436 Messrs. S. G. Shattock and L. S. Dudgeon. [Mar. 18, 



breakfast. The plasma, as studied in the blood films, contained free fat, the 

 presence of the latter, under the circumstances mentioned, being possibly due 

 to its less ready manipulation in consequence of the excessive bulk of water 

 in the blood. 



The amount of fat in the finely granular leucocytes in this case is very 

 striking ; every cell held a certain number of fine scarlet points or 

 droplets, and many are loaded. How much of the fat in the leucocytes is to 

 be ascribed to ingestion, and how much to degeneration, it is impossible 

 to say. 



As in the case where oedema follows venous obstruction the transudation 

 occurs only after the stasis has lect to damage of the endothelium, so in 

 a somewhat similar way, in the case of anaemia, we should regard the 

 deficient oxygenation as involving injury to the leucocytes ; the intra- 

 cellular fat appears in consequence. 



In the case of pyloric carcinoma there was an associated chlorotic anaemia 

 arising from the ill-nourished condition of the body in general, including the 

 blood-forming organs. 



The fat droplets in the leucocytes, of which only a certain number were 

 affected, are of conspicuous size, the change being a far advanced one. No 

 free fat was present in the plasma. 



And finally, in the case of diabetes and lipaemia, in which typhoid infection 

 terminated life, the amount of free fat in the plasma makes it clear that 

 much of the fat in the leucocytes must be ascribed to phagocytic ingestion, 

 but how much to this, and how much to the toxic condition of the blood, 

 cannot be stated. The peritoneal fluid removed after death was full of fat 

 droplets. The bone-marrow showed a highly abnormal number of large 

 endothelial cells holding an abundance of multiple fat droplets. The gall- 

 bladder held no bile, and its contents were so white that they were at first 

 thought to be purulent ; microscopic examination revealed the presence of 

 free fat and shed columnar cells. 



It is interesting to note, in passing, that the bases of these cells were loaded 

 with fat, which had evidently been ingested by them whilst in situ, as it is by 

 those of the intestine. The absorptive capacity of the epithelium of the gall- 

 bladder has been shown, also, by Aschoff. 



The Presence of Granules in the Leucocytes, which Stain of a Deep Broion 

 Colour. — Scharlach Granulation. 



From the foregoing list of diseases in which fat was found in the finely 

 granular polymorphonuclear leucocytes, some, in which a fatty degeneration 

 might have been particularly anticipated, are conspicuous by their absence. 



