Fat and Blood

Excerpt:

Yet as life advances there are peculiarities which belong to individuals and to families. One group thins as life goes on past forty; another group as surely takes on flesh; and the same traits are often inherited, and are to be regarded when the question of fattening becomes of clinical or diagnostic moment. Men, as a rule, preserve their nutritive status more equably than women.

Every physician must have been struck with this. In fact, many women lose or acquire large amounts of adipose matter without any corresponding loss or gain in vigor, and this fact perhaps is related in some way to the enormous outside demands made by their peculiar physiological processes. Such gain in weight is a common accompaniment of child-bearing, while nursing in some women involves considerable gain in flesh, and in a larger number enormous falling away, and its cessation as speedy a renewal of fat. I have also found that in many women who are not perfectly well there is a notable loss of weight at every menstrual period, and a marked gain between these times.

I was disappointed not to find this matter dealt with fully in Mrs. Jacobi's able essay on menstruation, nor can I discover elsewhere any observations in regard to loss or gain of weight at menstrual periods in the healthy woman.

How much influence the seasons have, is not as yet well understood, but in our own climate, with its great extremes, there are some interesting facts in this connection. The upper classes are with us in summer placed in the best conditions for increase in flesh, not only because it is their season of least work, mental and physical, but also because they are then for the most part living in the country under circumstances favorable to appetite, to exercise, and to freedom from care. Owing to these fortunate facts, members of the class in question are apt to gain weight in summer, although many such persons, as I know, follow the more general rule and lose weight. But if we deal with the mass of men who are hard worked, physically, and unable to leave the towns, we shall probably find that they nearly always lose weight in hot weather.

Some support is given to this idea by the following very curious facts. Very many years ago I was engaged for certain purposes in determining the weight, height, and girth of all the members of our city police force. The examination was made in April and repeated in the beginning of October. Every care was taken to avoid errors, but to my surprise I found that a large majority of the men had lost weight during the summer. The sum total of loss was enormous. As I have mislaid some of the sheets, I am unable to give it accurately, but I found that three out of every five had lessened in weight. It would be interesting to know if such a change occurs in convicts confined in penitentiaries.

I am acquainted with some persons who lose weight in winter, and with more who fail in flesh in the spring, which is our season of greatest depression in health,-the season when with us choreas are apt to originate5 or to recur, and when habitual epileptic fits become more frequent in such as are the victims of that disease.

Climate has a good deal to do with a tendency to take on fat, and I think the first thing which strikes an American in England is the number of inordinately fat middle-aged people, and especially of fat women.

This excess of flesh we usually associate in idea with slothfulness, but English women exercise more than ours, and live in a land where few days forbid it, so that probably such a tendency to obesity is due chiefly to climatic causes. To these latter also we may no doubt ascribe the habits of the English as to food. They are larger feeders than we, and both sexes consume strong beer in a manner which would in this country be destructive of health.

These habits aid, I suspect, in producing the more general fatness in middle and later life, and those enormous occasional growths which so amaze an American when first he sets foot in London. But, whatever be the cause, it is probable that members of the prosperous classes of English, over forty, would outweigh the average American of equal height of that period, and this must make, I should think, some difference in their relative liability to certain forms of disease, because the overweight of our trans-Atlantic cousins is plainly due to excess of fat.

I doubt whether in this country as notable a growth in bulk as multitudes of English attain would be either healthy or desirable in point of comfort, owing to the distress which stout people feel in our hot summer weather. Certainly "Banting" is with us a rarely-needed process, and, as a rule, we have much more frequent occasion to fatten than to thin our patients. The climatic peculiarities which have changed our voices, sharpened our features, and made small the American hand and foot, have also made us, in middle and advanced life, a thinner and more sallow race, and, possibly, adapted us better to the region in which we live. The same changes in form are in like manner showing themselves in the English race in Australia.

Some gain in flesh as life goes on is a frequent thing here as elsewhere, and usually has no unwholesome meaning. Occasionally we see people past the age of sixty suddenly taking on fat and becoming at once unwieldy and feeble, the fat collecting in masses about the belly and around the joints. Such an increase is sometimes accompanied with fatty degeneration of the heart and muscles, and with a certain watery flabbiness in the limbs, which, however, do not pit on pressure.