ANTAGONISTIC NUTRITIVE ANOMALIES.
Virchow first called attention to certain abnormal nutritive pro cesses in adipose tissue, which presuppose a natural disposition to general hyperplasia of the fatty tissue or are prone to produce a partial form, even when the consumption of fat-forming substances in the food does not exceed the normal. These nutritive anomalies have not yet found a satisfactory explanation.
The cases to be first enumerated here are rare and should be kept apart from the ordinary cases of polysarcia because of their patho logical peculiarities and defects. The obesity beginning at birth and increasing during childhood is termed by Chambers a kind of mal formation in which the patients usually suffer from some other phy sical deformity, or from a lack of intelligence, or from some greater defects of cerebral development. An accumulation of fat _which is often very great is found in acephalous monsters and was first observed and described by Lobstein ; it occurs likewise in cretinous dwarfs, and Virchow has classed the obesity of the acephali with the latter. Treatment of course is hopeless.
Antagonistic nutritive relations exist moreover between obesity and the functional activity of the sexual organs and the nutritive re lations dependent upon it, or between the absence of this activity and the loss or disease of the sexual organs. In men whose sexual ac tivity ceases early or who have become impotent from any cause, or have undergone castration, we often observe a rapid increase of fat formation. In the same way fattening is effected more easily and
extensively in castrated animals—capons, oxen, and sheep. . Not rarely, too, the adipose tissue of women is augmented considerably when menstruation ceases, sometimes also after the normal puerpe rium and prolonged lactation; in such cases, however, the conser vation of nutritive material must be taken into consideration. In like manner women with insufficient exercise of the sexual function or young widows who live virtuous and care-free lives frequently become obese. According to a compilation by Tilt (Kriegel.), of 282 women whose menstruation had ceased for five years 121 had become obese, 71 had retained their normal figure, and 90 had become thinner. Moreover in women who are sterile in consequence of uterine or ovarian disease an increase of adipose tissue has been observed. There can also be no doubt that among religious celibates, some of whom live immured in monasteries (monks, nuns), the plentiful ingestion of fat forming substances in their diet, especially during Lent, with their quiet life free from care and subject to few exertions, must contribute largely to the development of obesity.
A similar nutritive contrast would, according to Kisch, also ex plain the excessive corpulence of scrofulous children and the occur rence of lipomatosis after recovery from secondary syphilis.
Another disposition to increased formation of fat is furnished by