# Popular Science Monthly/Volume 17/May 1880/The Impediment of Adipose: A Celebrated Case

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* THE IMPEDIMENT OF ADIPOSE.—A CELEBRATED CASE.
By E. VALE BLAKE.
FROM the days of Hippocrates, intelligent medical observers have noticed that an unusual accumulation of fat, far from adding to the strength of a person, was a source of physical weakness, and, to a certain extent, an outward sign of incapacity; that it limited activity and shortened life. It is only in comparatively modern times that scientific experimentalists have ascertained precisely how the system generally, and the heart particularly, is affected either by the overloading or infiltration of superfluous fatty matter upon or in its muscular substance. In fact, it was not until the microscope was carefully applied to the investigation that the disease now known as "fatty degeneration" was really understood.
Every one knows that a certain amount of adipose matter in the human system impedes rapidity of motion. No sportsman would back a pedestrian who turned the scale at three hundred pounds, for instance; but there are other kinds of impedimenta to the human faculties which are certainly to be traced to superfluous fat, though this is rarely suspected of being the cause. A common case is that of the obese gourmand who complains that nothing tastes as it used to; on whose palate, formerly so sensitive, everything palls, and fails to awaken the delicious sensations of former days. He is very apt to attribute the change to the incompetent chef de cuisine, or even to degenerate Nature herself, in not growing the same quality in bird or fish; while the looker-on is apt to imagine that the change results from mere satiety. But suppose we had our fat friend on the dissecting-table, what should we probably find? No doubt, insidious deposits of fatty matter which have impeded the lively sensations of the organs of taste and smell, the latter of which so greatly aids the imagination and assists in the pleasure of the table. In the "Medico-Chirurgical Transactions," of 1870, Dr. W. Ogle gives five distinct cases of anosmia arising from an excess of fatty deposit permeating the cells of the olfactory apparatus.
Still more curious, and as generally unsuspected, is the deposit of adipose tissue as a cause of deafness; and this not directly in the organs of hearing, but in the canals leading to the air-passages of the nose and throat. This naturally requires some explanation to non-professionals, though the fact is well established. It results from the sympathetic connection which is formed by the continuous mucous membrane, which covers at once the interior of the mouth and throat, the pendulous palate, the tonsils, the isthmus of the fauces, and the ​pharynx, etc.; this same web of membrane is carried to the Eustachian tubes (which lead from the back part of the mouth to the cavity of the ear), and thus it is that what only visibly affects one portion, say the lachrymal canal, or the tonsils, may sympathetically disorder the sense of taste or hearing. The substance of this mucous membrane is composed of three layers, containing a cellular or folliculous system of roundish or oval cells, which are subject to morbid alterations, that affect pails far removed from the local appearance of disorder. Thus, Dr. Harvey reports: "I have seen and treated many cases of deafness which appeared to depend solely on nasal obstruction from adipose deposit. It does this by interfering with or impeding the entrance of the air to the mouth of the Eustachian tubes, undue limitation of air lessening the sensibility and acuteness of the auditory organ. These cases usually occur in persons of great corpulence, in which case local treatment is almost valueless. The corpulence itself must be reduced."
We might go on and point out many physical ills which result from obesity, and we will name a few; but our principal object in these images is to show that a redundance of adipose matter essentially weakens and impedes the power of the will. We know that it disinclines to activity, produces shortness of breath, palpitation of the heart, and comparative weakness in proportion to size, and is often accompanied by anæmia. We can make this clearer, perhaps, by an illustration. The normal weight of a man five feet in height is 120 pounds; of a man five feet ten inches, 169 pounds. Now, suppose the latter really weighs 300 pounds by accumulation of fat, what results but that all this superfluous matter has to be supplied with capillaries, and these have to get blood from vessels only constructed to circulate the original quantity? No wonder is it that the circulation is enfeebled and impeded! By this increase of adipose there is no increase of propelling force. Hence, the overstrain upon the capillaries and the ensuing comparative weakness in the vital functions are explained, and also why external injuries are less easily repaired.
It is a well-settled rule in all animal structures that, when the quantity of fat exceeds the law of their construction, bulk becomes a source of imperfect equilibrium, and therefore of danger. The most bulky animals are not the most useful nor the strongest. An elephant compared with its size is not as strong as an ant. Then there is this physiological fact, that the oleaginous principle is actually less alive than any other part of an animal. Observe the blubber of a whale, into which parasites bore an inch deep without causing any inconvenience, and into which a harpoon may be thrust without serious injury if it does not penetrate to the muscular substance. The quantity of fatty matter in animals seems to bear an inverse relation to the quantity of bodily and mental activity. Hibernating animals, who may be said to live on their own fat, are ​the perfection of indolence. All shepherds know that a very fat ewe will not produce a strong lamb.
Some Brahmans pride themselves on their obesity—did one of them ever run a race, or write a book? Chesterfield said that fat and stupidity were such inseparable companions that they might be used as convertible terms. We should not be willing to indorse that opinion exactly; but, if he had said fat and inactivity, he would not be far wrong—though we have seen exceptions even to this. But it is undoubtedly true as a rule. Carnivorous animals that have to earn their dinners are generally thin; domestic ruminants are fat. Animals shut up in cages either pine and die or get fat. At Strasburg, famous for páté-de-fois-gras, geese are shut up in warm coops and overfed to produce the fat (and diseased) livers so much admired by gourmets. In Italy, wealthy connoisseurs are very fond of fat ortolans, and this is the device by which they obtain them: They shut the birds up in a dark chamber, (knowing that in their natural state it is their habit to feed at sunrise). They then arrange artificial lights which can be cast at will into the dark prison of the birds, on seeing which the ortolans immediately seek the food which is provided for them; the light is withdrawn, and they go to sleep; after a few hours it is again introduced, and so the process is repeated five or six times in the twenty-four hours, so that the birds are kept constantly feeding or sleeping; the consequence is, that in about three days the ortolan becomes "a delicious ball of fat," and ready for the table.
In the human being there is, however, a difference, just as there is in the domesticated animals; there is what is known as "good fat," which must not of course be too redundant, and "bad fat." The fat of the florid person may generally be classed with the good, that of the flabby anæmiac with the bad: the latter is recognized in the unwholesome look of the chronic victim of alcohol.
But, to turn from the purely physical aspects of adipose, we wish to invite the reader's attention to a celebrated case of the impediment of adipose in affecting the mental character, and the action or inaction superinduced by this malady.
One of Shakespeare's famous characters—we should say perhaps his supreme portrait—is described thus with one dash of the pen:
"He's fat and scant of breath!"
The character of Hamlet has suffered such constant distortion at the hands of commentators, and has been made unintelligible and mysterious through a very natural but fatal oversight, namely, the habitual neglect of the annotators to take into the account the physical organization of the Danish Prince—an oversight which the poet never made. He never failed to make the physique conform to the character.
​Every shade of capacity and ingenuity has been expended on the consideration and explanation of Hamlet's mental traits, but unfortunately with an essential factor left out. Not one, of all the numerous writers who have essayed to enlighten the world on the meaning and intent of this "consummate flower" of the poetic insight, has thought to inquire whether the body was not that "unknown quantity" which confounded Schlegel, and which Goethe thought he had found in the lines—
that is, that the Prince was overborne by the too great pressure of an Herculean task with which he was conscious he had not the ability to cope. But that there was really no insufficiency of mental power appears patent at every forward movement of the play. He perceives the situation clearly, argues about it rationally, notes all the circumstances, and acknowledges his own duty in the premises; but he does not do the thing which he sets before himself to perform.
Why? Because "he's fat and scant of breath"—in other words, is weighted down with a non-executive or lymphatic temperament.
Painters, as well as actors, have done much to foist a false Hamlet upon the public imagination. He has habitually been represented by both as possessing a nervous, bilious, saturnine temperament, for which there is no warrant in the poet's description of him. Artists have portrayed him as fleshless and dark-hued. Fechter, the sole exception, did indeed remember his nationality to the extent of introducing the novelty of a flaxen wig, which was barely tolerated by the audience, so counter to the truth was the ill-taught popular fancy. But who has yet dared, on canvas or on the stage, to present a true Shakespearean Hamlet "grunting and sweating under his weary load of life"?—so fat really as to need that "napkin" which the queen offers him to wipe the perspiration from his brow.
Yet is this "fat" the keynote and solution of the "mystery of Hamlet."
Remembering that he was fat and scant of breath, we can readily understand many things which are otherwise certainly perplexing; particularly the inconsistency between his thoughts and desires and his chronic inaction. He would represent in modern life those persons whose cerebral developments are put down at maximum figures by the expert phrenologist, and who exhibit to admiring friends their large brain-power as thus indicated, but who never do anything to confirm the diagnosis. Again, why? because they lack the energizing temperament without which the brain is but a dumb mass of latent possibilities.
​The character of Hamlet is generally conceded to be the most wonderful production amid all that vast galaxy of dramatic figures which has enchanted the world for three hundred years, and if one new to the subject inquires why it thus takes precedence of Lear, Othello, Macbeth, Shylock, and their proximate peers, we must first answer negatively that it is not because there is so much deeper philosophy in Hamlet than may be found, scattered pearl-like, throughout all the plays by the same master hand, nor because any single passion is therein better delineated—but, affirmatively, because in the Prince of Denmark there is combined the greatest complexity of mental acumen, allied to an unparalleled variety of passional influxes, and bound, alas! to an inefficient temperament. It is not one master passion which stirs, nor one affection alone that is outraged; not one sole grief that afflicts, or one emotion which reigns supreme over that great but erratic mind: it is a commingling of jarring elements, most difficult to reconcile in the formation of a characteristic individuality.
In the rising tide of the Moor's jealousy we have the most vivid description of a half-savage tornado of mental suffering, produced by the uncontrolled agonies of a strong but simple and ill-balanced mind; in Lear, an already tottering intellect, quite overthrown by the cruel irritations of unimagined ingratitude; in Macbeth, an unsafe ambition troubled with a conscience; in Shylock, a member of an outraged race, essaying an hereditary revenge, stimulated by avarice: but in Hamlet we have a whole circle of passions, a complication of emotions to draw into one converging action, like an engine required to run on a main road with many branches, and no steam in the boiler.
To particularize: there is first his natural sorrow for the death of his father; sorrow, anger, and chagrin at the hasty marriage of his mother; hatred and suspicion of his uncle; his loss of the crown of Denmark for an indefinite time; the necessity for concealing his suspicions as to the "taking off" of the King; the perplexing and terrifying impressions produced by the vision of the ghost; its adjuration to active revenge; his love for Ophelia, and its interruption apparently at her own caprice; the annoying surveillance of old Polonius; distrust of his old school friends, Guildenstern and Rosencrantz; the voluntary assumption of the rôle of madness, and the necessity of combining this with the retention of his true mental status with certain of his friends; his unintended injury of Ophelia and her brother through his "brainish" homicide of their father, when he had hoped to slay the King; the distressing madness and death of Ophelia, with her scanty burial rites—imperiling her soul, in the common opinion of the time; the encounter with the irate Laertes: all these and minor complications and difficulties were thrust upon him, a situation scarcely to be successfully encountered by a soul incased in the very fittest framework which nature ever contrived as its instrument for setting a ​disjointed world to rights—by one whose blood and judgment were so well commingled that every thought is not only wise and just but also briefly precedent to action.
Now, what has our Shakespeare done in this masterpiece of dramatic composition, but allied all these untoward events and Tempestuous emotions of a great, grieved soul to a body physically unadapted to success?
This is the "mystery of Hamlet," and the world has been long making the discovery.
Hamlet's "too too solid flesh" caused him to procrastinate. Had it not been for that weight of adipose substance he "were simply the most active fellow in Europe"; but the inertia of fat was like gyves upon his hands and feet, and could not be overcome except under extraordinary provocation, and then, the sudden impulse subsided, flagged again, mastered by the chronic habit of (let us give the right word, though the heavens fall!)—laziness!—the result of his "fatty degeneration."
We know that we have to encounter the settled prejudices of the world against us in this view of the character of Hamlet. We certainly had our own preconceived notions to conquer before arriving at this conviction; but a close examination of the text undoubtedly bears it out, and indeed we can see no other satisfactory solution of the problem offered, by the contradictions of the clear reasonings and the muddled deeds of the Prince of Denmark.
That the above scientific but simple explanation has not been previously reached by some one of the many keen and learned critics of the play, is only to be accounted for by the transcendent attraction of the intellectual traits displayed therein. The pivotal point in nearly all these discussions being the question whether the dramatist really intended to portray an assumed or real insanity—and certainly, ignoring the theory we now propound, that must ever remain a mooted point; but, admitting the dominant power of his "too solid flesh," every apparent inconsistency is accounted for.
In the very first scene of the first act we get an intimation, though no description, of Hamlet's physical temperament. Why, we may well ask, should the poet represent the Ghost as first appearing to certain officers of the guard, to whom it had no communication to make, and to whom none was necessary, unless it was to show a certain lack of sensitiveness to spiritual influences in the Prince, an absence of that refinement of nerve which originates, by attraction, spiritual influences? This preliminary stalking suggests a certain grossness of material texture in the Prince not present, for instance, in Horatio. The son of the royal Dane needed, it seems, a better attuned medium to put him en rapport with his own father's spirit. Here we have the first intimation, a sort of prelude as it were, amply borne out by the succeeding events, that in everything which was to be really ​accomplished others must take the initiative. The very expression which Hamlet uses in that frenzied burst of passion on parting with the Ghost, "While memory holds a seat in this distracted globe," is suggestive of a rotund and corpulent person. We can not conceive of the phrase-culling poet applying it to the narrow caput, for instance, of Master Slender, but must believe that Shakespeare kept well in mind the personnel of his hero; in fact, when did he ever forget that important item in the description of his creations! Indeed we are very soon again reminded of the characteristic physical development of the Prince by the expression Ophelia makes use of when she applies the term "bulk" in her sad description of Hamlet's visit to her closet.
Bulk! the very word Shakespeare employs to describe the ponderous Wolsey—"His very bulk take up the rays o' the beneficial sun."
Ophelia had taken an accurate survey—she notes the disorder of his garments, mentions that he is pale (a symptom of anæmic adipose), but gives no hint that he has "fallen away vilely," which would have been the first thing to attract the attention of a young lady who believed one mad for the love of her. No, his "bulk" is evidently undiminished either by love or lunacy.
As with Ophelia, so with all the persons who address or describe him, none make any comment which would suggest a thin or haggard appearance. When Polonius describes to the King the course of the seeming madness, he confines himself exclusively to the mental analysis, and makes no mention that the Prince's body has succumbed to the malady. When the King drinks to him, it is not to his better health or better wits, but to his "better breath"! And the Queenmother, watching him anxiously during the passage-at-arms with Laertes, makes the exclamation which we have taken as the keynote of our theory, "He's fat and scant of breath." And then, with instinctive maternal tenderness calls to him, "Here, Hamlet, take my napkin, rub thy brow"; which he not heeding, she repeats, "Come, let me wipe thy face."
Can we not see the perspiration trickling over the broad, heavy cheeks as we read these lines? It was surely from experience that he spoke of "sweating and grunting under a weary life."
That he is consciously represented as feeling the impediment of the weight of his own flesh is clearly discerned by the frequent references to it. A gaunt, thin, wiry, or even an ordinary muscular man, would not be apt to describe his flesh as "too solid," or to enumerate as one of the serious ills of humanity "the grunting and sweating under ​burdens." In Hamlet's description of himself to Guildenstern, where he says he "has lost all his mirth," and so forth, it is still the dejection of his mind which he puts forward: he does not pretend to excite sympathy by pointing to his failing body. So in his complimentary address to Horatio, who appears to him to be so fortunately endowed, physically and mentally, he recognizes in his friend that favorable constitution where the blood and will power are so equably adjusted that they "are not a pipe for Fortune's finger to sound what stop she please." In other words, Horatio was seen to possess what the speaker was conscious of lacking, a constitution in which the body is subordinate to the will, a temperament which Hamlet had not, but quite the reverse—in which the will was dominated by the body. This he vaguely feels but can not explain, and so he soliloquizes:
except that he was a "muddy-metalled rascal"; but we perceive clearly enough that it was not his brain but his body which was muddy-metalled.
Again, he evidently feels the drag-anchor of his heavy mold, and the consequent ill-cooperation of his bodily frame with his discerning spirit, when even under great excitement he stops to explain that he "is not splenetic and rash," though yet there is a sort of ground-swell of "something dangerous" in him. Yes, dangerous if sufficiently aroused; but his was a kind of nature which could endure a great deal of arousing before it culminated in action. When he takes his leisurely walk in the hall this quiet exercise goes under no other name with him than a "breathing-time"; and, once familiarized with his true physical picture, how apt appears his reply to Osric: "Sir, I will walk here in the hall; if it please his Majesty, this is the breathing-time of day with me."
When he apologizes to Laertes, he says, "You must needs have heard how I am punished with a sore distraction." He says "heard," because he is conscious that there is nothing in his appearance to indicate failing health, and this under the circumstances he would scarcely have omitted had he lost any of his superfluous flesh. He was himself a keen observer of physiological peculiarities, was ready enough to detect changes in the personal appearance of others, and therefore would have been thoroughly conscious of his own had any marked falling away taken place. Notice his reception of the players. One he addresses thus:
And to her who is to play the Queen—
Your ladyship's nearer to heaven Than when I saw you last, by
An executive temperament would have needed no other incitement, one would think, to action than the reproving adjuration of the ghostly visitant.
must that son have been who could passively subside after such a nocturnal interview; yet Hamlet stops, considers, hesitates, questions, and—does nothing. Not from any thought that it was a crime to revenge even a father's murder by killing another; no, for he deliberately postpones the most favorable opportunity of revenge which occurs, that he may at some future time insure the killing of his uncle's soul, as well as his body, by taking him, if possible, while he was about some act "that had no relish of salvation in't."
To conceal from himself the evident pusillanimity of his course he assumes the rôle of lunacy, which required no violent exertion and afforded ample time for meditation, delay, and the use of other persons to accomplish his ends. It seems also a cover for cowardice, in that he expects the mantle of his assumed malady to cover him from blame in the execution of that long-considered vengeance he is never destined to take; for, when at last he does stab the King, there is no thought of his father in his mind; it is but the reprisal for later treacheries aimed at his own life. This role of madness, however, only causes a stricter watch to be put upon him; nor does it help him forward one step toward the fulfillment of the Ghost's injunction. The accidental arrival of the players is indeed seized upon and applied by him to the purpose of testing the truth of the ghostly asseverations; but he had evidently never thought of sending for them, for the purpose of questioning the King's conscience—the opportunity was thrust upon him.
The moment of confusion which ensues at the dénouement of that plot, when the King arises in remorseful perturbation, would have seemed to furnish the precise instant when vengeance would have been commended by justice; but the unequaled opportunity is allowed to pass with merely a satirical jest.
That Hamlet meant to slay the King, when he really killed Polonius, is but cumulative evidence that the excitement of the interview with his mother (sought by her, not him) was the immediate cause of his rash and ill-directed act. It was not premeditated, and required no courage, as the party behind the tapestry had no opportunity of defense, and the act can scarcely be considered as part of his settled ​purpose to revenge his father's death. Like all persons of a lymphatic temperament, Hamlet could be suddenly aroused to a high pitch of daring, but was utterly incapable of persistent effort. He follows the Ghost to the edge of the cliff in defiance of the warnings of his companions, threatening to "make a ghost of him that lets me"—he could make a sudden stab in the hangings of his mother's apartment—could leap into the grave with Laertes, and outrave the latter's frenzied demonstration, with the self-asserted passion of "forty thousand brothers," but it was soon over. The immediate cause of excitement being removed, he returns to his natural inactivity.
The episode of the voyage to England at the instance of the King, submitted to without protest, is a terrible descent from the sublime grandeur of his philosophizing and thunderous threats. A tame passivity rules him; but, discovering the imminence of his danger on the voyage, there is revealed a cunning cruelty in his nature that the brave, active man would have scorned. But persons who are noted for their general inertia, when they do move, are very liable to astonish by the intensity and unexpected turn of their action.
Once again, toward the close of the play, we get another insight into the torpid constitution of the Prince. In the preliminary discussion with Horatio as to his fitness for the duel with Laertes, his friend says:
"You will lose the wager, my lord."
And Hamlet replies: "No, I shall win at the odds; but thou wouldst not think how ill all's here about my heart; but it's no matter." Just such an answer as a person might make who was suffering from "fatty degeneration." Evidently, in the opinion of the writer, the consideration of the unpleasant possibilities of the duel had brought the action of the heart almost to a standstill—the result of a chronic, sluggish circulatory system. Had his blood been accelerated, as would naturally have occurred in a nervous temperament, other expressions would have been more fitting; but the phrase above quoted better indicates partial stagnation than anything else. His philosophy, indeed, "defies augury," but his physical organization can not choose but respond to the near presence of a fatal venture. With the one not surprising exception of the first sight of the Ghost, Hamlet is throughout like the obese class generally which he represents, sufficiently careful of his personal safety. He puts himself to no bodily risk. In leaping into the open grave after Laertes, it must be remembered that he is on his native heath, as it were, surrounded by friends, while the unfortunate brother is the alien and unwelcome guest; and the apparent calmness but real tremor with which he accepts the invitation to a passage at arms is painfully betrayed by the abnormal action of the heart above referred to: besides, in that age it required more courage to decline a duel than to accept one.
The medley of the last scene, including the death of the King, ​though the latter is finally slain by Hamlet, is all brought about by the management of other heads and hands, and its conclusion evidently unforeseen by the Prince. From first to last he accomplishes nothing of set purpose. He moralizes by temperament and habit, but acts only when inaction is the more difficult resource. The fine spirit, the clear insight, the keen reader of other men's thoughts, is imprisoned in walls of adipose, and the desire for action dies out with the utterance of wise maxims, philosophic doubts, and morbid upbraidings of his own inertness. Hamlet is like one of those persons (to be met with in every community) who can relieve themselves by talking. This is a kind of character well understood by Shakespeare. In the third Richard's conference with the murderers of Clarence, one replies to him:
Again, in describing a character the very opposite to that of Hamlet—one of few words, Cordelia—the poet makes her say, "What I well intend, I'll do't before I speak." Now, of all the characters drawn by Shakespeare, Hamlet is preeminently the man of words; not only his famous soliloquies but his dialogues take up unwonted space; he is the most prolific moralizer of the dramatist's conception, and thus all practical manhood is allowed to ooze out in words.
To judge the better whether Shakespeare intended in this play to show how the body may clog the aspirations of the mind, we have only to observe that whenever the physical appearance of any character is described by him, we find that leanness is an element of the executive man, and "bulk" or fatness of the dilatory and procrastinating, just as we see it in every-day life. Says Prince Henry to Falstaff:
"What! stand'st thou idle here? Lend me thy sword!"
And the fat knight replies:
"O Hal, I prithee give me leave to breathe awhile"—
the very expression used by both the King and Queen in regard to Hamlet, and in which he also describes his own case.
On another occasion Prince John addresses the pseudo-hero of Salisbury Plain:
"Now, Falstaff, where have you been all this while? —When everything is ended, then you come."
And the inimitable old rogue, knowing that he must be pardoned for his fat, answers:
"Do you think me a swallow, an arrow, a bullet?"
So also Cæsar, recognizing the physiological improbability of a fat man actually carrying out a treasonable conspiracy, says:
"Let me have men about me that are fat."
If my name were liable to fear, I do not know the man I should avoid
Macbeth was not fat, nor Richard III., nor Henry V., nor Harry Hotspur. They did the things which they planned to do. They did not have to stop to "breathe" themselves like the Prince of Denmark. Who can possibly conceive of a fat Coriolanus? The fat man may be greedy and avaricious like Cardinal Wolsey, or witty and sensual like old Jack, or brooding and melancholy like Hamlet; but he who can vault into his saddle "like feathered Mercury" will ever win the day by action.
Hamlet's uncle-father might confidently have left the unhappy philosopher to his questionings and musings; had he not set his own trap he might have finished his reign in safety, if not in peace, for the Hamlet of Shakespeare, unlike the real Hamlet of Saxo Grammaticus, would no more have set the palace on fire than he would have produced a conflagration of the Skager Rack—for he was "fat and scant of breath," impeded at every step by a superfluity of adipose.
* ↑ Profuse perspiration is a recognized symptom of one form of heart-disease—endocarditis.
* ↑ Medical men indicate frequent sighing as a sign of heart-disease, caused by superfluous fat.
* ↑ Chopine, a high-heeled shoe, or clog.