b. This doctrine further does not rest upon evidence deduced from the mere symptomatic characters of the disorder. In fatal instances of diffuse inflammation, we find the adipose membrane not only partially mortified and suppurated, but that part of it adjoining to the skin and to the bloodvessels very much loaded, with injected vessels containing dark-coloured blood.
c. It is chiefly in the corpulent, either by habit or by age, that this disease assumes its most exquisite, intense, and unmanageable forms. In persons of this description, who it is matter of common observation are generally not only plethoric but bloated, and liable to imperfect circulation, and disorders of the cir-: culation and secretions generally, and in whom very slight causes often induce serious disor ders, the adipose tissue appears to lose a great proportion of the small degree of vital energy which it possesses, and the more abundant its secreted product is, the less active are its vessels and the inherent properties of the membrane. In consequence of this greatly impaired energy, slight causes, as cold, injury, punctures, &c. produce suddenly a complete loss of circula tion and action in the tissue; for it is not in creased but diminished action ; and this im paired energy continues, until the natural func tions of the tissue become extinct. It is thus that the secreted or inorganic matter of the adipose tissue becomes, as it were, a cause of strangulation of the tissue itself, or at least leads so directly to suppress the energies of its organic part, that it is incapable of resisting morbific agents of ordinary power, and hence the organic part either may be smitten with immediate death or is very easily made to assume a very low and imperfect form of mor bid action, which speedily terminates in death.
On this subject it is further proper to ob serve that Mr. Bromfield, surgeon to St. George's Hospital, who sixty years ago main tained the distinct characters and situation of the adipose membrane from the cellular, taught also that the former was liable to inflammation, but erroneously imagined that this inflamma tion was of the circumscribed kind only.* 2. Hemorrhage.—Effusion of blood into the adipose tissue is not very common. It is ob served in the same circumstances nearly in which it occurs in the filamentous tissue. Thus it has been seen in land and sea-scurvy. Hux ham observed it in fevers with petechial erup tions. And Cleghorn states that one of the appearances after death in the continuous and malignant tertians of Minorca was extravasa tion of blood in the form of black patches in the adipose layer of the mesentery, omentum, and colon.
3. Excessive deposition.—In certain subjects, and in peculiar circumstances, the quantity de posited is enormous. The average weight of the human subject at a medium size is about 160 pounds, or between eleven and twelve stones. Yet instances are on record of its
attaining, by deposition of fat in the adipose membrane, the extraordinary weight of 510 and 600 pounds, or from thirty-five to forty stones. Cheyne mentions a case in which the weight was 448 pounds, equal to thirty-two stones. In the Philosophical Transactions are recorded two cases of persons so corpulent, that one weighed 480 pounds and another 500 pounds.
And the Breslau Collections contain cases ill which the human body weighed 580 and GOO pounds.
In females and in eunuchs it is more abun dant than in males ; in females deprived of the ovaries it is more abundant than in those pos sessed of these organs ; and it is well known that sterility is frequent among the corpulent of both sexes. In some circumstances this accu mulation may be so great as to constitute dis ease, (polysarcia adiposa of several nosolo gists); and in other circumstances the deposi tion of fat is a means which the secreting system seems to employ to relieve fulness and tension of the vessels, and if not to cure, at least to obviate morbid states of the circula tion. (Parry.) Accumulations of fat are said to take place in some animals in a few hours in certain states of the atmosphere. During a fog of twenty-four hours continuance, thrushes, wheat-ears, ortolans, and red-breasts are report ed to become so fat that they are unable to fly from the sportsman. (Bichat.) 4. Extreme diminution.—The diminution or disappearance of fat is much more frequent than its extraordinary abundance. This dimi nution is said to depend on one or other of the following causes. 1st. Long abstinence, as in fasting, and the periodical sleep of dormant animals ; 2d, organic diseases, as consumption, cancer, disease of the liver, of the heart, ulce ration of the intestines, &c.; 3d, purulent col lections or secretions ; 4th, leucophlegmatic and dropsical states; 5th, gloomy and melan choly thoughts or passions ; 6th, long and un interrupted effort of the intellectual powers ; 7th, preternatural increase of the natural evacu ations, as in cholera, diarrhoea, diabetes, &c. mucous discharges, especially from the pulmo nary and intestinal membranes, as in chronic catarrh, inflammation of the intestines, and dysentery ; 8th, long and intense heat, whether natural, as during hot summers, or artificial, as in furnaces, _ hot-houses, &c.; 9th, running, riding, and every species of fatiguing exercise long-continued, as is exemplied in the case of grooms at Newmarket, Doncaster, &c. ; 10th, states of long disease, not organic; 11th, night watching and want of sleep in general ; 12th, immoderate use of spirituous liquors ; 13th, habit of eating bitter and spiced or acid aliments.