A Case of Polysarcia, reported by Dr. Ira D. Hopkins in the Buffalo Medical and Surgical Journal (November 1861), volume I(4):114-115:
Richard Holmes, colored, a cook, aged 41 years, was admitted into the Utica City Hospital on the 14th of August, 1861, suffering from polysarcia, of which he died September 3d, 1861. He was 5 1/2 feet high, weighed about 350 pounds; and measured in circumference 4 feet 10 inches, other portions of his body were in equal proportion. For 14 years he clothed himself in female apparel.
5’6″ and 350 pounds is pretty big. That’s a BMI of 56. We don’t know how common that is today, since statistics are only grouped into “overweight”, “obese”, and “morbidly obese” (BMI>40). But it happens.
Utica is in Oneida County, New York. According to the State Department of Health, as of 2010-2012, 25.7% of adults in the county are obese. African-Americans like Richard Holmes are more likely to be obese, according to the CDC’s National Health Interview Survey. To be in his situation, where he could lose 100 pounds and still have a BMI of 40 … still not common.
But either way, in 2014 a man of 41 dying of “polysarcia” (which just means morbid obesity), who has apparently been polysarcic for most of his adult life (“For 14 years he clothed himself in female apparel”), wouldn’t merit a special report in a medical journal.
And it would certainly not get picked up by today’s British Medical Journal.
But there he is, in the “Progress of Medical Science” section of the February 8, 1862 issue (subscription required, apparently, though it’s in the public domain). Right between Mr. H.T. Higginson’s “Easy Mode of Applying Leeches”, and the dispatch from Philadelphia about Dr. Nebinger’s theory of puerperal convulsions.