Obesity and Emaciation. 437 



So far as obesity and emaciation are dependent on diet they 

 may be checked by subjecting the patient to the dietary which 

 will favor a more health y liver function. For excessive obesity a 

 strictly nitrogenous food in restricted amount will tend to lessen 

 the glycolytic action of the liver and secure the formation of 

 muscle rather than fat. An outdoor life, and an active though 

 not exhaustive use of the muscles will greatly favor this result. 

 For the carnivora or omnivora a diet of lean meat or skim milk 

 might be employed, while for the herbivora, wheat bran, cotton 

 seed hulls, beans, peas, vetches, or cotton seed would measure- 

 ably meet the demand. Cholagogues and saline laxatives, by 

 eliminating from the liver and intestine, will contribute to the 

 same end. 



If emaciation depends on a deficiency of sugar, that may be 

 freely fed along with richly amylaceous food, and the liver may 

 be stimulated to increased glycogenesis by stimulants such as 

 chloroform, ammonia, or ether, and by a moderate use of carbon- 

 ate of soda or other alkalies. Ether has in addition a stimulating 

 effect on the pancreas and will tend to increase that ferment which 

 stimulates the liver to its glycogenic work. Mild laxatives and 

 cholagogues will second this, such as small doses of podophyllin, 

 taraxacum, nitro-muriatic acid, chloride or bromide of ammonium, 

 plenty of pure air, abundance of green or aqueous food, and 

 plenty of pure drinking water. Finally, moderate exercise, by 

 increasing the aspiratory action of the chest and thereby ac- 

 celerating the hepatic circulation is a material stimulant of the 

 glycolytic function. Bitter and other tonics are contributions 

 to the same object and should not be neglected, 



