On the so-called fatty degeneration of the placenta / by James M. Cowan.

  • Cowan, James Moffat.
Date:
1854
Catalogue details

Licence: Public Domain Mark

Credit: On the so-called fatty degeneration of the placenta / by James M. Cowan. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    flammatory view of this condition. I have not been able, in those two instances which fell under my observation, to sa- tisfy myself that the layer of granules was deposited under- neath an external membrane, as Mr Paget has pointed out in the vessels of the brain. The regular and equal distri- bution of the granules over the exterior of the vessels ; the non-coincidence with any general inflammatory symptoms ; their occurrence in patients of a certain cachectic constitu- tion, in whom it is reasonable to suppose there existed some modification of the nutritive process ; their continuance in a low stage of development, with the fact of fibrine occurring as a constituent of the coats of the vessels,—all such circum- stances go in support of the view of fatty degeneration of the coats of the vessels. That this morbid condition of the placenta is not an in- stance of fatty deposition,1 I consider demonstrated already by what has been said in the preface to this paper regarding what is to be understood by the phrase “ fatty deposition.” ls(, The terms imply a certain amount of fat to be a normal constituent of the organ. True fat cannot be detected, even by chemical analysis in almost inappreciable quantity, in the tissue of the placenta ; the first condition, then, for fatty de- position is awanting. 2d, The terms imply a deposit of true adipose tissue. In the placenta true adipose cells have never been seen under the microscope, either in its normal or abnormal state. The only other view of the pathology of this lesion which remains is that of fatty degeneration, and this is divisible into two branches, according to the supposed material which under- goes degeneration ; some regarding it as the tissue proper of the placenta, others, a material foreign to its normal con- stitution. The facts' opposed to the former view are the following:— 1 st, The villi, even in the most exaggerated forms of the dis- ease, present their natural configuration ; they never appear broken up nor disintegrated ; occasionally, they are more compressed, and present a smaller extent of surface than normally, but this is quite explicable on mechanical grounds. 2d, The placenta in these cases feels hard and condensed. If such were the real explanation of the phenomenon, it would be natural to expect the tissue of a softer consistence. 3d. The fat globules are situated on the surface of the villi, and do not form part and parcel of their structure. Besides 1 Dr Quain, in his paper on “ Patty Heart,” in the London Medico-Chirurg. Society’s Transactions, restricts what is implied by the phrase Catty deposition in the same manner. (January 1851.)