What is "Pickwickian Syndrome"?

QUESTION: As you once observed in one of your columns, much can be overheard
when doctors discuss medical affairs. Such a situation recently occurred when
I heard the term "Pickwickian syndrome" mentioned. As a lover of the works of
Charles Dickens, I know there must be a "tale" here somewhere. Do you know
it, and will you share it with your readers?
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ANSWER: Yes, I am aware of the syndrome, as are most physicians; for it is a
commonly encountered situation in practice. The condition, which consists of
obesity, sleep apnea (a sleep disturbance in which breathing stops for 10
seconds or more, sometimes more than 300 times a night), impaired respiration,
heart failure and daytime drowsiness, occurs in about 10% of obese adults, but
is rare in obese children. The name for the syndrome was first suggested by
Sir William Osler and was more fully described by Drs. C.S. Burwell, E.D.
Robin and R.D. Whaley in a paper that appeared in the American Journal of
Medicine in 1956. It is based upon the Charles Dickens novel, "The Posthumous
Papers of the Pickwickian Club" written in 1837, in which he describes a
character that goes by the name of Joe, a "fat, red faced boy in a state of
somnolency". Joe goes to deliver a message, knocking loudly at the door. By
the time the occupants answer the summons Joe has fallen asleep, and is found
standing at the entrance snoring. Since heavy snoring, as well as compulsive
eating and headache, all form part of the symptoms of the syndrome, Dickens'
description seemed appropriate and Osler's suggestion has been widely
accepted. We know know that the condition is more than just a drowsy,
snoring, fat boy, yet the name is firmly fixed, and medical students still
dutifully memorize and remember all the signs and symptoms involved as the
Pickwickian Syndrome.