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Obesity - History

fat, physicians, especially, occurrence, directions, times, body and antiquity

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The possibility of the occurrence of the disease Known as obesity or corpulence, and which is due to errors of nutrition such as the in gestion of unsuitable or excessive amounts of food, was undoubtedly present in the earliest period of development of the human race, at all times and places.

It is least likely to have occurred among those nations of antiq uity which had to struggle for existence with their crude surround ings and whose food was procured by hunting and fishing. Besides, in the flesh of game and fish they possessed a diet which even when consumed in large quantities had the least tendency to favor the de position of fat.

The conditions changed with the increase of cattle raising and the invention of especially with the discovery of the grape and the production of wine in the south, and the preparation of mead and beer from barley and hops in the Borth. These furnished opportuni ties for the consumption of food and drink rich in fat-forming sub stances and alcohol, which by their pleasant taste and intoxicating effect induced the ingestion of amounts beyond the needs of the body. Hence we find in early times personifications of. indulgence and its consequences in mythological figures, in the well-nourished Bacchus and the pot-bellied Silenus in the south and in the legendary fat king of Flanders in the north.

With the progress of civilization and general prosperity among the nations, bringing in their train greater ease of living and love of enjoyment, especially in southern countries bordering on the Mediter ranean, the occurrence of obesity with all its evil consequences became more and more common. For this reason the state took charge of the nutrition and education of its adolescents among those nations whose existence and government, whose cultural development rested upon the vigor and fighting power of their citizens, and upon the highly trained sense of the beauty of form, like the old Greeks and Romans. The laws of Lycurgus were thorough hygienic measures against obesity, laziness, muscular weakness, and stupidity among the Spartan youth and the people in general.

The closely observing physicians of antiquity were as fully alive to the evil results of obesity as were the statesmen. Hippocrates was acquainted with the slight power of resistance of the corpulent against febrile diseases, with the coincidence of obesity and sterility in wo men, with the shortness of life and the occurrence of sudden death in fat persons, and gave strict directions for the prevention of the dis ease. A hard couch, severe physical labor in the early morning be

fore breakfast, vegetable diet, especially the ingestion of greens, hardening of the body in the open, the prohibition of warm baths and of the use of wine unless largely diluted with water, were among his prescriptions.

The later physicians of antiquity, too, Celsus and Galen, gave strict directions against obesity, which the latter author ascribed to the preponderance of phlegm, one of the cardinal humors of his sys tem. He was also aware of the dangers to life, the occurrence of sudden death, and the putrid (asthenic) character of the pyrexia in fe brile diseases in such patients. The directions of the physicians of this period had to do chiefly with the somatic relations and external influences—exercise in the hot sun, the use of baths, especially sea baths (Celsus), vigorous frictions of the body (Ccelius Aurelianus). The influence of nutrition was but little understood in antiquity and the directions in this respect possess merely the character of general restrictive courses.

In the Middle Ages up to recent times no particular progress was made in the knowledge and treatment of obesity. Even the publi cations from the seventeenth and eighteenth centuries, containing chiefly mere descriptions of isolated cases of excessive corpulence and its evils, supply nothing new regarding the pathogenesis of the dis ease nor do they augment the therapeutic resources against it. Mention need be made only of the attempt of surgeons to proceed against obesity by operation and to excise the monstrous and cumbersome masses of fat. Thus a German prince, desiring to become thin, had a physician from upper Italy remove his fat, but unfortunately he died from the operation. It is reported of Ithotonet, a surgeon of Paris, that he in 1718 excised nine pounds of fat from the abdomen of a well-known person and thus relieved her. While during the seventeenth century but few physicians like Panaroli, Sebitz, and Wolf published papers on obesity, the number of dissertations and treatises which have since ap peared in France, England, and Sweden has increased consider ably ; but they contain nothing new iu the pathology of the disease and change or add but little with reference to the well-known thera peutic resources.

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