PRACTICAL CONSIDERATIONS. 699 



The loss in weight of all of our subjects was a resultant of 

 the restricted diet and the relatively active daily program. After the 

 short periods of excess food on the free Sundays or holidays, the loss 

 in weight was accentuated by severe physical exercise. The reduction 

 in body-weight primarily by excessive physical exercise is also a prob- 

 lem that, in the Ught of the present research, assumes new significance; 

 a complete interpretation of the physiology of weight reduction can 

 not be made unless this factor has been thoroughly tested. A prac- 

 tical appHcation of the principles laid down in this research may be 

 found, however, in the question of moderate reduction cures. With 

 the weight reduction produced by these men, either absolute or per- 

 centagewise, no serious physiological effects were noted. A word of 

 caution, however, should be inserted, for, as McKenzie^ has pointed 

 out, weight reduction without accompanying physical exercise is 

 liable to cause a loss of bodily power; furthermore, in connection with 

 the loss of protein, when loss of weight is produced without due regard 

 to keeping up the general tone of the body by muscular activity, con- 

 stipation, hernia, and gastroptosis, particularly in middle-aged and 

 excessively fat women, may occasionally occur. Although the rapid 

 absorption of fat has occasionally caused displacements of the kidneys 

 and uterus, the resulting symptoms have usually not been more trouble- 

 some than the obesity itself. For moderate weight reductions of 10 

 per cent it is safe to predict that even such rare occurrences may not 

 be noted. Further weight reduction should be carried out only with 

 the constant supervision of a competent physician. 



Entirely aside from the laboratory and clinical suggestions arising 

 from this research, we should consider the influence of an observation 

 of this kind upon the feasibility of general dietetic restrictions as a 

 food-conservation measure. Judging superficially from the appearance 

 of these men at the end of their long period of restricted diet and from 

 the amount of their intellectual and physical activity, one could assert 

 almost with certainty that a reduction of total caloric intake of one- 

 third was an assured possibility. Certain objections to this have been 

 cited in our discussion. Of these the picture of secondary anemia 

 indicated by the blood findings, the marked repression of all normal 

 sex expression, the mental unrest and dissatisfaction experienced by 

 many of these men should all be seriously considered. Dr. Minot 

 beheves that the anemia would not progress much farther with con- 

 tinuance of this diet. The absence of sex interest has an important 

 bearing on the subject of the propagation of the race. It is possible 

 that nature is insistent that the metabolic level found in practically all 

 normal individuals is that best adapted for propagation and that 

 reduction in this level can only be made at a sacrifice of sex interest and 



^McKenzie, Exercise in Education and Medicine, Philadelphia, 1915, 2d ed. p. 530. 



