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Advice to Thin Persons

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Review and Herald Publishing Association · Takoma Park Station, Washington, D. C. · Jan 11, 1912

FromReview and Herald, Vol. 89, No. 2.

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Advice to Thin Persons

By P. A. DE FOREST, M. D.

P. A. DE FOREST, M. D.
Thin persons generally enjoy the warmer seasons of the year better than the winter months. They revel in hot weather, when fleshy people are at their wit's end to know how to keep cool, sweltering as they are under the sun's smiling rays.
But their turn comes when the leaves fade, and Jack Frost begins to bite. The thin, bony fingers and toes feel the change. The coat of fat which distresses the person who has just enough or a little too much avoirdupois, comes in very handy in cold weather, as it constitutes an overcoat which is placed just right to protect from too rapid heat absorption by the cold. They have warmer hands and feet, wear less clothing than thin people, and enjoy winter weather much more.
There is a health hint in these facts which thin people would do well to ponder over. A proper amount of adipose tissue (say one to two centimeters) below the skin, acts as a sort of packet or filter which keeps the heat of the internal parts from being dissipated too quickly. Heat is formed principally in the internal organs and muscles in two ways,—by chemico-vital activity and by friction. The body is depressed when the call for heat is too great; and if the person has a dilated stomach or deficiency in intestinal activity or an improper dietary or one that is too difficult of digestion, there will not be enough glycogen stored up in the liver to meet the demand for heat-producing material. Then the body seizes upon that which can most easily be converted into heat, and the adipose tissue gradually disappears. During the winter, if one clothes one's self warmly, there generally is a gain in weight.
The body thrives best when the inner temperature is at 37 degrees centigrade, and the skin temperature about 34 degrees. The chilliness which supervenes when the temperature falls below that point, is caused by vital depression, faulty clothing, etc., and could easily produce congestion of the internal viscera. Persons who habitually have cold hands and feet habitually have low morning temperatures and contract nasal, intestinal, and other catarrhs very easily.
One way to get back the coat of fat which has been lost is artificially to supplement that loss, to clothe one's self warmly twenty-four hours a day. Thin people should distribute their clothing so as to especially protect those parts of the body where the surface is habitually the coldest.
It is interesting to note that the thicker the part, the warmer the skin over that part. This is due to the fact that the amount of heat there generated is greater in proportion to the skin surface than in the thinner parts of the body. This is one reason why the trunk is generally warmer than the extremities. Another reason is that heat being generated principally in the internal organs and in the muscles, the parts of the body directly over those centers of heat are heated more directly, while other parts are warmed mainly by the circulation of the blood. About forty-two per cent of body weight is made up of the muscles, and eight per cent internal viscera; so we have about one half of our weight concerned directly in heat production. The house we live in is comparable to an ordinary house heated by central heating. The warmest corner is naturally the one where the boiler is.
The surface thermometer gives some interesting facts relative to skin temperature. Healthy people of normal weight never have more than 10 degrees centigrade between the highest internal and the lowest external temperatures; but in thin, weak people the skin of the abdomen may be 33 to 34 degrees centigrade, that of the back 32 degrees, knees 26 to 27 degrees, feet 22 to 28 degrees, inner arm 30 to 32 degrees, outer arm 28 to 30 degrees, hand 28 to 30 degrees, ear 28 degrees. The surface temperature in healthy,active young people should not vary over 4 to 5 degrees centigrade from the general bodily temperature, and it is easy to understand that when there is a difference in certain places of 10 to 15 degrees centigrade from the normal internal temperature, or nearly 20 degrees below the highest normal internal temperature, the blood stream will be cooled down too much, and that vital depression will surely follow.
The body loses heat in three ways,—by perspiration, by conduction, and by radiation. Generally for every rise of temperature of one degree centigrade the amount of heat lost is augmented six per cent, and vice versa.
Many people suffer from chilliness, muscular weakness, cold extremities, congestion of internal organs, constipation, catarrhs, without finding a remedy. They feel the cold worst around the chest and abdomen and back, and so accumulate clothing on these parts. Not possessing a warm bath-room, they neglect bathing; the epidermis becomes thickened and dead, and saturated with perspiration which is absorbed by the dead epidermis instead of escaping. Heat is conducted away rapidly by moisture, and so the vital forces are depleted in trying to produce more heat than they are able to produce.
An agreeable bath in a warm room twice a week, with vigorous rubbing to take off superfluous epithelium, is what thin people need, as the dead skin not only holds moisture, but retains organic matter as well, this latter being more or less absorbed if it is not removed.
The clothing of thin people needs most careful attention. Not one woman in a thousand clothes her limbs as she should. The blood-vessels in the extremities are expressly made larger in proportion to those in the trunk so that those parts far removed from the warm center may maintain a normal temperature.
When the skin becomes cold through insufficient clothing, a spasmodic contraction of the capillaries of the skin prevails, which, if long continued, extends to the veins and arteries, and may set up a chronic condition of anemia of the extremities. In these cases there is generally irritation of the sympathetic nerves of the abdominal and pelvic plexus, which produces a reflex effect in the corresponding nerves which control the caliber of the vessels in the limbs. Thus dilated stomachs, irritation of gastric and intestinal nerves, cold extremities, and thinness are but segments of a vicious cycle which generally continues through life when decided measures are not taken.
The essential thing in clothing for warmth is to secure a dry skin, and then place in contact with it an artificial skin which will let the moisture of the insensible perspiration pass through, and at the same time hold back the heat. It must be a poor heat-conductor.
In our way of looking at it there is no material which fills the requirement like wool. This should be knit goods, and not too close. If it can not be worn with comfort, a thin porous cotton or linen undersuit may be worn next the skin. This will keep the wool clean—an important advantage which obviates the necessity of too frequent washing.
Tight clothing must be avoided. Garters, tight stockings and shoes prevent a proper circulation in the limbs and skin. Even the stretching of the skin at the knees and hips in the sitting position, predisposes to coldness of those parts. Knee-warmers, loose felt shoes, and woolen stockings complete the leg-wear in cold weather.
Women, on account of the little protection they receive from flowing skirts, in cold weather should be especially careful to protect the limbs. In winter flannel drawers over combination suits may be used, and it is more logical to add a pair of knit bloomers rather than a heavy skirt when going out in the cold.
The modern bed is not made for thin people. Linen and cotton sheets are clean, but they conduct away heat rapidly, and so to keep warm thin people need flannel or thin cotton flannel night-clothing with a thick woolen night-robe over all; this latter should extend below the feet, or loose warm socks be worn.
Thus equipped, with plenty of warm bedclothes, the thin, anemic person prevents a too rapid loss of heat during the hours of sleep when the windows are open and the cold night air enters the room.
If cold friction baths are taken in the morning, they must be short (five to fifteen seconds), or they may be taken in a warm room, or at least with some one to help rub dry quickly, the person returning to the warm bed for a few minutes to warm up. If these baths reduce weight, they should be discontinued.
As to dietary, dry foods with emulsified fats are the best, especially if dilatation of the stomach be present.
Exercise is essential, and the more it is enjoyed the more good it will do. One must always stop short of fatigue.
The writer hopes that these remarks will be of benefit to the vast army of thin, more or less anemic persons, who need every little assistance possible in the struggle for life.
Gland, Switzerland.