An introduction to pathology and morbid anatomy / by T. Henry Green.

Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: An introduction to pathology and morbid anatomy / by T. Henry Green. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    The immediate effect of the interstitial growth is to displace and compress the muscular fibres between which it insinuates itself, and in doing so it diminishes the con- tractile power of the muscle. This is especially important when occurring in the heart. The pressure, however, which it exercises upon the fibres and the accompanying blood-vessels, ultimately causes atrophic and degenerative changes. Thus the fasciculi gradually atrophy, the trans- verse striation becomes indistinct and is replaced by mo- lecular fat; in fine, true metamorphosis of the muscle is estabUshed. These two processes, indeed, not uncommonly go hand in hand together, the interstitial infiltration pre- ceding the intrastitial metamorphosis. FATTY INFILTEATION 01 THE LIVER. It is in the liver that fatty infiltration assumes its most important aspect, and in this organ it is exceedingly frequent, constituting what is commonly known as the fatty liver. The hepatic cells always contain a small quantity of fat, which is temporarily increased after the ingestion of fatty substances. lb will be well to describe this physiological infiltration before proceeding to the morbid process. The ingestion of an ahment rich in fatty substances is followed by a temporary excess of fat in the portal blood, and by the deposition and temporary accumulation of a portion of this within the hepatic cells. This fat is first deposited in the cells which are in immediate contact with the capillaries of the portal vein, and thus is produced an excess of fat in the cells at the circumference of the hepatic lobules. This gradually passes from the cells at the circumference to those in the interior, whence it is ultimately conveyed again into the circiilation. This process goes on until the excess of fat is removed from the blood, when the hepatic cells again acquire their former character. There is thus a transitory accumula- tion of fat within the hepatic cells which is gradually