398 FAT METABOLISM. OBESITY 



every-day surroundings, all these are elements which make 

 for success in such an establishment for the cure of the 

 obese. First and foremost the result is that these obese 

 people, who either are unwilling or cannot use the necessary 

 energy and precaution at home to deal with their trouble, 

 amuse themselves with the annual outcome of their Marien- 

 bad or Kissingen sojourn and make excuses for their per- 

 sistent failings." 



The thyroid gland medication in the obese depends upon 

 an entirely different principle. Gr. von Bergmann 40 holds 

 that an increase of calory-exchange of from 25 to 50 per 

 cent, can be obtained by administration of thyroid sub- 

 stance, with protection of the protein store; and believes 

 that (if we exclude direct or indirect toxic influences, espe- 

 cially upon the nervous system, which may give rise to 

 contraindication for this method of treatment) thyroid 

 gland substance is "from a purely metabolic standpoint the 

 ideal means of reducing fat/' As has been previously 

 stated (Vol. I of this series, p. 450, Chemistry of the Tissues), 

 we cannot fully share this view, and are more likely to accept 

 the idea (on the basis of the statements of Magnus-Levy, 

 Ebstein, v. Noorden, Umber and others) that the antifat 

 treatments by administration of thyroid not only are want- 

 ing in every practical but also every physiological 

 justification. 



Fattening. In conclusion of the present discussion we 

 may point out what principles are involved if the opposite 

 of the above depicted effect is sought to be obtained, namely, 

 putting on fat. Probably nothing better can be done than to 

 follow herein the lines of thought which C. von Noorden has 

 developed in his remarkable monograph concerning hyper- 

 nutrition. 41 



40 G. v. Bergmann, Handb. d. Biochem., 4", 230-237, 1910. 



41 C. von Noorden, " Die Ueberernahrung," Handb. d. Pathol. des Stoffw., 2d 

 ed., 1, 548-577, 1906. 



