OBESITY.
The treatment of obesity or corpulency cannot be regarded as in a satisfactory state, as of the various so-called " systems " some are founded upon erroneous theories at variance with recognised physiological laws, whilst others, though based upon sound theory, cannot be carried out as a routine owing to individual peculiarities. The physician, before adopting any system, must carefully investigate the causal factor in each case. Thus, in the hereditary type, which may not, however, show itself till middle life, the obese condition flourishes upon a dietary which is barely sufficient to maintain a healthy standard of nutrition in ordinary individuals, whilst in the acquired type of obesity, over-eating, with insufficient physical and mental exercise, are the causes which can be easily removed.
Drugs as a rule should be discarded in every case; the only substance known to possess any specific action is Thyroid Gland, which possesses a powerful influence over the body metabolism, causing serious reduction in the amount of fat along with wasting of the nitrogenous tissues when given in full doses. Hence, if thyroid feeding be pressed into the service of the therapeutics of obesity, it becomes absolutely necessary to administer large amounts of proteids to make up for the increased nitrogenous waste. Not more than 5 grs. twice a day of the dried gland substance should be administered, and never for very prolonged periods.
Fucus Vesiculosus is the basis of several patent or proprietary nostrums for the cure of obesity. The writer knows that this—the common bladder seaweed or wrack—has been used in the North of Ireland as a food for fattening pigs, and owing to the physiological relationship existing between man and this despised animal, as shown by the dentition and omnivorous character of the food, it might be reasonably expected that it would tend to increase instead of diminish corpulency.
Vinegar and alkalies have been resorted to from time to time to cause diminution of fat, but this effect can never be obtained without dangerous deterioration of the general health from serious blood change.
Citric Acid is now very extensively used, alone or as a part of some popular system; the best that can be said for it is that, though not so dangerous perhaps as vinegar, its power of decalcifying the blood must never be lost sight of.
Before considering the subject of dietary, the effects of exercise may be briefly referred to, as these two agents must constitute the basis of all systems of treatment for the reduction of obesity. As inactivity of body due to indolence, laziness or sloth is a common factor in the acquired and a frequent adjuvant in the hereditary type of obesity, the opposite condition may be rationally expected to effect a reduction of fat. Muscular exercise should always be associated with some plan of increasing mental activity, and no system of treatment should be pursued for the reduction of obesity which does not include the fullest possible degree of physical combined with mental exercise. An important detail in this connection must not be lost sight of—in order to get the best results from physical exercises these must be carried out systematically in the open air. Mountain climbing is a part of Oertel's system. The best results are obtainakde from swimming exercises carried out in the open sea or in some inland lake or large river, and a very considerable degree of obesity may be successfully removed by this form of vigorous exercise.
When the physical condition of the patient contra-indicates active open-air exercises, much benefit may be obtained by a prolonged course of vigorous general massage, and this may be combined with Sandow's or other form of gymnastic exercises, followed up by the Turkish Bath. The Electric Light Bath, in which the entire surface of the body, excluding the head, is exposed to powerful arc lights, as in the Winternitz cabinet and horizontal electric light baths, is a most effective method of increasing oxidation, improving metabolism, and diminishing fatty deposition. The open-air Sun Baths at Peebles and Battle Creek effect the same results.