CORPULENCE, or OBESITY, is a condition of the body characterized by the over-accumulation of fat under the skin and around certain of the internal organs. In all healthy persons a greater or less amount of fat is present in these parts, and serves important physiological ends, besides contributing to the proper configuration of the body. Even a considerable measure of corpulence, how-ever inconvenient, is not inconsistent with a high degree of health and activity, and it is only when in great excess or rapidly increasing that it can be regarded as a morbid state. The extent to which obesity may proceed is illustrated by numerous well-authenticated examples recorded in medical works, of which only a few can be here mentioned. Thus Bright, a grocer of Maldon, in Essex, who died in 1750, in his twenty-ninth year, weighed 616 lb. Dr F. Dancel records the case of a young man of twenty-two, who died from excessive obesity, weighing 643 lb. In the Philosophical Transactions for 1813 a case is recorded of a girl of four years of age who weighed 256 lb. But the most celebrated case is that of Daniel Lambert of Leicester, who died in 1809 in his fortieth year. He is said to have been the heaviest man that ever lived, his weight being 739 lb. (52 st. 11 lb.). Lambert had publicly exhibited himself for some years prior to his death, which occurred suddenly at Stamford. At the inn where he died two suits of his clothes were preserved, from which some idea of his enormous dimensions may be obtained, when it is stated that his waistcoat could easily inclose seven persons of ordinary size. Lambert ate moderately, drank only water, and slept less than most persons. He is said to have had an excellent tenor voice.
Health cannot be long maintained under excessive obesity, for the increase in bulk of the body, rendering exercise more difficult, leads to relaxation and defective nutrition of muscle, while the accumulations of fat in the chest and abdomen occasion serious embarrassment to the functions of the various organs in those cavities. In general the mental activity of the highly corpulent becomes impaired, although there have always been many notable exceptions to this rule.
Various causes are assigned for the production of corpu-| lence, but it must be admitted that in many cases it cannot
be accounted for. In some families there exists an hereditary predisposition to an obese habit of body, the manifestation of which no precautions as to living appear capable of averting. But beyond this it is unquestionable that certain habits favour the occurrence of corpulence. A luxurious, inactive, or sedentary life, with over-indulgence in sleep and absence of mental occupation, are well recognized predisposing causes. The more immediate exciting causes are over-feeding and the large use of fluids of any kind, but especially alcoholic liquors. Fat persons are not always great eaters, though many of them are, while again, leanness and inordinate appetite are not in-frequently associated. Still, it may be stated generally that indulgence in food, beyond what is requisite to repair daily waste, goes towards the increase of flesh, particularly of fat. This is more especially the case when the non-nitrogenous (the fatty, saccharine, and starchy) elements of the food are in excess. Although it is still undetermined whether the fat of the body is derived alone from these, or also from the nitrogenous (albuminous) elements of the food, it seems certain that while an excess of the latter constituents accelerates the oxidation and metamorphoses of the fatty tissues, an excess of the non-nitrogenous retards these changes, and thus tends directly to the pro-duction of obesity (Parkes). The want of adequate bodily exercise will iu a similar manner produce a like effect, and it is probable that many cases of corpulence are to be ascribed to this cause alone, from the well-known facts that many persons of sedentary occupation become stout, although of most abstemious habits, and that obesity frequently comes on in the middle-aged and old, who take relatively less exercise than the young, in whom it is com-paratively rare. Women are more prone to become corpu-lent than men, and appear to take on this condition more readily after the cessation of the function of menstruation.
For the prevention of corpulence and the reduction of superfluous fat many expedients have been resorted to, and numerous remedies recommended. It is unnecessary to allude to these in detail, further than to state that they embrace such regimen as bleeding, blistering, purging, starving, the use of different kinds of baths, and of drugs innumerable, most of which means have been found utterly to fail in accomplishing the desired object. The drinking of vinegar was long popularly supposed to be a remedy for obesity. It is related of the marquis of Cortona, a noted general of the duke of Alba, that by drinking vinegar he so reduced his body from a condition of enormous obesity that he could fold his skin about him like a garment. Such a remarkable result was only a proof of the injury done to his health by the excessive use of vinegar. There is no evidence, whatever, that this liquid has any power to remove fat, while its pernicious effects upon the health, when taken in large quantity, are well known to medical men. Another medicinal agent, which has been proposed on the high authority of Dr T. King Chambers, is the liquor potasses. This medicine, which is recommended on the ground of the chemical affinity of the alkalis for fats, is directed to be taken in teaspoonful doses in milk twice or thrice daily, at the same time that a restricted diet and abundant exercise is enjoined. But even this plan, although occasionally yielding good results, cannot be said to have been widely successful. The more rational and hopeful system of treatment appears to be that which is directed towards regulating the quality as well as the quantity of nutriment ingested. This method has of late years received much attention, chiefly in consequence of the publication, in 1863, of a pamphlet entitled Letter on Corpulence, Addressed to the Public by William Banting, in which was narrated the remarkable experience of the writer in accomplishing the reduction of his own weight in a short space of time by the adoption of a particular kind of diet. Mr Banting describes the condition of obesity in which he was in August 1862, and which, although certainly less than those examples above mentioned, appears to have been sufficient to prove a source of much discomfort and even of actual suffering. After trying almost every known remedy without effect, he was induced, on the suggestion of Mr Harvey, a London aurist, to place himself upon an entirely new form of diet, which consisted chiefly in the removal, as far as possible, of all saccharine, starchy, and fat food, the reduction of liquids, and the substitution of meat or fish and fruit in moderate quantity at each meal, together with the daily use of an antacid draught. Under this regimen his weight was reduced 46 lb in the course of a few weeks, while his health underwent a marked improve-ment. Mr Banting's recorded experience, as might have been expected, induced many to follow his example, and in numerous instances the effects were all that could be desired. But in many cases the diminution in weight was found to be attended with such a serious impairment of health as to render the carrying out of this system impos-sible. It is probable that in some at least of these cases the unfavourable effects might have been avoided had the change in diet been more gradually brought about. There seems little reason to doubt that this method, founded as it is on well-recognized principles of physiological chemistry, is that which is most likely to yield the best results in the treatment of corpulence. It evidently cannot, however, be safely adopted in all cases, and ought not to be attempted to be carried out except under medical advice and observa-tion; for however desirable it be io get rid of superabundant fat, it would be manifestly no gain were this to be achieved by the sacrifice of the general health. An important ele-ment in the treatment of obesity is the due regulation of the amount of bodily exercise, and this, too, ought to be made the subject of the physician's careful attention.
Cursory Remarks on Corpulence, or Obesity considered as a Disease, by William Wadd, 3d ed., London, 1816 ; Corpulence or Excess of Fat in the Human Body, by Dr. T. King Chambers, London, 1850 ; Traité théorique et pratique de l'obésité, by Dr F. Dancel, Paris, 1863 ; Letter on Corpulence, addressed to the Public by William Banting, 3d ed., London, 1864 ; The Practice of Medicine, by Dr Tanner, London, 6th ed., London, 1869. (J. O. A.)