OBESITY 



By W. EBSTEIN, Gottingen 



We understand by obesity an excessive infiltration of fat into the con- 

 nective tissue in areas of the body where, also in healthy individuals, fat is 

 found in varying quantities. The chief points of deposit of fat are the sub- 

 cutaneous connective tissue and the mesentery. Special parts of the subcu- 

 taneous connective tissue are particularly involved, chiefly the abdomen. In 

 the region of the breasts the deposit of fat may also reach enormous grades. 

 The female breast has been known to attain a weight of 33 pounds. The high- 

 est grades of corpulence we designate obesity. In this condition fat also col- 

 lects in regions where under normal conditions fat can hardly be perceived. 

 Larrey, who accompanied Napoleon I as chief surgeon in all of his campaigns, 

 saw in the Arabs in Syria scrota which attained, owing to fat formation, the 

 size of a bulging cow's udder though under the skin of the normal scrotum 

 only a very scanty loose connective tissue is found. Pat may, therefore, appear 

 even in this region and in great quantity. In regard to the words in common 

 use to designate obesity something may be added in the way of definition. 

 Adipositas is a term often used and this designation is quite clear. A more 

 general term is obesity; ^ the French speak of obesite. The word is derived 

 from " ob " and " edere," and means literally " to eat up quickly." In Eng- 

 lish the term corpulence is generally employed — a term which is also used 

 by the Germans, but not to indicate the most marked grades of obesity. In 

 the excellent book of William Osier: The Principles and Practice of Medi- 

 cine, third edition (Kew York and London), 1898, page 439, the disease is 

 described under the name of obesity, and it is mentioned that Lord Byron 

 who was himself quite fat, as is well known, defined the condition — " oily 

 dropsy." The designations " pimelosis " and " physconia " are but little em- 

 ployed. Like the other terms just discussed, pimelosis refers directly to the 

 main factor of the disease, being derived from the Greek word " v 7rLfj.€Xrj" 



1 According to the Latin dictionary of Forcellinus, the word '' obesitas " occurs in 

 the writings of Columella (a contemporary of Celsus and Seneca), about the middle 

 of the first century A.D., and in Suetonius (according to Teuffel's History of Roman 

 Literature, about 65 a.d. to 160 a.d. ) . The former, in his " de re rustiea " 6, 24, writes : 

 " Ne steriles eas reddat, nimia corporis obesitas." The latter mentions in his biography 

 of Domitian (18), that he was disfigured by a bald head as well as by " obesitate 

 ventris." Further, Suetonius in his history of the life of Claudius (41) tells us that 

 laughter was provoked " defraetis compluribus subselliis obesitate cujusdam." In the 

 Historia Naturalis, Pliny the mder (born 23 a.d.) mentions (17, 27) that certain trees 

 also " laborant obesitate." 



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