Usually it is first seen in the face and neck, then it is noticed in the
back and flanks, next in the belly, and finally in the limbs, the legs
coming last in the order of gain, and sometimes remaining comparatively
thin long after other parts have made remarkable and visible gain.
These observations have been checked by careful measurements, so that I
am sure of their correctness for people who fatten while at rest in bed.
The order of increase might be different in people who fatten while
afoot.
Facts of this nature suggest that the putting on of fat must be due to
very generalized conditions, and be less under the control of local
causes than is the nutrition of muscles, for, while it is true that in
wasting from nerve-lesions the muscular and fatty tissues alike lessen,
it is possible to cause by exercise rapid increase in the bulk of muscle
in a limb or a part of a limb, but not in any way to cause direct and
limited local increment of fat.
Looking back over the whole subject, it will be well for the physician
to remember that increase of fat, to be a wholesome condition, should be
accompanied by gain in quantity and quality of blood, and that while
increase of flesh after illness is desirable, and a good test of
successful recovery, it should always go along with improvement in
color.
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