152 OBESITY 



(= fat) . Hyrtl (Text-Book of Human Anatomy, 20th edition, Vienna, 1889, 

 p. 114) holds that the word constructed by pathologists, " pimelosis," is quite 

 superfluous, since the Greek physicians already had a word for this disease, 

 namely iridri^s. Physeonia, from "6 i/rwKw," big-bellied, is the nickname 

 of Ptolemy the Eighth, Energetes the Second (170 B.C.), the classic prede- 

 cessor of Banting. Occasionally polysarcia adiposa (j^a-dpi, flesh) is used as 

 a synonym for obesity. Strictly speaking, polysarcia should only be used for 

 that stage of obesity in which the fat patient still retains his muscular power, 

 as is occasionally observed at the beginning of the disease. But frequently 

 such persons suffer from muscular weakness at the very onset of obesity. 

 Among many other designations for obesity, lipomatosis universalis may be 

 mentioned — a term which is used as a synonym for the highest grades of 

 obesity. The fat which is normally present about the epicardium attains 

 decided development, and, for example, in lipomatosis cordis, or true fatty 

 heart, we note that the myocardium almost completely disappears before the 

 proliferating fat which permeates it. 



That fat people have existed since the coming of man is in itself probable, 

 but this is also proven by the oldest records. In the Book of Judges, 3, 21, 

 we read that Ehud (a left-handed man whom Jahve had raised up to deliver 

 the Israelites from the bondage of Eglon king of Moab), in obedience to God's 

 command put forth his left hand, and took the dagger from his right thigh, 

 and thrust it into Eglon's belly, and the haft also went in after the blade, and 

 the fat closed upon the blade, so that he could not draw the dagger out of his 

 belly; for Eglon was a very fat man. In Psalms 73, 7, there is written, 

 " Their eyes stand out with fatness : they have more than heart could wish," 

 and, finally, in the Book of Job, 15, 27, we read : " Because he covereth his 

 face with his fatness, and maketh collops of fat on his flanks." ^ Whether 

 obesity was a matter for professional treatment among the Israelites cannot 

 be determined from Biblical records; we shall revert to this later. In the 

 Hippocratie writings we find the earliest rules regarding the treatment of 

 obesity — rules which hold good even to-day. In the art of the Greek mythol- 

 ogy, Silenus is usually represented as a bald-headed old man with a pug nose, 

 small pig ears, and pot-bellied, a typical representation of obesity in the stage 

 which I have designated as the " ludicrous." Rubens, in one of his pictures 

 has graphically portrayed the plump, drunken Silenus, supported by a negro 

 who walks behind him. That obesity during the time of the Roman Emperors 

 excited ridicule is proven by the previously mentioned quotation from Sue- 

 tonius, and Columella alludes delicately to the prohibitive influence of obesity 

 upon feminine fertility. Pliny the Elder, who was almost contemporaneous 

 with Columella, formulated rules for the treatment of obesity which later were 

 generally accepted. These ancient views have lately been brought forth by 

 some authors as the result of their individual investigations. I shall subse- 

 quently revert to this again. 



Obesity is a very common disease. Indeed L. Traube considers that a 

 certain amount of stoutness (which the French and sometimes the Germans 



1 W. Ebstein, " Die Medicin im Alten Testament," Stuttgart, 1900, pp. 10 and 150. 



