CHAPTER IV.
Physical beauty, like virtue, is a type to which all approximate in different degrees, and which, when not wholly departed from, admits the possessor among the number of the accepted in the eyes of the world; but if, in the case of outward figure as with inward morality, any human attribute should appear distorted or unseemly, it gives rise immediately to a feeling of displeasure and aversion.
Occupied at present with the consideration of physical form only, it may be averred that one of the most frequent deformities of the human body consists in an excessive development of fat.
In accordance with the opinions of able physiologists, fat ought to constitute one-twentieth of the entire weight of the body in man (in the female about one-third more than in the male). It consists of a multitude of minute cells, frequently forming large masses held together by a very delicate membrane, the areolar tissue, which serves as a reservoir, and prevents the fat (which is fluid during life) from floating.
When once fat begins to make its appearance in more than ordinary amount, there is no reason why this augmentation should naturally cease at any given point. This corpulence continues to increase until some disease, often occasioned by the condition itself, terminates this frightful increase of size.
Cases of obesity are rarely met with in mountainous countries, and those having a great elevation above the level of the sea, where the atmosphere is dry; whilst they are frequent in valleys and plains at the level of the sea, having a moist atmosphere.
Men are less subject to obesity than women. The areolar tissue which contains the fat is firmer in the male than in the female, and is not so readily distended by the accumulation of adipose matter. Corpulence is usually developed after the body has acquired its full growth, but childhood is not exempt.
Not long ago, a child of four years old was exhibited at Paris, which weighed one hundred and four pounds. Dr. Coe, an English physician, makes mention of a man named Edward Bright, who weighed one hundred and four pounds at ten years of age; at twenty, three hundred and fifty-six pounds; and thirteen months before his death, five hundred and eighty-four pounds. Another person, a nativeof Lincolnshire, weighed five hundred and eighty-three pounds, and was ten feet in circumference: he died in his twenty-ninth year. In another instance a man weighed six hundred and nine pounds: his coat, when buttoned, could contain seven medium-sized persons. A case is recorded of a man who weighed six hundred and forty-nine pounds, and measured four feet three inches across the shoulders. In the "Javannah News," for June, 1853, the following case is communicated by a medical writer: "A young man, who lived about eighteen miles from Batavia, was remarkable for his great size. When twenty-two years of age, he weighed five hundred and sixty-five pounds. He continued to increase to over six hundred pounds. He lived upon his plantation in easy circumstances. Four weeks since, his weight began to increase at the rate of a pound and a half, and subsequently two pounds a day. He died one day last week, suddenly, while sitting in his arm-chair. Three days before his death, he weighed six hundred and forty-three pounds." Dupuytren has recorded the case of one Mary Frances Clay, of whom a plaster cast is preserved in the Museum of the Ecole de Médecine, at Paris. This woman, a native of Vieille Eglise, was of humble parents. Her husband travelledas a pedler from town to town. When thirty-six years of age, she was no longer able to accompany her husband, and took her place at the door of a church, to beg her bread. Her height was five feet one inch, and her circumference five feet two inches. Her head, which was small in proportion to her size, was almost lost between two enormous shoulders, giving her an appearance of immobility. A furrow, several inches deep, was the only boundary between the head and chest. Her breasts were enormous. Looking at her from behind, the shoulders were elevated by fat, and formed two huge protuberances. The arms stood out from the body, in consequence of cushions of fat in the armpits. On observing the plaster cast of this person, the right side will be seen to be much more developed than the left, owing to her habit of lying on that side, and the fat gravitating towards it. For several years she was able to walk from her dwelling to the station at the church door, about a mile; but finally she was compelled to stay at home. She suffered, while walking, from loss of breath, and had violent palpitations of the heart. She was unable to lie down, from a sense of impending suffocation, and was obliged to retain an upright position night and day, seated in an arm-chair. Under these circumstances,nature soon gave out. She fell sick, and was taken to the hospital, where she died. About twenty years ago there was a German in Paris, named Frederick Arrhens. He was then twenty years of age, and weighed four hundred and fifty pounds. In circumference he measured five feet five inches, which corresponded exactly with his stature. He was poor, and had lived chiefly on vegetable and milk diet.
It is almost unnecessary to describe obesity, since it is known at the first glance. The face is animated; the circulation is impeded, and renders the complexion turgid, and sometimes almost of a deep wine-colour. The eyes suffer from this impeded circulation; they are sparkling, and frequently suffused with blood. The ears, which are generally colourless in health, are, for the most part, red in those labouring under obesity. The circulation through the head being greater than through any other part of the body, and being impeded, an almost continual perspiration with great heat is established; thus it is that fat people can seldom bear to have the head covered; in some cases it even produces dizziness. As this condition progresses, if fortunate enough to escape threatened cerebral affections, the blood loses its chief characteristic, and becomes watery; such persons are pale and flabby. The integument of the lower part of the face is capable of great distension, and here, in obesity, fat accumulates, and forms on both sides an unsightly mass, sometimes reaching to the chest. A roll of fat is often found on the back of the neck. The trunk becomes enormously developed, and the breasts particularly enlarged. The arms are very fat; and as the areolar tissue which surrounds the wrist is of a close texture, fat cannot accumulate there, and the skin not being distended, a deep groove or furrow is formed, as is the case in very fat children. The hands usually participate in this excess ofembonpoint, but at a later period than other parts of the body. The abdomen attains a vast size, and impedes walking; so that a person labouring under obesity carries the head erect, and the body thrown back, as in the case of a pregnant woman, in order to preserve the necessary equilibrium and not fall forward. The intestinal mass, with its surrounding fat, being connected with the kidneys, by its weight gives rise to a dragging sensation, and causes pain on walking. It also pushes up the diaphragm, compresses the lungs and the heart, and becomes one of the causes of the sense of oppression complained of by fat people. Many such, especially females, have between theabdomen and the thighs deep furrows, which become scalded, and require the application of starch, or of some other powder, as is the case with infants when very fat. The integument of the thigh is readily distensible, and allows the deposition of fat as far down as the knee joint. At this point the areolar tissue is more dense, and less in quantity. The skin of the thigh, being thus distended, forms large folds, falling over the knee joint. The legs become likewise enlarged, frequently engorged, and troubled with varicosities, more especially towards the lower portion of the limb. Gradually the feet participate in this engorgement.
This general view of the outward appearance of the body of a person labouring under obesity, may give some idea of the disturbance which an excessive amount of fat can produce when situated within the body. On the outer surface it causes an extraordinary distension of the integument, giving rise, as we have before said, to various diseases, such as pimples, boils, eczema, prurigo, &c., which can only be cured by a reduction of corpulence. In the interior of the organism this same excess of fat causes displacement of the viscera, interferes with the due performance of their functions (as we have already explained), and leads to the sudden death of the patient, whilst occupying his arm-chair rather than his bed, for he can rarely assume a recumbent position.
It has been said, moreover, that excessive corpulence modifies the intellectual faculties, diminishes their power, and may even completely annihilate them. The incessant desire for sleep, the somnolence with which fat people are tormented, is sufficient proof of the correctness of the assertion.
The experience of all medical men goes to shew that when persons of obesity are attacked by any acute form of disease, they succumb more easily than those possessing an ordinaryembonpoint. Death usually occurs in such cases unattended with great suffering. Destruction goes on so quietly and imperceptibly, that the physician becomes aware of it only when it is too late to grapple with it.
Excessive corpulence is promoted by want of sufficient exercise, riding in a carriage, lying in bed too much, and the continued use of the warm bath. Having been told by many females, as I have said before, that theirembonpointhad commenced after giving birth to their last child, which they had not suckled, and that they attributed the development of thisembonpointto their not having suckled the child, it may be asked, can this be assigned as one of the causes of excessive corpulence infemales? I mention these facts without venturing at present to give an opinion.
Some physicians, and many of the laity, think that repeated bleedings tend to the development of fat. For my part, the fact is indisputable, both theoretically and as the result of experience. Bleeding removes a portion of the blood, which is flesh in a fluid state, having for its object not only the nutrition of the several organs, but also the stimulation of the heart's movements, and thus the maintenance of life. Taking a little blood, is taking a little of that which maintains life, and is therefore a weakening of every organ of the body. Areolar tissue, which becomes more extensible in proportion as the body becomes more feeble, must have its power of resistance diminished by the bleeding, and more readily permit the deposition of adipose matter. This affords an explanation of the fact stated by many of my female patients, that their excessive corpulence had manifested itself subsequent to repeated blood-lettings.
Bleeding encourages the development of fat in the lower animals, as well as in the human species; a fact well understood by cattle-breeders, who put it in practice in the case of cattle which they wish to fatten. The only exception made by them to this rule, is inreference to those animals which have a soft and yielding skin, as more frequently happens with beasts of a red-and-white colour, which are said to fatten readily. With this intention, agricultural writers recommend the use of blood-letting. An article which appeared in an agricultural journal recommends that every animal intended for fattening should be bled twice, at an interval of a few days.
Some people think that exercise on horseback is apt to produce corpulency, while others entertain a different opinion. The former maintain that persons whose business requires them to be much on horseback, are frequently fat; a remark which is made especially in reference to cavalry officers, and which is quite true. But the following explanation may be offered: A man on horseback undergoes severe exercise; and if he possesses a strong constitution, and takes a sufficient amount of food, this exercise will facilitate the digestive function, and the volume of his body will be increased. But it is necessary that the horseman should be of a very vigorous constitution. In truth, few cavalry officers are corpulent, and these few are to be met with among those who are somewhat advanced in life, and who are by nature well adapted to the profession. The greater number of cavalry soldiers, whether officers or privates, suffer much at first from fatigue. The young men who join a cavalry regiment soon grow thin, and, with but few exceptions, remain thin so long as they are in the service; and indeed it has happened that both in the case of officers and privates, in consequence of not being able to endure horse exercise, they have been obliged to be transferred to the infantry. It is therefore incorrect to regard this kind of bodily exercise as favourable to the development of corpulence.
For the development of obesity, there must exist a certain predisposition. We meet with many who do all in their power to grow fat, and who still remain thin, because, no doubt, they possess some peculiarity of organization which prevents the development of fat.
Obesity may be hereditary; that is to say, the father or the mother may transmit to their children a peculiar formation, having a tendency to make fat. From certain physiological conditions, we may recognize at an early age a natural tendency on the part of some persons to become corpulent. In the young of both sexes, where this predisposition exists, the face is broad and short, the eyes round, and the nose short and thick; the hands and feet are small, and there is a general roundness of limb. When possessed of such an organization, obesity may be warded off by a rational system of diet, to be indicated in the following pages. But the immediate and producing cause of corpulence is to be sought and discovered in the character of the food. The present system is founded upon this principle. Medical authors assert that food has a most important bearing in the production of corpulence. They forbid the use of meat, and recommend watery vegetables, such as spinage, sorrel, salad, fruit, &c., and for beverage water; and at the same time they direct the patient to eat as little as possible. These instructions, like too many others, are given because they are asked, and that in every disease, curable or incurable, the physician is bound to offer some advice. Medical men themselves put no faith in them, since they pronounce obesity to be incurable.
Having devoted a great deal of attention to this enquiry, I have arrived at the conclusion that it is not to be wondered at that obesity should be incurable, because the very means which have been recommended to overcome it, are exactly those best fitted to induce and maintain it.
I lay it down as an axiom, in opposition to the received opinion of centuries, that a very substantial diet, such as meat, does not developfat, and that nothing is more capable of producing the latter than aqueous vegetables and water.
It is a principle which at first sight may appear inadmissible. Nevertheless, the consideration of a few physiological and chemical facts, within the comprehension of everybody, will suffice to prove its correctness.
The most favourable physiological condition for the production of fat, in man as in the lower animals, is a large extent of intestinal absorbent surface, the absorbent vessels being proportional in number to the amplitude of the intestinal surface. The intestines, however, are conformable to the nature of the aliment. The intestines are small in the lion, tiger and panther, because their food consists of a small quantity of flesh. The ox, on the other hand, a herbivorous animal, possesses an enormous paunch, to contain the large mass of food, yielding but little nutritive matter; consequently the herbivora must have a larger absorbent surface than the carnivora. The length of the intestinal tract in herbivorous animals is equal to fifteen times the length of the body; in the carnivora the length of the intestines is about three times that of the body; while in the tiger, feeding exclusively on blood, it equals only the length of the animal. Inthis respect man holds an intermediate position, the intestines being equal in length to about five or six times the height of the individual. This provision of nature is in keeping with the character of his food—partly animal, partly vegetable. It is at his option, however, to modify this natural condition, by living wholly upon meat or wholly upon vegetables. A person whose food is very substantial, but small in quantity (as, for example, meat), does not possess the dilated stomach and intestines of the vegetable feeder, and consequently has a less absorbent surface than the latter. Among animals, we notice that the carnivora have naturally but little fat, scarcely any belly, but an enormous development of muscular power; whilst the herbivora are more or less laden with fat. Among men, it may be noticed that the corpulent shew a preference for vegetable and farinaceous food, and partake largely of water, beer, &c.
If we examine this question from a chemical point of view, we obtain the most satisfactory evidence that flesh must be productive of less fat than vegetable matter. The composition of human fat in 100 parts is
The principal constituents of fat, therefore, are carbon and hydrogen. Again, chemistry teaches that all food not consisting of flesh, such as vegetables, farinacea, sugars, &c., resemble fat, being chiefly composed of carbon and hydrogen; and, still more, that fat exists, already formed, in some vegetable substances, as oil of olives, oil of nuts, and oleaginous seeds. If, therefore, we introduce into the system substances rich in carbon and hydrogen, we must make fat as inevitably as the bee makes honey from its elements contained in the flowers.
On the other hand, we learn also from chemistry, that one of the principal constituents of meat is nitrogen, an element which does not enter into the composition of fat. Food consisting chiefly of meat must be less productive of fat than food mainly composed of carbon and hydrogen, such as vegetables, &c.
Distinguished chemists have endeavoured to shew in what manner the development of fat takes place in the animal economy. A paper was read by me before the Academy of Sciences, at Paris, on the 15th December, 1851, from which the following extract is made:
"Three different opinions are entertained by distinguished chemists, who have given attention to this subject. The first, that of Dumas, maintains that the fatty matter of the body is derived solely from substances analogous to fat in composition, which pre-exist in the food. The second opinion, that of Liebig, is to the effect that the formation of fat is due to a modification of those ternary compounds which constitute so large a proportion of the food of animals. The third opinion suggests that fat may arise in consequence of some special fermentation taking place in the stomach.
"Numerous experiments have been made, in order to determine which of these opinions is correct; but it may be safely said that no satisfactory conclusion has been arrived at.
"In the first place, the experiments have never been conducted under circumstances favourable to the formation of a correct opinion. It is obviously of the first importance, when conducting experiments of this nature, that the food should be supplied so as not to interfere with the tone of the general health, considered morally as well as physically. We can conceive that the deprivation of liberty, in the case of an animal usually in the enjoyment of freedom, may render the experiment of dubious import. Although man is omnivorous, it is impossible that any one can submit, for a great length of time, to live uponone kind of food only, without suffering a sense of loathing.
"What inference can be drawn from those experiments, made for the purpose of ascertaining whether sugar is capable of producing fat, when they were made upon pigeons and doves, which were fed solely upon this substance; at one time being deprived altogether of water, and at another time allowing them as much as they chose to drink?
"Chemists wished to know if butter could engender fat, and doves have been gorged with it, being deprived of all other food during the few days that the experiment lasted; at the end of which time they died, of course excessively lean; and the experimentalists thence concluded that butter does not produce fat. What an extraordinary idea, to feed a granivorous animal upon butter solely, in order to test the question referred to! This experiment forms the subject of a paper written by me, and inserted in the proceedings of the Academy of Sciences, for the year 1844.
"Other experiments upon animals, conducted likewise by men of science, are less open to criticism than the one just referred to; yet it must be confessed that no safe inference could be drawn from them. I am about to submit a few established facts, which may throw somelight upon the question as to the cause of the development of fat.
"For several years past I have given much consideration to the reduction of corpulency in cases where it interfered with the comforts of life, and I can reckon by thousands those who have followed my instructions. I have established it as a fact, without a single exception, that it is always possible to diminish obesity, by living chiefly upon meat, and partaking only of a small quantity of other kinds of food. Make use of whatever medicine you please, it is impossible to obtain the same result in the case of a person partaking indiscriminately of everything which may be placed upon the table. There is yet another condition, without which success is impossible; that is, to absorb but little fluid, whether in the shape of soup or drink, or by means of the bath. A moist atmosphere is favourable to the development of fat: we increase in weight in wet weather.
"I have thousands of cases on record, in support of my statement. Persons from all parts of the world, who have followed my teachings, have experienced a decrease of their corpulence."
The paper upon this subject ended by saying, that according to my opinion, fat mightbe assimilated by either of the three several methods set forth in the beginning of the essay, one not forbidding the action of the others. I begged to be acknowledged by the Academy as the first who had established the fact that, in order to reduce corpulence without interfering with the general health, it is necessary to live chiefly upon meat, avoiding an excess of vegetable and aqueous food, or of any of which the basis is carbon or hydrogen.
These chemical principles are founded upon facts—upon observation. As I have said, carnivorous animals are never fat, because they feed upon a substance rich in nitrogen—flesh; which flesh makes flesh, and very little fat. They have no belly, because flesh, taken in small quantity, suffices for one day, or twenty-four hours.
It has been objected that the carnivora do not always obtain food when hungry, and that they are often obliged to chase their prey for a long time before catching it. This is true; but on the other hand, carnivorous animals, when domesticated and fed upon meat, are not more fat, and have no belly. The celebrated traveller, Levaillant, in his Travels in Africa, says that he has seen, in the southern part of the continent, flocks of gazelles, which live in the interior, numbering from ten to fifty thousand. These flocks are almost continually on the move; they travel from north to south, and from south to north. Those of the flock which are in advance, and in the enjoyment of a rich pasturage, frequently come upon the borders of the settlements of Cape Colony, and are fat; those composing the centre of the herd are less fat; while those in the rear are extremely poor, and dying with hunger. Being thus stayed in their course by the presence of man, they retrace their steps; but those which composed the rear are now in advance, and regain their fat, while those which were in advance become the rear, and lose fat. Notwithstanding the vast numbers which daily perish, their natural increase suffices to maintain the integrity of the herd. In connexion with my subject I may state that these flocks are always accompanied or followed by lions, leopards, panthers and hyenas, which kill as many of them as they please for food, devour a part, and leave the rest to the jackals and other small carnivorous animals, which follow upon their steps. Now, these lions, panthers, leopards and hyenas, which need make but the slightest exertion to find food when hungry, are never fat.
It has been said, by way of objection to my system, that butchers are generally fat, due to their living upon meat. Now, I have madesome enquiries in this matter, and have satisfied myself that butchers, as a general thing, are not fond of meat, but live chiefly upon vegetable food, and usually drink a great deal. It has been said also that their good condition is due to the atmosphere (filled with animal miasm) in which they live, a supposition which has yet to be proven. Again, it has been said that hogs can be fattened upon horse-flesh. My reply is, that they drink at the same time a large amount of water. And here I may remark, that the lard of hogs thus fattened upon flesh is soft and watery, and is considered by dealers to be of little value. It is evidently not due to the flesh upon which these hogs are fed, that their fat is soft and watery, but to the great amount of fluid they imbibe.
On the other hand, those animals which are enormously fat, live exclusively upon vegetables, and drink largely. The hippopotamus, for example, so uncouth in form from its immense amount of fat, feeds wholly upon vegetable matter—rice, millet, sugar-cane, &c. Naturalists long entertained the opinion that this animal, living mostly in the water, fed chiefly upon fish. It is now, however, well ascertained that the hippopotamus never touches fish, and is wholly a vegetable feeder.
The walrus, which, according to Buffon,seems to afford the connecting link between amphibious quadrupeds and the cetacea, is a veritable mass of fat, and lives exclusively upon marine herbage. The walrus of Kamschatka measures from twenty to twenty-three feet in length, sixteen to eighteen feet in circumference, and weighs from six to eight thousand pounds.
The following fact may be cited as a remarkable proof that the quantity of fat in any animal is mainly dependent on the character of its food: Among the whale tribe, those monsters in size, that of Greenland (Balæna mysticetus of Linnæus) possesses the greatest amount of blubber, and it feeds upon zoophytes, of which many resemble as much in character the plant as the animal. The fin-backed whale (Balæna böops of Linnæus), which does not feed upon mucilaginous matter, but upon small fish, has a much thinner layer of blubber than the former. The sperm whale or cachalot (Balæna physalus of Linnæus), which feeds on mackerel, herrings, and northern salmon, although nearly as long as the Greenland whale, is much thinner. The layer of blubber is not so thick as in the fin-backed, and yields only ten or twelve tuns of oil; while the Greenland whale yields fifty, sixty, and even eighty tuns.
Now, chemistry, as we have said, furnishes a rational explanation of these facts. With the exception of flesh, all alimentary substances (the mucilaginous, the gummy, the saccharine, the aqueous, &c.) consist of carbon and hydrogen, and fat is composed of the same elements. Success in the treatment of disease would be more frequent, if medical practitioners would pay greater attention to the chemistry of the vital functions; and the reason why certain articles of diet have a greater tendency than others to the formation of fat, would, by the aid of the exact science of chemistry, be rendered self-evident.
All medical writers agree that want of sufficient exercise—as by lying too much in bed, riding in a carriage, &c.—is favourable to the development of obesity. The explanation is simple. We are all cognizant of the fact, that the body is sustained chiefly by means of food; but we also know that the atmosphere by which we are surrounded, plays an important part in the nourishment of the body. The atmosphere we inspire contains oxygen gas, a portion of which is destined to revivify the blood in its passage through the lungs; another portion we expel, we expire, no longer pure, but in combination with carbon obtained from the body, in the form of carbonic acid gas. Inproportion as the respiration is more active, a larger quantity of oxygen is taken into the system, and more carbon in combination with oxygen is expelled as carbonic acid gas. There is consequently a less amount of carbon left in the system to form fat. The greater the activity of the animal, the more frequent do the respirations become. Having said this, it is readily understood why want of exercise, riding in a carriage, lying too much in bed, tend to the development of fat; because, with this want of activity, respiration is less frequent, and the oxygen combines with a less amount of carbon, and a larger quantity is left to enter into combination with the existing hydrogen, forming fat. Consequently the mountaineer, breathing an atmosphere rich in oxygen, is generally less prone to the formation of fat than the dweller in the valley.
The Bedouin Arab, owing to the activity of a nomadic life, is never fat. Our peasantry are rarely over fat, unless they have acquired wealth sufficient to relieve them from the necessity for labor. Animals which are in constant motion, such as the roebuck and the deer, although feeding upon substances rich in carbon and in hydrogen, have usually but little fat.
Those birds which are continually on thewing are never very fat. On the other hand, birds or animals leading an inactive life readily take on fat. A means frequently resorted to, in order to fatten them, is to feed them in a small enclosure. Some domestic animals are even deprived of all power of motion in order to hasten their fattening.
Among orientals, where the men remain seated the greater part of the day, and the women are obliged to stay in the house without ever going out, frequent examples of obesity are to be met with.
Nuns in their cloistered convents, prisoners in jails often grow fat in spite of their wretched food, because the air they breathe being deficient in oxygen, withdraws but a small portion of the carbon from the system, the remainder going to the formation of fat. It is when the human body has attained its full growth, and especially in the decline of life, that fat in excess begins to be developed. I am of opinion that want of exercise is one of its principal causes. With increasing age the step becomes more guarded, and a repugnance is felt for all bodily exertion. In this way the quality of the air, and the quantity of oxygen it contains have much to do with the formation of fat.
By virtue of that happy distribution and balance of forces to be met with throughoutthe universe, the expired carbonic acid gas of men and animals is destined to the nutrition of plants, which assimilate the carbon and set free oxygen gas. Plants being thus chiefly composed of carbon, are, when taken as food, rich in the chief constituent of fat; and fat itself is frequently a vegetable production. Mutton fat resembles that of the cacao bean, and human fat is similar to olive oil.
It is therefore clearly established that the immediate and direct cause of the development of fat in the case of men and animals is to be sought in the nature of the aliment, giving, at the same time due weight to the several general conditions which have a tendency to favor the development of obesity. All food which is not flesh—all food rich in carbon and hydrogen must have a tendency to produce fat. Upon these principles only can any rational treatment for the cure of obesity satisfactorily rest.