution of the interstitial connective tissue and cell membranes. The latter process 

 appears to occur by mucoid or gelatinoid softening, and results in the formation of 

 the gelatinous matter in which the altered constituents of the fat are so frequently 

 found to be embedded. Whether the affection, however, primarily originates in the 

 lat itself, the connective tissue, or the lymph-spaces, we are not in a position to state. 

 Once such a degenerative process has occurred, the masses of fatty concretions and 

 gelatinous substance resulting from it are virtually portions of dead matter, really 

 external to and unconnected with the economy, and little prone to change save in so 

 far as the fatty constituents tend towards the assumption of crystalline forms. Such 

 foreign, extraneous substances must naturally tend to excite a certain amount of 

 irritation in the surrounding tissues, causing a thickening of the connective tissues 

 around them, and the gradual formation of cyst-like cavities so characteristic of the 

 disease. A further progress of the irritant action may ultimately lead these cysts 

 to open into one another, thereby forming irregular cavities, and cause the formation 

 of channels lined with a membrane of connective tissue, and in many cases opening 

 externally and allowing of the escape of the products of the degeneration. 



The degree to which the degeneration may proceed varies greatly in different 

 instances, as also does the proportion which the fatty and gelatinous products bear to 

 one another. In some cases we find roe-like masses and other crystalline elements in 

 comparatively small proportion, while the tissues are bathed in an abundance of oleo- 

 gelatinous fluid. In other instances the separation of the fatty and gelatinoid materials 

 is found to have advanced to a high degree, and distinct cavities containing roe-like 

 masses of fatty concretions characterise the tissues. Once, however, the gelatinoid 

 degeneration of the connective tissues and an alteration in the fat cells with oblitera- 

 tion of the vascular supply has occurred, it is not necessary that distinct concretions 

 should form in order to cause the degenerate matter to act as a foreign body and 

 lead to the formation of cavities, with channels and openings for its discharge. 

 Specimen I (page 345) afforded a characteristic example of this ; for in it, although 

 the degeneration was widely diffused and the characteristic openings were present on 

 the surface, the amount of roe-like, crystalline concretions was comparatively small. 



The amount and nature of deformity present in different instances, vary with 

 the degree to which the various tissues have been involved, and to which an hypertrophy 



