Lectures on nutrition, hypertrophy, and atrophy : delivered in the Theatre of the Royal College of Surgeons, May 1847 / by James Paget ; reported by William S. Kirkes.

  • Paget, James, Sir, 1814-1899.
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on nutrition, hypertrophy, and atrophy : delivered in the Theatre of the Royal College of Surgeons, May 1847 / by James Paget ; reported by William S. Kirkes. 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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    In conclusion of this subject, it mny be proper to shite that there appears no neces- sary, or even frequent, connection between the fatty degeneration of any organ in par- ticular, and that general tendency to the formation of fat which constitutes obesity. No doubt a person who has a natural ten- dency, even when in health, to become corpulent, would, cwteris paribus, be more likely to have fatty degeneration than to have a wasting atrophy in any organ which might fall into the conditions in which these changes originate. And, as a general rule, spirit-drinking, and the excessive use of other hydro-carbonous articles of food, while favouring a general formation of fat, does, also, often give rise to special fatty degeneration in the liver, or some other organ. Yet, on the other hand, one com- monly finds the proper elements of all the tissues—the heart, the liver, and the rest— quite healthy in men who are very corpu- lent. The muscular fibres of the heart, or of the voluntary muscles, may be imbedded in adipose tissue, and yet may be themselves free from the least degeneration. So, also, the hepatic cells may be nearly free from fat within, though there be much oil around them. Fat accumulated in tissue round a part is a very different—probably an essen- tially differen—thing from fat within it; the one is compatible with perfect strength, the other is always a sign of loss of power. In the muscles of some fish—the eel espe- cially—it is hard to get a clear sight of the fibres, the oily matter round them is so abundant: but the fibres are peculiarly strong, and, in their own texture make a striking contrast with the fibres of a dege- nerate muscle, in which the fat is, in great part, within. The same essential distinction between general and local fat-formation, though they may often coincide, is shown in the fact that the local formation very often happens in those whose general condition is that of emaciation. It was so, in the cases o f paralysed lower extremity with diseased hip ; of the fatty pancreas,—in a case of osteoid tumor, with fatty liver,—and in the cancer of the spleen in a patient emaciated with cancer of the breast. On the whole, therefore, we must con- clude that something much more than a general tendency to form fat, or a general excess of fat in the blood, is necessary to produce a local fatty degeneration. The general conditions are favourable, but not essential, to this form of atrophy.