Page:A Handbook of the Theory and Practice of Medicine - Volume I - Frederick T. Roberts.djvu/84

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THEORY AND PRACTICE OF MEDICINE,

scribed as a falty hypertrophy. The deposit occurs in the form of oil-drops, which ultimately run tog-ether, completely obscuring- the other contents of the cells, without of necessity destroying- them. In course of time the tissues may deg-enerate from the mere pressure of the infiltrated fat, and F'g- s-

may even finally become absorbed. The best examples of fatty g-rowth are found in the in- crease of ordinary adipose tissue observed in some individuals, subcutaneous as well as around internal org-ans, constituting- general obesity ; in connection with the heart ; and in the cells of the liver. In the two former instances the con- nective-tissue cells become filled with fat; while in the liver the hepatic cells are more or less loaded with drops of oil, which cause them to. „ - ^,, _

, !•! Liver-cells, inhltrated With

become larg-er and more spherical, and niae oil, .^.j. {Rindjicisch). their contents.

.Etiology. — i. Excess of fat in the blood is a common cause of fatty infiltration, which is then usually indicated by g-eneral obesity, as well as by changes in org-ans. This may result from consump- tion of too much fat or of aliments which contribute to its formation ; from a deficiency in the amount of exercise taken, and g-eneral luxurious habits ; or from both these causes combined. There is also a diminution in the ordinary waste of fat under these circum- stances.

2. In certain wasti^tg affectiofis some of the org-ans are prone to become the seat of fatty infiltration, especially the liver. This is best seen in phthisis, and is supposed to be due to the absorption of the g'eneral fat, and its consequent accumulation in the blood, from which it is afterwards deposited in the liver.

3. Urtdoubtedly interference ivith the respiratory process may lead to fatty infiltration, because the fat is then not properly consumed, and thus its not infrequent occurrence in connection with pulmonary and cardiac aflfections will be partly accounted for.

4. Local inactivity may be the cause of fatty infiltration. Thus it may be observed in voluntary muscles which are paralyzed or otherwise rendered inactive.

Anatomical Characters. — Fatty infiltration may occasion en- larg-ement of org-ans, accompanied with a certain degree of al- teration in form, there being a tendency to roundness of margins and of the general outline. The colour also becomes paler, and may be similar to that of adipose tissue. The principal changes observed are that the affected structure is softened, and has the doughy feel characteristic of ordinary fat : while evidence of the presence of more or less oil may be obtained, either by the finger, the knife, blotting-paper, or ether. Microscopic examination re- veals the appearances described above.

Symptoms. — General obesity is usually evident enough in the ap- pearance of the individual. The subjects of this condition feel languid, are deficient in bodily activity and vitality, disinclined for exertion, and easily tired. The muscles are wanting in healthy