eir excessive
use or a failure of supply; and when either condition is to be suspected
it becomes our duty to learn the reasons for this striking symptom. Loss
of flesh has also a collateral value of great import, because it is
almost an invariable rule that rapid thinning is accompanied soon or
late with more or less anaemia, and it is uncommon to see a person
steadily gaining fat after any pathological reduction of weight without
a corresponding gain in amount and quality of blood. We too rarely
reflect that the blood thins with the decrease of the tissues and
enriches as they increase.

Before entering into this question further, I shall ask attention to
some points connected with the normal fat of the human body; and, taking
for granted, here and elsewhere, that my readers are well enough aware
of the physiological value and uses of the adipose tissues, I shall
continue to look at the matter chiefly from a clinical point of view.

When in any individual the weight varies rapidly or slowly, it is nearly
always due, for the most part, to a change in the amount of adipose
tissue stored away in the meshes of the areolar tissue. Almost any grave
change for the worse in health is at once betrayed in most people by a
diminution of fat, and this is readily seen in the altered forms of the
face, which, because it is the always visible and in outline the most
irregular part of the body, shows first and most plainly the loss or
gain of tissue. Fatty matter is therefore that constituent of the body
which goes and comes most easily. Why there is in nearly every one a
normal limit to its accumulation we cannot say, nor yet why this limit
should vary as life goes on. Even in health the weight of men, and still
more of women, is by no means constant, but, as a rule, when we are
holding our own with that share of stored-up fat which belongs to the
individual we are usually in a condition of nutritive prosperity, and
when after any strain or trial which has lessened weight we are slowly
repairing mischief and laying by fat we are equally in a state of
health. The loss of fat which is not due to change of diet or to
exercise, especially its rapid or steady loss, nearly always goes along
with conditions which impoverish the blood, and, on the other hand, the
gain of fat up to a certain point seems to go hand in hand with a rise
in all other essentials of health, and notably with an improvement in
the color and amount of the red corpus