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Page 4
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
originate[5] 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 have sought in vain for English tables giving the weight of men and
women of various heights at like ages. The material for such a study of
men in America is given in Gould's researches published by the United
States Sanitary Commission, and in Baxter's admirable report,[6] but is
lacking for women. A comparison of these points as between English and
Americans of both sexes would be of great interest.
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.[7]
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