Alcoholism also gives rise in some people to a vast increase of adipose tissue, and the sodden, unwholesome fatness of the hard drinker is a sufficiently well known and unpleasant spectacle.  The overgrowth of inert people who do not exercise enough to use up a healthy amount of overfed tissues is common enough as an individual peculiarity, but there are also two other conditions in which fat is apt to be accumulated to an uncomfortable extent.  Thus, in some cases of hysteria where the patient lies abed owing to her belief that she is unable to move about, she is apt in time to become enormously stout.  This seems to me also to be favored by the large use of morphia to which such women are prone, so that I should say that long rest, the hysterical constitution, and the accompanying resort to morphia make up a group of conditions highly favorable to increase of fat.

Lastly, there is the class of fat anaemic people, usually women.  This double peculiarity is rather uncommon, but, as the mass of thin-blooded persons are as a rule thin or losing flesh, there must be something unusual in that anaemia which goes with gain in flesh.

Bauer[8] thinks that lessened number of blood-corpuscles gives rise to storing of fat, owing to lessened tissue-combustion.  At all events, the absorption of oxygen diminishes after bleeding, and it used to be well known that some people grew fat when bled at intervals.  Also, it is said that cattle-breeders in some localities—­certainly not in this country—­bleed their cattle to cause increase of fat in the tissues, or of fat secreted as butter in the milk.  These explanations aid us but little to comprehend what, after all, is only met with in certain persons, and must therefore involve conditions not common to every one who is anaemic.  Meanwhile, the group of fat anaemics is of the utmost clinical interest, as I shall by and by point out more distinctly.

There is a popular idea, which has probably passed from the agriculturist into the common mind of the community, to the effect that human fat varies,—­that some fat is wholesome and some unwholesome, that there are good fats and bad fats.  I remember well an old nurse who assured me when I was a student that “some fats is fast and some is fickle, but cod-oil fat is easy squandered.”

There are more facts in favor of some such idea than I have place for, but as yet we have no distinct chemical knowledge as to whether the fats put on under alcohol or morphia, or rapidly by the use of oils, or pathologically in fatty degenerations, or in anaemia, vary in their constituents.  It is not at all unlikely that such is the case, and that, for example, the fat of an obese anaemic person may differ from that of a fat and florid person.  The flabby, relaxed state of many fat people is possibly due not alone to peculiarities of the fat, but also to want of tone and tension in the areolar tissues, which, from all that we now know of them, may be capable of undergoing changes as marked as those of muscles.