THE DISTRIBUTION OF FAT IN THE LIVER

1. Nearly all livers at autopsy contain fat which is histologically demonstrable. 2. Fatty substances in the liver appear chiefly in two forms, as small granules and as globules of various sizes. 3. We suppose that granules indicate the (protoplasmic) change commonly spoken of as fatty degeneration, and that globules of small size are excess of fat, stored up by reason of some pathological change which may be merely temporary. 4. Fat is oftenest central, least often in the mid-zone. 5. A heavy deposit of fat is compatible with a competent liver. 6. Intense fattiness, generally globular, occurs with intoxications of bacterial and chemical nature, as well as in cases where a complex toxin is manufactured by the body-cells. 7. Granular fat occurs oftener than globular: it affects most often the central zone; globular affects most often the peripheral. 8. " Accidental " masses of globular fat are found at times, and appear to follow no rule of position: these are comparable to lipomata, which are evidently the result of a pathological process. 9. We found no deposit of fat characteristic of uremia. 10 We know of no analysis of the liver fats in the granular and globular states respectively: it seems to have been taken for granted that the deposits were one and the same. To determine the relationship, if any, between these two forms should be the basis of investigation.