62 



ADIPOSE TISSUE. 



with injected vessels containing dark-coloured 

 blood. 



c. It is chiefly in the corpulent, either by 

 habit or by age, that this disease assumes its 

 most exquisite, intense, and unmanageable 

 forms. In persons of this description, who it 

 is matter of common observation are generally 

 not only plethoric but bloated, and liable to 

 imperfect circulation, and disorders of the cir- 

 culation and secretions generally, and in whom 

 very slight causes often induce serious disor- 

 ders, the adipose tissue appears to lose a great 

 proportion of the small degree of vital energy 

 which it possesses, and the more abundant its 

 secreted product is, the less active are its vessels 

 and the inherent properties of the membrane. 

 In consequence of this greatly impaired energy, 

 slight causes, as cold, injury, punctures, &c. 

 produce suddenly a complete loss of circula- 

 tion and action in the tissue ; for it is not in- 

 creased but diminished action ; and this im- 

 paired energy continues, until the natural func- 

 tions of the tissue become extinct. It is thus 

 that the secreted or inorganic matter of the 

 adipose tissue becomes, as it were, a cause of 

 strangulation of the tissue itself, or at least 

 leads so directly to suppress the energies of its 

 organic part, that it is incapable of resisting 

 morbific agents of ordinary power, and hence 

 the organic part either may be smitten with 

 immediate death or is very easily made to 

 assume a very low and imperfect form of mor- 

 bid action, which speedily terminates in death. 



On this subject it is further proper to ob- 

 serve that Mr. Bromfield, surgeon to St. 

 George's Hospital, who sixty years ago main- 

 tained the distinct characters and situation of 

 the adipose membrane from the cellular, taught 

 also that the former was liable to inflammation, 

 but erroneously imagined that this inflamma- 

 tion was of the circumscribed kind only.* 



2. Hemorrhage. Effusion of blood into the 

 adipose tissue is not very common. It is ob- 

 served in the same circumstances nearly in 

 which it occurs in the filamentous tissue. Thus 

 it has been seen in land and sea-scurvy. Hux- 

 ham observed it in fevers with petechial erup- 

 tions. And Cleghorn states that one of the 

 appearances after death in the continuous and 

 malignant tertians of Minorca was extravasa- 

 tion of blood in the form of black patches in 

 the adipose layer of the mesentery, omentum, 

 and colon. 



3. Excessive deposition. In certain subjects, 

 and in peculiar circumstances, the quantity de- 

 posited is enormous. The average weight of 

 the human subject at a medium size is about 

 1 60 pounds, or between eleven and twelve 

 stones. Yet instances are on record of its 

 attaining, by deposition of fat in the adipose 

 membrane, the extraordinary weight of 510 and 

 600 pounds, or from thirty-five to forty stones. 

 Cheyne mentions a case in which the weight 

 was 448 pounds, equal to thirty-two stones. 

 In the Philosophical Transactions are recorded 

 two cases of persons so corpulent, that one 

 weighed 480 pounds and another 500 pounds. 



* Chirurgical Observations, vol. i. p. !H. 



And the Breslau Collections contain cases in 

 which the human body weighed 580 and 600 

 pounds. 



In females and in eunuchs it is more abun- 

 dant than in males ; in females deprived of the 

 ovaries it is more abundant than in those pos- 

 sessed of these organs ; and it is well known 

 that sterility is frequent among the corpulent of 

 both sexes. In some circumstances this accu- 

 mulation may be so great as to constitute dis- 

 ease, (polysarcia udiposa of several nosolo- 

 gists); and in other circumstances the deposi- 

 tion of fat is a means which the secreting 

 system seems to employ to relieve fulness and 

 tension of the vessels, and if not to cure, at 

 least to obviate morbid states of the circula- 

 tion. (Parry.) Accumulations of fat are said 

 to take place in some animals in a few hours 

 in certain states of the atmosphere. During 

 a fog of twenty-four hours continuance, thrushes, 

 wheat-ears, ortolans, and red-breasts are report- 

 ed to become so fat that they are unable to fly 

 from the sportsman. (Bichat.) 



4. Extreme diminution. The diminution or 

 disappearance of fat is much more frequent 

 than its extraordinary abundance. This dimi- 

 nution is said to depend on one or other of the 

 following causes. 1st. Long abstinence, as in 

 fasting, and the periodical sleep of dormant 

 animals ; 2d, organic diseases, as consumption, 

 cancer, disease of the liver, of the heart, ulce- 

 ration of the intestines, &c. ; 3d, purulent col- 

 lections or secretions ; 4th, leucophlegmatic 

 and dropsical states ; 5th, gloomy and melan- 

 choly thoughts or passions ; 6th, long and un- 

 interrupted effort of the intellectual powers ; 

 7th, preternatural increase of the natural evacu- 

 ations, as in cholera, diarrhoea, diabetes, &c. 

 mucous discharges, especially from the pulmo- 

 nary and intestinal membranes, as in chronic 

 catarrh, inflammation of the intestines, and 

 dysentery ; 8th, long and intense heat, whether 

 natural, as during hot summers, or artificial, as 

 in furnaces, hot-houses, &c. ; 9th, running, 

 riding, and every species of fatiguing exercise 

 long-continued, as is exemplied in the case of 

 grooms at Newmarket, Doncaster, &c. ; 10th, 

 states of long disease, not organic; llth, night- 

 watching and want of sleep in general ; 12th, 

 immoderate use of spirituous liquors; 13th, 

 habit of eating bitter and spiced or acid 

 aliments. 



Yet even in these states the fat of the animal 

 body is seldom entirely wasted. In several 

 organic diseases, in which great emaciation 

 takes place, a considerable quantity of fat is 

 always found in the orbits behind the eyeball, 

 round the substance of the heart, around the 

 kidneys, in the colon, and in the mesentery 

 and omentum. Thus one or both lungs may 

 be extensively occupied by tubercles and indu- 

 rated portions giving rise to the usual symptoms 

 of pulmonary consumption terminating fatally, 

 yet without removing the fat from the subcuta- 

 neous layer of the chest and belly; and in 

 various organic affections of the brain espe- 

 cially, a considerable quantity of fat is found, 

 not only in the subcutaneous layer, but at the 

 outer surface of the serous membranes. 



