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TREATMENT 161 



This is attained by a process of training, so called, which consists in systematic 

 and gradually increased exercise combined with a suitable diet. In this man- 

 ner such persons fit themselves for various feats of strength. There is special 

 training for riding, for marching, for swimming, for rowing, etc. We are 

 all familiar with the training of race horses; by a special kind of treatment, 

 by feeding and systematic muscular exercise, they are prepared for their task. 

 By the same means men may prevent an increase of obesity, and eventually 

 even become rid of it. In the well known processes of training, therefore, the 

 first principles of the treatment of obesity are embodied. ISTevertheless the 

 detailed application of the latter is decidedly different, in that such tests of 

 strength as are used in training are not suitable in the treatment of obesity, 

 and, as a rule, would be dangerous in a corpulent person. 



Nothing is easier than to make a person lean. Debove at a meeting of 

 the Academic de Medecine at Paris on the 6th of March, 1900, showed a patient 

 who had just passed through an emaciation cure (cure d'amaigrissement). 

 To explain this method I will quote briefly a review of Debove's treatment 

 published in the Semaine Medicale, No. 10, 1900, showing what this physician 

 advises in the treatment of obesity. 



I must remark at the outset that obesity cures and emaciation cures are 

 by no means to be looked upon as synonymous. In the former only the super- 

 fluous fat is to be removed, while in the latter both fat and muscle are to 

 be diminished. Leanness is attained by hunger ; a treatment to produce lean- 

 ness and a hunger cure are identical. Debove's obese patient, who suffered 

 from urinary gravel, weighed before treatment (which lasted less than a year), 

 147 kilograms; after treatment he weighed only 94 kilograms. The patient, 

 therefore, in less than a year lost 53 kilograms of body-weight. How was this 

 attained? The patient was put upon a pure milk diet. He received daily 

 for one month 2^ liters of milk, during the second month only 2 liters, and 

 in the third month only one liter per day. The patient, who was unable to 

 leave his bed, lost in the first two months of this treatment 15, and in the 

 third month 5, kilograms of body-weight. After the first three months he 

 weighed only 127 kilograms. During the next four months the patient re- 

 ceived daily only one liter of milk. At the end of seven months from the begin- 

 ning of the treatment he weighed only 105 kilograms. He then ceased to 

 emaciate. But after a change of diet which permitted the patient to take 

 cooked vegetables, salad and fruit in any quantity that he desired, he lost 

 12 kilograms more, so that he then weighed only 94 kilograms. As the 

 result of this treatment Debove reports that the man not only was re- 

 duced in flesh but that he regained his health and his physical and moral 

 capacity. Debove hopes that the good effects of this treatment will be 

 maintained. 



This case demonstrates that occasionally, by means of a starvation cure, 

 we may obtain good results. In this case there was certainly a considerable 

 degree of malnutrition, for 2.5 liters of milk per day, the amount which the 

 patient received for the first month, is decidedly insufficient for nutrition, to 

 say nothing of the fact that he had to content himself for months with one liter 

 a day. Now it is certainly strange that, in this patient, loss of weight ceased 

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