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difference between the matter called steatomatous and that of atheroma, remarks how desirable it is that we should be informed, from accurate analysis, whether there be any relation between these two morbid productions and tubercle. In short, morbid states of the arteries have been denominated steatomatous, just as vaguely as other diseases have been called caseous, colloid, encephaloid, &c.

The situation of the disease spoken of as steatomatous is by no means clearly defined; for while it has generally been understood to be contained between the middle and internal coats of the artery,* some authors have described the affection as seated in the latter coat, or at least as distinct from atheroma; and certain tumours or growths projecting into the cavity of the vessel have received the appellation of steatoma.‡

It appears to me, that as the importance of fatty degenerations has never been fully recognised, so their frequency and precise nature has escaped investigation. My observations lead me to infer that certain animal tissues are not more commonly weakened and obstructed by the anormal presence of

* Alex. Monro, Medical Essays and Observations, 4th ed. Edin. 1752, p. 237. Cruveilhier, Dictionnaire de Médecine et de Chirurgie Pratiques, Paris, 1829, tom. 3, p. 397.

ed.

Scarpa, Treatise on Aneurism, translated by Wishart, 2nd Edin. 1819, pp. 88-89. Hodgson, on the Diseases of Arteries and Veins, Lond. 1815, pp. 15-16.

Stenzel, De Steatomatibus in Aorta repertis. (Haller, Disp. Morb. 2, 527.) Wittemberg, 1723.

phosphate of lime than by that of fatty matter. The premises on which this deduction is founded having been given as far as regards the arteries, it remains only to add a few brief remarks on some other parts.

We never hear of fatty degeneration of the testicles, of the kidney and other glands, of the lungs, of the blood, &c. ; yet these affections are rather common in a variety of chronic diseases, especially of old people, and often in connection with great general emaciation.

In wasting of the testicle, and when the functions of that gland are impaired by lingering diseases or old age, the seminal tubes are often more or less obstructed by fatty matter, which occurs in free globules, and in more equal sized and minuter molecules, generally aggregated into comparatively large rounded or irregular masses, nearly opaque, and of a brown or dull yellowish colour. There is reason to believe that the molecules of the semen, which I have elsewhere* described as occurring in healthy animals, are of a fatty nature; but these molecules do not form the dark granular masses or corpuscles above mentioned. The seminal tubes of mammiferous brutes, which have died in confinement, are sometimes nearly opaque, in consequence of being obstructed with brown granular fatty bodies.

In every variety of consolidation of the lungs, more or less fatty matter will be found. In ruddy

* Proc. Zool. Society of London, July 26, 1842.

or red consolidation, the juice chiefly contains pale cells, minute molecules, and a few larger fatty globules. In one case Dr. Davy analysed the pale cells, and concluded that the envelopes contained a large proportion of margarine, and that the molecules were principally composed of oleine. The molecules are probably analogous to the elementary granules of Henle,* which he says are of a fatty nature. How much the molecules differ in size from the larger fatty globules will be seen by a reference to figures 5 and 7. In brown and leadcoloured consolidation of lung, the fatty matter is generally still more abundant than in the red variety, and occasionally in sufficient quantity to grease paper when dried and heated on it. In this form of pneumonia the chief constituents of the juice are dark granular corpuscles, minute molecules, and a few fatty drops. The corpuscles are very variable in magnitude, but frequently about oth of an inch in diameter; they appear dark when viewed by transmitted light, because they are nearly opaque, for they have a lighter hue when seen by reflected light. They are made up of the molecules, and occasionally include much larger fatty globules. There is reason to believe that they are principally composed of oleine. Dr. Davy examined a part of the lung from which figure 8 was made, and found the fatty matter to be chiefly oleine, with a very small proportion of margarine. He concluded that the molecules were composed of oleine.

* Anatomie Générale, traduit par Jourdan, Paris 1843, p. 161.

The foregoing observations, and a comparison of the pale cells of red pneumonia with the dark granular corpuscles of brown pneumonia, as depicted in figures 7 and 8, will show that these two morbid states differ in more respects than in colour. But as the brown and red varieties are apt to be intermingled, so the particles of each will often occur together. The brown consolidation of lung commonly exists in phthisis, and is not at all infrequent independently of tubercular disease.

In gangrene of the lungs, and in inflammation of the black lungs sometimes seen in old persons, fatty globules are generally rather numerous. Some of them are frequently contained in corpuscles like epithelial cells, of which examples are represented in the upper part of figure 5, from ruddy consolidation. Hence it would appear probable that, in some cases, the fatty substance may be secreted or separated from the blood by cells, and not merely derived from it by exudation through the vessels, a circumstance of some interest in relation to the recent doctrine of the ultimate secreting structure.*

The fatty condition of the liver, so well known in pulmonary consumption, has usually been considered as a consequence of impaired respiration. There are some facts, especially those afforded by

* See Henle, Anatomie Générale par Jourdan, p. 211. Goodsir on the Ultimate Secreting Structure, Trans. Roy. Soc. Edin. vol. 15. Carpenter on the Origin and Functions of Cells, p. 23, from Brit. and For. Med. Review, No. 29.

comparative anatomy, favourable to this view. Yet it has appeared to me, after numerous observations, that the quantity of fatty matter in the liver, as a product of disease, is not regularly increased in proportion to the diminution of the special function of the lungs. I have often found the fatty matter of the liver scarcely exceeding the healthy standard in cases where there was the most extensive tubercular disease of the lungs ; and in several other chronic diseases there was an excess of fatty matter in the liver, although the lungs were nearly healthy, quite free from tubercle, and only slightly inflamed. In children cut off by various chronic maladies, but quite free from pulmonary consumption, the liver is not uncommonly surcharged with fatty matter. When this matter is in excess, although plentifully contained in the microscopic cells, as shown by Mr. Bowman,* I have generally found it chiefly accumulated in the interlobular fissures and spaces described by Mr. Kiernan,† or at least around the surface of the lobules, where it forms a distinct buff-coloured boundary to each of them. The ruddy-coloured hepatic lobules appear to diminish in size as the paler fatty substance increases. In a few instances it was principally seated in the centre of the lobules.

SEVERAL months after the foregoing paper was read before the Society, I had an opportunity, for the first

* On the Minute Anatomy of Fatty Degeneration of the Liver: Lancet, 1841-42, vol. i. p. 560.

† Phil. Trans. 1833.

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