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there is no question whatsoever. And, while with great care as to the
diet and by proper exercise, obesity may, as a rule, be avoided in
those predisposed, it none the less often will develop in spite of all
measures taken against it. Some very obese people eat only one-half or
less of what many thin people do; but in the former, everything seems
to run to fat.
Obesity must be considered a dysgenic factor. The obese are subject to
heart disease, asthma, apoplexy, gallstones, gout, diabetes,
constipation; they withstand pneumonia and acute infectious diseases
poorly, and they are bad risks when they have to undergo major
surgical operations. They also, as a rule, are readily fatigued by
physical and mental work. (As to the latter, there are remarkable
exceptions. Some very obese people can turn out a great amount of
work, and are almost indefatigable in their constant activity.) Each
case should be considered individually, and with reference to the
respective family history. If the obese person comes from a healthy,
long lived family and shows no circulatory disturbances, no strong
objections can be raised to him or to her. But, as a general
proposition, it must be laid down that obesity is a dysgenic factor.
But bear in mind that obesity and stoutness are not synonymous terms.
Arteriosclerosis means hardening of the arteries. All men over fifty
are beginning to develop some degree of arteriosclerosis; but, if the
process is very gradual, it may be considered normal and is not a
danger to life; when, however, it develops rapidly and the blood
pressure is of a high degree, there is danger of apoplexy.
Consequently, arteriosclerosis and high blood pressure must be
considered decided bars to marriage.
It must be borne in mind that the sexual act is, in itself, a danger
to arteriosclerotics and people with high blood pressure, because it
may bring about rupture of a blood-vessel. There are many cases of
sudden death from this cause of which the public naturally never
learns. Married persons who find that they have arteriosclerosis or
high blood pressure should abstain from sexual relations altogether or
indulge only at rare intervals and moderately.
A consideration of gout in connection with the question of heredity
will show how near-sighted people can be, how they can go on believing
a certain thing for centuries without analyzing, until somebody
suddenly shows them the absurdity of the thing. Gout was always
considered a typical hereditary disease; for it was seen in the
grandfathers, fathers, children, grandchildren, and so on. So,
certainly, it must be hereditary! It did not come to our doctors'
minds to think that perhaps, after all, it was not heredity that was
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