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Page 5
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.
Alcoholism also gives rise in some people to a vast increase of adipose
tissue, and the sodden, unwholesome fatness of the hard drinker is a
sufficiently well known and unpleasant spectacle. The overgrowth of
inert people who do not exercise enough to use up a healthy amount of
overfed tissues is common enough as an individual peculiarity, but there
are also two other conditions in which fat is apt to be accumulated to
an uncomfortable extent. Thus, in some cases of hysteria where the
patient lies abed owing to her belief that she is unable to move about,
she is apt in time to become enormously stout. This seems to me also to
be favored by the large use of morphia to which such women are prone, so
that I should say that long rest, the hysterical constitution, and the
accompanying resort to morphia make up a group of conditions highly
favorable to increase of fat.
Lastly, there is the class of fat an�mic people, usually women. This
double peculiarity is rather uncommon, but, as the mass of thin-blooded
persons are as a rule thin or losing flesh, there must be something
unusual in that an�mia which goes with gain in flesh.
Bauer[8] thinks that lessened number of blood-corpuscles gives rise to
storing of fat, owing to lessened tissue-combustion. At all events, the
absorption of oxygen diminishes after bleeding, and it used to be well
known that some people grew fat when bled at intervals. Also, it is said
that cattle-breeders in some localities--certainly not in this
country--bleed their cattle to cause increase of fat in the tissues, or
of fat secreted as butter in the milk. These explanations aid us but
little to comprehend what, after all, is only met with in certain
persons, and must therefore involve conditions not common to every one
who is an�mic. Meanwhile, the group of fat an�mics is of the utmost
clinical interest, as I shall by and by point out more distinctly.
There is a popular idea, which has probably passed from the
agriculturist into the common mind of the community, to the effect that
human fat varies,--that some fat is wholesome and some unwholesome, that
there are good fats and bad fats. I remember well an old nurse who
assured me when I was a student that "some fats is fast and some is
fickle, but cod-oil fat is easy squandered."
There are more facts in favor of some such idea than I have place for,
but as yet we have no distinct chemical knowledge as to whether the
fats put on under alcohol or morphia, or rapidly by the use of oils, or
pathologically in fatty degenerations, or in an�mia, vary in their
constituents. It is not at all unlikely that such is the case, and that,
for example, the fat of an obese an�mic person may differ from that of a
fat and florid person. The flabby, relaxed state of many fat people is
possibly due not alone to peculiarities of the fat, but also to want of
tone and tension in the areolar tissues, which, from all that we now
know of them, may be capable of undergoing changes as marked as those of
muscles.
That, however, animals may take on fat which varies in character is well
known to breeders of cattle. "The art of breeding and feeding stock,"
says Dr. Letheby,[9] "is to overcome excessive tendency to accumulation
of either surface fat or visceral fat, and at the same time to produce a
fat which will not melt or boil away in cooking. Oily foods have a
tendency to make soft fats which will not bear cooking." Such
differences are also seen between English and American bacon, the former
being much more solid; and we know, also, that the fat of different
animals varies remarkably, and that some, as the fat of hay-fed horses,
is readily worked off. Such facts as these may reasonably be held to
sustain the popular creed as to there being bad fats and good fats, and
they teach us 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.
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