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THE IMPEDIMENT OF ADIPOSE.-A CELEBRATED

CASE.

By E. VALE BLAKE.

FRO
VROM the days of Hippocrates, intelligent medical observers have

noticed that an unusual accumulation of fat, far from adding to the strength of a person, was a source of physical weakness, and, to a certain extent, an outward sign of incapacity ; that it limited activity and shortened life. It is only in comparatively modern times that scientific experimentalists have ascertained precisely how the system generally, and the heart particularly, is affected either by the overloading or infiltration of superfluous fatty matter upon or in its muscular substance. In fact, it was not until the microscope was carefully applied to the investigation that the disease now known as “fatty degeneration” was really understood.

Every one knows that a certain amount of adipose matter in the human system impedes rapidity of motion. No sportsman would back a pedestrian who turned the scale at three hundred pounds, for instance; but there are other kinds of impedimenta to the human faculties which are certainly to be traced to superfluous fat, though this is rarely suspected of being the cause. A common case is that of the obese gourmand who complains that nothing tastes as it used to; on whose palate, formerly so sensitive, everything palls, and fails to awaken the delicious sensations of former days. He is very apt to attribute the change to the incompetent chef de cuisine, or even to degenerate Nature herself, in not growing the same quality in bird or fish ; while the looker-on is apt to imagine that the change results from mere satiety. But suppose we had our fat friend on the dissecting-table, what should we probably find ? No doubt, insidious deposits of fatty matter which have impeded the lively sensations of the organs of taste and smell, the latter of which so greatly aids the imagination and assists in the pleasure of the table. In the “Medico-Chirurgical Transactions," of 1870, Dr. W. Ogle gives five distinct cases of anosmia arising from an excess of fatty deposit permeating the cells of the olfactory apparatus.

Still more curious, and as generally unsuspected, is the deposit of adipose tissue as a cause of deafness; and this not directly in the organs of hearing, but in the canals leading to the air-passages of the nose and throat. This naturally requires some explanation to nonprofessionals, though the fact is well established. It results from the sympathetic connection which is formed by the continuous mucous membrane, which covers at once the interior of the mouth and throat, the pendulous palate, the tonsils, the isthmus of the fauces, and the

pharynx, etc.; this same web of membrane is carried to the Eustachian tubes (which lead from the back part of the mouth to the cavity of the ear), and thus it is that what only visibly affects one portion, say the lachrymal canal, or the tonsils, may sympathetically disorder the sense of taste or hearing. The substance of this mucous membrane is composed of three layers, containing a cellular or folliculous system of roundish or oval cells, which are subject to morbid alterations, that affect parts far removed from the local appearance of disorder. Thus, Dr. Harvey reports : “I have seen and treated many cases of deafness which appeared to depend solely on nasal obstruction from adipose deposit. It does this by interfering with or impeding the entrance of the air to the mouth of the Eustachian tubes, undue limitation of air lessening the sensibility and acuteness of the auditory organ. These cases usually occur in persons of great corpulence, in which case local treatment is almost valueless. . The corpulence itself must be reduced.”

We might go on and point out many physical ills which result from obesity, and we will name a few ; but our principal object in these pages is to show that a redundance of adipose matter essentially veakens and impedes the power of the will. We know that it disinclines to activity, produces shortness of breath, palpitation of the heart, and comparative weakness in proportion to size, and is often accompanied by anæmia. We can make this clearer, perhaps, by an illustration. The normal weight of a man five feet in height is 120 pounds; of a man five feet ten inches, 169 pounds. Now, suppose the latter really weighs 300 pounds by accumulation of fat, what results but that all this superfluous matter has to be supplied with capillaries, and these have to get blood from vessels only constructed to circulate the original quantity? No wonder is it that the circulation is enfeebled and impeded! By this increase of adipose there is no increase of propelling force. Hence, the overstrain upon the capillaries and the ensuing comparative weakness in the vital functions are explained, and also why external injuries are less easily repaired.

It is a well-settled rule in all animal structures that, when the quantity of fat exceeds the law of their construction, bulk becomes a source of imperfect equilibrium, and therefore of danger. The most bulky animals are not the most useful nor the strongest. An elephant compared with its size is not as strong as an ant. Then there is this physiological fact, that the oleaginous principle is actually less alive than any other part of an animal. Observe the blubber of a whale, into which parasites bore an inch deep without causing any inconvenience, and into which a harpoon may be thrust without serious injury if it does not penetrate to the muscular substance. The quantity of fatty matter in animals seems to bear an inverse relation to the quantity of bodily and mental activity. Hibernating animals, who may be said to live on their own fat, are

the perfection of indolence. All shepherds know that a very fat ewe will not produce a strong lamb.

Some Brahmans pride themselves on their obesity-did one of them ever run a race, or write a book? Chesterfield said that fat and stupidity were such inseparable companions that they might be used as convertible terms. We should not be willing to indorse that opinion exactly; but, if he had said fat and inactivity, he would not be far wrong—though we have seen exceptions even to this. But it is undoubtedly true as a rule. Carnivorous animals that have to earn their dinners are generally thin ; domestic ruminants are fat. Animals shut up in cages either pine and die or get fat. At Strasburg, famous for páté-de-fois-gras, geese are shut up in warm coops and overfed to produce the fat (and diseased) livers so much admired by gourmets. In Italy, wealthy connoisseurs are very fond of fat ortolans, and this is the device by which they obtain them: They shut the birds up in a dark chamber, (knowing that in their natural state it is their habit to feed at sunrise). They then arrange artificial lights which can be cast at will into the dark prison of the birds, on seeing which the ortolans immediately seek the food which is provided for them; the light is withdrawn, and they go to sleep; after a few hours it is again introduced, and so the process is repeated five or six times in the twenty-four hours, so that the birds are kept constantly feeding or sleeping; the consequence is, that in about three days the ortolan becomes “ a delicious ball of fat," and ready for the table.

In the human being there is, however, a difference, just as there is in the domesticated animals; there is what is known as “good fat," which must not of course be too redundant, and “bad fat.” The fat of the florid person may generally be classed with the good, that of the flabby anæmiac with the bad: the latter is recognized in the unwholesome look of the chronic victim of alcohol.

But, to turn from the purely physical aspects of adipose, we wish to invite the reader's attention to a celebrated case of the impediment of adipose in affecting the mental character, and the action or inaction superinduced by this malady.

One of Shakespeare's famous characters—we should say perhaps his supreme portrait—is described thus with one dash of the pen :

He's fat and scant of breath ! " The character of Hamlet has suffered such constant distortion at the hands of commentators, and has been made unintelligible and mysterious through a very natural but fatal oversight, namely, the habitual neglect of the annotators to take into the account the physical organization of the Danish Prince—an oversight which the poet never made. He never failed to make the physique conform to the character.

Every shade of capacity and ingenuity has been expended on the consideration and explanation of Hamlet's mental traits, but unfortunately with an essential factor left out. Not one, of all the numerous writers who have essayed to enlighten the world on the meaning and intent of this “consummate flower” of the poetic insight, has thought to inquire whether the body was not that “unknown quantity" which confounded Schlegel, and which Goethe thought he had found in the lines

"The time is out of joint; O cursed spite!

That ever I was born to set it right!' that is, that the Prince was overborne by the too great pressure of an Herculean task with which he was conscious he had not the ability to cope. But that there was really no insufficiency of mental power appears patent at every forward movement of the play. He perceives the situation clearly, argues about it rationally, notes all the circumstances, and acknowledges his own duty in the premises ; but he does not do the thing which he sets before himself to perform.

Why? Because “he's fat and scant of breath”-in other words, is weighted down with a non-executive or lymphatic temperament.

Painters, as well as actors, have done much to foist a false Hamlet upon the public imagination. He has habitually been represented by both as possessing a nervous, bilious, saturnine temperament, for which there is no warrant in the poet's description of him. Artists have portrayed him as fleshless and dark-hued. Fechter, the sole exception, did indeed remember his nationality to the extent of introducing the novelty of a flaxen wig, which was barely tolerated by the audience, so counter to the truth was the ill-taught popular fancy. But who has yet dared, on canvas or on the stage, to present a true Shakespearean Hamlet "grunting and sweating under his weary load of life” ?—so fat really as to need that “napkin ” which the queen offers him to wipe the perspiration from his brow.*

Yet is this “fat” the keynote and solution of the “mystery of Hamlet.”

Remembering that he was fat and scant of breath, we can readily understand many things which are otherwise certainly perplexing ; particularly the inconsistency between his thoughts and desires and his chronic inaction. He would represent in modern life those persons whose cerebral developments are put down at maximum figures by the expert phrenologist, and who exhibit to admiring friends their large brain-power as thus indicated, but who never do anything to confirm the diagnosis. Again, why? because they lack the energizing temperament without which the brain is but a dumb mass of latent possibilities.

* Profuse perspiration is a recognized symptom of one form of heart-disease-endocarditis.

The character of Hamlet is generally conceded to be the most wonderful production amid all that vast galaxy of dramatic figures which has enchanted the world for three hundred years, and if one new to the subject inquires why it thus takes precedence of Lear, Othello, Macbeth, Shylock, and their proximate peers, we must first answer negatively that it is not because there is so much deeper philosophy in Hamlet than may be found, scattered pearl-like, throughout all the plays by the same master hand, nor because any single passion is therein better delineated-but, affirmatively, because in the Prince of Denmark there is combined the greatest complexity of mental acumen, allied to an unparalleled variety of passional influxes, and bound, alas ! to an inefficient temperament. It is not one master passion which stirs, nor one affection alone that is outraged; not one sole grief that afflicts, or one emotion which reigns supreme over that great but erratic mind : it is a commingling of jarring elements, most difficult to reconcile in the formation of a characteristic individuality.

In the rising tide of the Moor's jealousy we have the most vivid description of a half-savage tornado of mental suffering, produced by the uncontrolled agonies of a strong but simple and ill-balanced mind; in Lear, an already tottering intellect, quite overthrown by the cruel irritations of unimagined ingratitude ; in Macbeth, an unsafe ambition troubled with a conscience ; in Shylock, a member of an outraged race, essaying an hereditary revenge, stimulated by avarice : but in Hamlet we have a whole circle of passions, a complication of emotions to draw into one converging action, like an engine required to run on a main road with many branches, and no steam in the boiler.

To particularize : there is first his natural sorrow for the death of his father; sorrow, anger, and chagrin at the hasty marriage of his mother ; hatred and suspicion of his uncle ; his loss of the crown of Denmark for an indefinite time; the necessity for concealing his suspicions as to the “taking off” of the King; the perplexing and terrifying impressions produced by the vision of the ghost; its adjuration to active revenge ; his love for Ophelia, and its interruption apparently at her own caprice; the annoying surveillance of old Polonius; distrust of his old school friends, Guildenstern and Rosencrantz ; the voluntary assumption of the role of madness, and the necessity of combining this with the retention of his true mental status with certain of his friends ; his unintended injury of Ophelia and her brother through his “brainish” homicide of their father, when he had hoped to slay the King; the distressing madness and death of Ophelia, with her scanty burial rites-imperiling her soul, in the common opinion of the time; the encounter with the irate Laertes : all these and minor complications and difficulties were thrust upon him, a situation scarcely to be successfully encountered by a soul incased in the very fittest framework which nature ever contrived as its instrument for setting a dis

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