Fat and Blood | Page 3

rapid lessening of the deposits of hydro-carbons stored away in the
areolæ of the tissues is of importance, as indicating their excessive use
or a failure of supply; and when either condition is to be suspected it
becomes our duty to learn the reasons for this striking symptom. Loss
of flesh has also a collateral value of great import, because it is almost
an invariable rule that rapid thinning is accompanied soon or late with
more or less anæmia, and it is uncommon to see a person steadily
gaining fat after any pathological reduction of weight without a
corresponding gain in amount and quality of blood. We too rarely
reflect that the blood thins with the decrease of the tissues and enriches
as they increase.
Before entering into this question further, I shall ask attention to some
points connected with the normal fat of the human body; and, taking

for granted, here and elsewhere, that my readers are well enough aware
of the physiological value and uses of the adipose tissues, I shall
continue to look at the matter chiefly from a clinical point of view.
When in any individual the weight varies rapidly or slowly, it is nearly
always due, for the most part, to a change in the amount of adipose
tissue stored away in the meshes of the areolar tissue. Almost any grave
change for the worse in health is at once betrayed in most people by a
diminution of fat, and this is readily seen in the altered forms of the
face, which, because it is the always visible and in outline the most
irregular part of the body, shows first and most plainly the loss or gain
of tissue. Fatty matter is therefore that constituent of the body which
goes and comes most easily. Why there is in nearly every one a normal
limit to its accumulation we cannot say, nor yet why this limit should
vary as life goes on. Even in health the weight of men, and still more of
women, is by no means constant, but, as a rule, when we are holding
our own with that share of stored-up fat which belongs to the individual
we are usually in a condition of nutritive prosperity, and when after any
strain or trial which has lessened weight we are slowly repairing
mischief and laying by fat we are equally in a state of health. The loss
of fat which is not due to change of diet or to exercise, especially its
rapid or steady loss, nearly always goes along with conditions which
impoverish the blood, and, on the other hand, the gain of fat up to a
certain point seems to go hand in hand with a rise in all other essentials
of health, and notably with an improvement in the color and amount of
the red corpuscles.
The quantity of fat which is healthy for the individual varies with the
sex, the climate, the habits, the season, the time of life, the race, and the
breed. Quetelet[3] has shown that before puberty the weight of the male
is for equal ages above that of the female, but that towards puberty the
proportional weight of the female, due chiefly to gain in fat, increases,
so that at twelve the two sexes are alike in this respect. During the
child-bearing time there is an absolute lessening on the part of the
female, but after this time the weight of the woman increases, and the
maximum is attained at about the age of fifty.

Dr. Henry I. Bowditch[4] reaches somewhat similar conclusions, and
shows from much more numerous measurements of Boston children
that growing boys are heavier in proportion to their height than girls
until they reach fifty-eight inches, which is attained about the
fourteenth year. Then the girl passes the boy in weight, which Dr.
Bowditch thinks is due to the accumulation of adipose tissue at puberty.
After two or three years more the male again acquires and retains
superiority in weight and height.
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