PATHOLOGICAL OCCURRENCE OF FATTY ACIDS 345 



combine to form large droplets. Fischer doubts if the droplets 

 ever fuse together enough to cause embolism, supporting his 

 contention both by experiments and clinical records. 



The cause of lipemia has not yet been satisfactorily deter- 

 mined. In alcoholism it is commonly ascribed to a failure to 

 burn fat, because of the presence of the more readily oxidized 

 alcohol, and the common coexistence of diabetes and lipemia sug- 

 gests for both a common cause ; i. e. y lack of oxidation of fat and 

 sugar. In corroboration may be cited the occurrence of lipemia 

 in other conditions associated with defective oxidation ; i. e., 

 pneumonia, anemia, phosphorus-poisoning. As we are still 

 unfamiliar with the essential factors and steps in the oxidation 

 of fat, it would be mere speculation to attempt to explain further 

 the reason for the failure of destruction of the fat. The origin 

 of the fat in lipemia is likewise undetermined. Ebstein con- 

 siders that it arises partly from the food, partly from fatty 

 degeneration of the cells of the blood, the vessel-walls, and the 

 viscera. Neisser and Derlin consider it as merely food fat 

 coming from the chyle and accumulated in the blood. Fischer 

 believes that it is largely derived from the fat depots, and that 

 because of loss of the lipolytic power of the blood it cannot be 

 rendered diffusible, and hence it cannot enter the tissues where 

 it is normally consumed. 



PATHOLOGICAL OCCURRENCE OF FATTY ACIDS 



Fatty acids occasionally occur free in pathological processes. 

 The best example of this is fat necrosis (q. v.\ where crystals of 

 fatty acids appear in the necrotic fat-cells, arising through 

 splitting of fat, and later becoming combined with calcium from 

 the blood. Similar crystals, consisting of a mixture of pal- 

 mitic and stearic acids, frequently called margarin or margaric 

 add crystals, may be found in decomposed pus, in sputum from 

 bronchiectatic cavities, and from gangrene of the lungs, in gan- 

 grenous tissue, and in atheromatous areas. According to 

 Schwartz and Kayser, 1 the free fatty acids, at least in pulmonary 

 gangrene, arise from lipolysis by bacterial action rather than by 

 the lipase of the tissues. Eichhorst found crystals of fatty 

 acids in the neighborhood of acute patches of sclerosis in the 

 central nervous system in multiple sclerosis, and McCarthy 2 

 found them in a spinal cord undergoing secondary degeneration 

 from compression. 



1 Zeit. klin. Med., 1905 (56), 111. 



2 Univ. of Penn. Med. Bull., 1903 (16), 141. 



