310 THE EFFECTS OF OBESITY 



respiratory excursion, and by lessening the suction force of the re- 

 spiratory pump impede the return of venous blood. The efficiency 

 of the heart is diminished by the weight of fat on its substance. 



The tendency to obesity can be met by a diet of lean meat, 

 green vegetables, and fruit. By taking potatoes or coarse brown 

 bread with much waste in place of white bread. By avoiding all 

 food cooked with fat or flour. By lessening appetite, by drinking 

 between and not at meal times. 



The following diet of von Noorden, given to a man of average 

 height, will with systematic muscular exercise in many cases lessen 

 fat by 10 Ibs. in the first month, and 5 Ibs. in the next two months. 



100 grm. (3J oz. approx.) lean meat = 130 Cal. 



1 1. (If pint ) milk - 600 



1 1. (If pint ,, j butter milk - 450 



200 grm. (7 oz. ) potatoes = 160 



100 grm. (3J oz. ) black bread = 180 



100 grm. (3|- oz. ,, ) raw fruit = 40 ,, 

 Coffee ad lib. 



1560 Cal. i.e. f of 

 a normal diet. 



Mountain climbing is the most efficient means of relieving a 

 robust man of surplus fat. Climbing should be regulated so as 

 never to disturb deep and regular breathing. Quick superficial 

 respiration overburdens the heart. The influence of climbing is 

 shown by the fact that progressing one metre on the level uses 

 up 0-1196 c.c. 2 per kg. of body weight; climbing one metre 

 uses up 1'4425 c.c. 2 per. kg. of body weight. 



Massage has no effect on metabolism, and cold baths have 

 little effect unless combined with friction to produce vaso-dilatation 

 and loss of heat. 



It has been an article of faith that castration lessens the rate 

 of oxidation and increases fattening, but this Ltietige has failed 

 to confirm. 



The feeding of thyroid gland increases the 2 use and C0 2 

 output, and in many cases the N 2 metabolism. In some it lessens 

 fat, in others not. It may cause glycosuria, nervous symptoms, 

 and palpitation of the heart, and is not a treatment to be re- 

 commended. Less food and more exercise, and especially the latter, 

 is the one and only remedy for fat people. 



