CHAPTER XIV 



RETROGRESSIVE PROCESSES (CONTINUED) 



Fatty* Amyloid, Hyaline, Colloid, and Glycogenic Infiltration 

 and Degeneration 



FATTY METAMORPHOSIS 



IN 1847, in the first number of his Archiv, Virchow 

 divided the forms of fatty changes that may occur in patholog- 

 ical conditions into two groups " infiltration " and " degenera- 

 tion " a division that has since become classical. By infiltra- 

 tion he indicated the excessive accumulation of fat in the cells 

 in the form of large droplets, without destruction of the nucleus 

 or irreparable damage to the cells, and by the use of the term 

 infiltration he implied his belief that the fat entered the cell 

 from without. When the fat remained in the form of fine drop- 

 lets and the cell became much disintegrated, Virchow considered 

 that the fat was derived from the breaking down of the cell 

 proteids, and hence the process was considered to be a fatty 

 degeneration of the protoplasm. Since that time scarcely any 

 other subject in pathology has been more warmly discussed 

 than that of the origin of the fat in fatty degeneration, and an 

 appalling amount of literature has accumulated concerning the 

 question involved. It will be impossible to give more than the 

 essential facts that have been developed, referring the reader for 

 the full details of the discussion and evidence to the numerous 

 compilations of literature, particularly those of Rosenfeld, 1 and 

 to the original articles cited in the text. 



PHYSIOLOGICAL FORMATION OF FAT 



Concerning the normal formation of fat we may summarize 

 the evidence as follows : 



(1) A large proportion of the fat of the body comes from 



lu Fat Formation." Ergebnisse der Physiol., Abt. 1, 1902 (1), 651 ; ibid., 

 1903 (2), 50. Also see discussion in the Verb. Deut. Path. Gesell., 1904 (6), 

 37-108, and the review by Leathes in his " Problems in Animal Metabolism ," 

 1906, pp. 71-121 . Concerning modern theories of role of lipase in fat metabolism 

 see Chap. iii. Other reviews of literature on pathological fat formation by 

 Christian, Johns Hopkins Hosp Bull., 1905 (16), 1 ; Herxheimer, Ergebnisse 

 der Pathol., 1902 (8), 625; Lohlein, Virchow's Arch., 1905 (180), 1 ; Pratt, 

 Johns Hopkins Hosp. Bull, 1904 (15), 301 (particular reference to heart). 

 Later references of importance cited in the text. 

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