A rational therapy of polysarcia is only possible on the basis of a more precise differentiation between the principal types or degrees of this metabolic anomaly.
A number of authors have attempted to distinguish between the forms of corpulency. The classification of Immermann1 into the plethoric and the anemic types, partly on account of a certain clinical justification, but mostly on account of its adoption by Oertel,2 is the best known and enjoys universal acceptance by later writers on the subject. This differentiation, however, is one of degree more than of character, and, in advanced cases of obesity when pronounced degenerative changes have taken place, the one type can not be distinguished from the other.
Guided by the external appearance, Immermann assigns the cases to one of the two categories: 1, to the plethoric group he refers the instances occurring in the robust; 2, to the anemic class,
STERN H. ON THE TREATMENT OF OBESITY.. JAMA. 1902;XXXVIII(7):447–455. doi:10.1001/jama.1902.62480070013001f
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