The first of Dercum's cases was a widow of Irish birth, who died both alcoholic and syphilitic.

When forty-eight or forty-nine her arms began to enlarge.

In June, 1887, the enlargement affected the shoulders, arms, back, and sides of the chest.

The parts affected were elastic, and there was no pitting.

In some places the fat was lobulated, in others it appeared as though filled with bundles of worms.