PERSONAL APPEARANCES IN HEALTH AND DISEASE. 35 



the foundation for a condition of corpulence to which 

 the subject was previously quite a stranger. The slower 

 process of losing flesh that occurs in chronic wasting 

 diseases affects the same parts, and depends either upon 

 actual starvation, the disease involving the digestive 

 organs, or upon some interference with the natural 

 transformation of food into tissue, or the occurrence of 

 prolonged discharges impoverishing the blood. 



Mere modifications in quantity of the subcutaneous 

 materials are not the only causes of change of form in 

 the soft parts ; abnormal products may accumulate in 

 their tissues and lead to change of shape. This is seen, 

 e.g., after an injury, when a swelling is produced by the 

 escape of blood into the tissues ; or when a part is 

 inflamed. Then it becomes swollen by the escape not 

 actually of blood but of some of the constituents of the 

 blood, and may even go on to form a limited swelling full 

 of matter, an abscess. Or tumours of all kinds may give 

 rise to local derangements in shape. But there is a con- 

 dition, in dropsy, which may effect a change in the whole 

 body, or may be limited to one part. Here the serum of 

 the blood which is unduly watery escapes into the tissues, 

 and replaces the fat; and the skin becomes stretched 

 and smooth in proportion to the amount of the dropsy. 

 Seen to its greatest extent in the dependent lower limbs, 

 where the fluid naturally gravitates, it may appear in all 



