Fat and Blood | Page 6

the lesson that in man, as in animals, there may
be a difference in the value of the fats we acquire, according as they are
gained by one means or by another.
The recent researches of L. Langer have certainly shown that the fatty
tissues of man vary at different ages, in the proportion of the fatty acids
they contain.
I have had occasion, of late years, to watch with interest the process of
somewhat rapid but quite wholesome gain in flesh in persons subjected
to the treatment which I shall by and by describe. Most of these persons
were treated by massage, and I have been accustomed to question the
masseur or masseuse as to the manner in which the change takes place.
Usually it is first seen in the face and neck, then it is noticed in the back
and flanks, next in the belly, and finally in the limbs, the legs coming
last in the order of gain, and sometimes remaining comparatively thin
long after other parts have made remarkable and visible gain. These

observations have been checked by careful measurements, so that I am
sure of their correctness for people who fatten while at rest in bed. The
order of increase might be different in people who fatten while afoot.
Facts of this nature suggest that the putting on of fat must be due to
very generalized conditions, and be less under the control of local
causes than is the nutrition of muscles, for, while it is true that in
wasting from nerve-lesions the muscular and fatty tissues alike lessen,
it is possible to cause by exercise rapid increase in the bulk of muscle
in a limb or a part of a limb, but not in any way to cause direct and
limited local increment of fat.
Looking back over the whole subject, it will be well for the physician
to remember that increase of fat, to be a wholesome condition, should
be accompanied by gain in quantity and quality of blood, and that while
increase of flesh after illness is desirable, and a good test of successful
recovery, it should always go along with improvement in color. Obesity
with thin blood is one of the most unmanageable conditions I know of.
The exact relations of fatty tissue to the states of health are not as yet
well understood; but, since on great exertion or prolonged mental or
moral strain or in low fevers we lose fat rapidly, it may be taken for
granted that each individual should possess a certain surplus of this
readily-lost material. It is the one portion of our body which comes and
goes in large amount. Even thin people have it in some quantity always
ready, and, despite the fluctuations, every one has a standard share,
which varies at different times of life. The mechanism which limits the
storing away of an excess is almost unknown, and we are only aware
that some foods and lack of exertion favor growth in fat, while action
and lessened diet diminish it; but also we know that while any one can
be made to lose weight, there are some persons who cannot be made to
gain a pound by any possible device, so that in this, as in other things,
to spend is easier than to get; although it is clear that the very thin must
certainly live, so to speak, from hand to mouth, and have little for
emergencies. Whether fat people possess greater power of resistance as
against the fatal wasting of certain maladies or not, does not seem to be
known, and I fancy that the popular medical belief is rather opposed to

a belief in the vital endurance of those who are unusually fat.
That I am not pushing too far this idea of the indicative value of gain of
weight may be further seen in persons who suffer from some incurable
chronic malady, but who are in other respects well. The relief from
their disease, even if temporary, is apt to be signalled by abrupt gain in
weight. A remarkable illustration is to be found in those who suffer
periodically from severe pain. Cessation of these attacks for a time is
sure to result in the putting on of flesh. The case of Captain Catlin[10]
is a good example. Owing to an accident of war, he lost a leg, and ever
since has had severe neuralgic pain referred to the lost leg. These
attacks depend almost altogether on storms. In years of fewest storms
they are least numerous, and the bodily weight, which is never
insufficient, rises. With their increase it lowers to a certain amount,
beneath which it does not fall. His weight is, therefore, indirectly
dependent upon the number of storms to the influence of which he is
exposed.