Thyroid preparations may be used with great caution, as they promote wasting of muscle as well as of fat. A small dose is given, and its effect on the pulse watched, as patients react strongly in some eases, and scarcely at all in others. Its use greatly hastens the loss of weight, but it should not be continued if it produces any other effects. V. Hoesslin (Edinburgh Med. Jour., Nov., '99).
Obesity treated by a diet unmodified by cooking or preserving, such as raw milk, eggs, meat, salads, and fruits. Case of a man reported, whose weight after less than a year of treatment was re duced from 325 to 204 pounds. G. M. Behove (Bull de BAcad. de Med., Mar. 6, 1900).
The following dietary may be ordered in selected,cases:— Morning Meal.—Fine wheat-bread, 1 ounces (-10.0); a soft-boiled egg; milk, 1 ounce (32.0); sugar, 77 grains (4.9); coffee, 4 ounces (136.0).
Noon Meal.—Soup, 3 ounces (96.0); fish, 3 ounces (96.0); roast or boiled beef, veal, game, or poultry, 6 to 8 ounces (192.0 to 256.0); green veg etables, 1 ounces (48.0); bread, 1 ounce (32.0); fruit, 3 or 4 ounces (96.0 to 128.0); no liquid (or only 4 or 5 ounces —120.0 to 148 cubic centimetres—of very light wine).
Afternoon Meal.—Sugar, 77 grains (4.9); coffee, 4 ounces (128.0); milk, 1 ounce (32.0); occasionally bread, 1 ounce (32.0).
Evening Meal.—Caviare, ounce (10.6); one or two soft-boiled eggs; beef steak, fowl, or game, 5 ounces (160.0); salad, 1 ounce (32.0); cheese, 1 drachm (4.0); bread, rye or bran, V, ounce (16.0); fruit or water, 4 to 5 ounces (120.0 to 148.0).
For the treatment of obesity, diet: five meals during the day. For break fast, a raw egg at S o'clock, 'I, ounce of lean meat or lean fish, the whole eaten cold and dry—this condition is empha sized, that the patient must eat his meat cold; cold meat may be consumed in greater quantity than hot meat without causing increase of weight; ounce of bread; 1 cup of hot tea without sugar. At 10 o'clock, 2 raw eggs, 1/, ounce of bread, 5 ounces of wine and water, or tea without sugar allowed. At noon, cold lean meat ad /Hilton, but no bread; a little water-cress or salad salted and flavored with lemon-juice; of raw fruits 3 to 5 ounces for dessert, and for drink, may be taken, with this meal, 1 or 2 tumblerfuls of water, or water simply reddened with a little wine. One-fourth hour after dinner a cup of weak tea not sweetened and at 4 P.M. a cup of weak tea not sweetened, and nothing else allowed. At 7 p.m. the same repast may be taken as in the morning 'at S o'clock, and a little more lean fish or meat may be added, which the patieht may eat warm; the whole quantity must not ex ceed 3 ounces.
Exercise in the open air is insisted on; this may consist of a walk of half or three-fourths of an hour after each meal; that is, five times a day. The time spent in this exercise should be gradually increased from half an hour to three-fourths of an hour of brisk walking after each meal, and all the in fluence of the physician should be ex erted to enforce this regulation. If the
patient be a woman, a carriage-ride, with a walk in the country, may be the utmost that can be exacted.
Hydrotherapy followed by frictions, in a word, everything which stimulates the functions of the skin — vapor-baths, massage, etc.—may be enjoined.
Sleep during the day-time should be absolutely interdicted. The patient should go to bed at 11 o'clock rise at 6 A.M. during the summer, and at 7 A.M. during the winter—not more than seven hours of sleep for the adult and eight hours for the child.
It is possible to obtain sufficiently good effects from regimen without hay ing recourse to any kind of medicine. A. Robin (Bull. Gen. de Then, Oct. 30, Apenta water succeeds in producing a reduction of fat in the body without detriment to the existing albumin; that the general health of the patient suffers in no wise, and the cure runs its course in a satisfactory manner. Gerhardt (Berliner klin. Woch.; Med. Brief, Feb., Too rigidly uniform measures in the treatment of obesity deprecated. Prin cipal indications discussed under seven heads: 1. All dietetic excess should be avoided; three, or at the outside four, meals a day should be permitted and no food allowed in the intervals. The quan tity and variety taken should be based upon the heat-giving properties of the food-substance. 2. The first essential is an adequate supply of proteids; a mod erate amount of carbohydrate may be allowed, but the fat must be reduced to a minimum. Piquant seasonings are to be avoided. 3. The consumption of fluid is not to be limited unless symp toms of cardiac failure are present; such liquids as are fancied, with the exception of alcohols, may be taken at any time, but moderation is to be observed at meals. Cold water, especially if charged with carbonic acid, is to be preferred. 4. Exercise and active movements in the treatment of plethoric obesity insisted upon, the state of the heart being al ways taken into consideration; they arc of particular value in increasing the activity of oxidation processes. In an subjects, however, these advan tages are counterbalanced by the in creased nitrogenous waste, which may injuriously affect the heart. In these patients passive movements and mass age are accordingly to be recommended. 5. Great importance is attributed to diminution in the hours of sleep; sleep should be entirely forbidden during the day. 6. Tissue-change is also to be in creased by baths, particularly in springs rich in carbon dioxide. Turkish baths are also of value if the heart is sound. 7. Important to secure pure air, rich in ozone, especially in a high and wooded neighborhood. Kisch (Wiener med. Presse, Mar. 13, '98).