65 



round one and the like. The cases in which the cells make 

 atnoimal grov;th only in one direction are extraordinarily 

 frequent • In this connection it should be noted further 



that in many cases of hypertrophy, the cell memhrane will 

 not he capable of abnormal growth in all its parts but 

 only oh cei^t^in sides and in limited regions. In the epi>- 

 dermal cells ^ for example, in many cases only the outer 

 wall makes any perceptible surface growth:- the form and 

 size of the original epidermal cell remaining permanently 

 recognizable, The added grov?th as ?;ell as the hypertrophied 

 cells, as a v^rhole^ are independent^ in their shape of the 

 normal form of the original cell, and entirely different 

 from it. (Compare fig, 45). Further:- cell^ which are 

 enclosed on all sides by tissue, and indeed by tissue, in- 

 capable of growth, havd at their disposal only a limited 

 space for their hypertrophic increase in volume, and only 

 a narrowly limited region of their membrane ean participate 

 in the surface growth. Thus this added growth appears often 

 as an independent appendage of the mother body of the cell, 

 whereby there results, as a matter of course, a complete 

 change in the form of the hypertrophied cell. 



Buring, or after the increase in volume, the contents 

 of the cells and the structure of their walls usually under- 

 go other and various changes. The cases are relatively 

 rare in which such changes are entirely omitted and the an- 

 atomical character of the cell remains the same. There is 

 usually a revaluation of the cell character: either regres- 

 sive changes result, the cytoplasm is used up, the cell 

 contents degenerate or are dissolved,- or progressive chang- 

 es take place, which give the cells new anatomical char- 

 acteristics and functions; the cells store up proteins, 

 starches and fats, or they develop chlorophyll and red col- 

 oring matter in the vacuoles, or their walls are thickened 

 characteristically. In hypertrophies of the first kind, 

 which we will designate as kataplastic hypertrophies, the 

 anatomical state does not lead us to believe that the ab- 

 normal grov/th is produced by an increased supply Sf food 

 stuffs, i.e., by "over-nutrition". On the contrary, the 

 processes described make it often probable, that the cells 

 are dependent on thejr own contents for nutritive material 

 folr the hsnpertrophic gror/th, thus exhausting it and there - 

 by preparing their own destruction. In cases of the second 

 kind, a combination, so to speak, of hypertrophy and meta** 

 plasia exists, we will speak of pros oplas tic hypertrophy . 

 In these cases, the abnormal growth often is apparently 

 accompanied by an afeundant supply of nutritive material, 

 if not caused by "over-nutrition". Indeed in them an in- 

 crease of the most important coll-^organs is p6esible; be- 

 sides the enrichment in cytoplasm there may be prCved at 

 times, an increase of the nuclei. Such multi-nucleated 

 cells serve as transition'-f orms betv/een hypertrophies and 

 those abnormal structures, by v/hich division bi the cells 

 usually follows upon cell growth, that is hyperplasies. 



I choose the designation " kataplastio hyper tro- 

 phy" for abnormal increase in volime of the cells 

 connected with degenerative atrophy of their living 

 contents with reference to the teitaninology pro- 



