TREATMENT I73 



pounds; upon the 2d of September as well as upon the 9th of September, 203 pounds- 

 upon the 15th of September as well as upon the 23d of September, 200 pounds; upon 

 the 30th of September, 198 pounds ; upon the 7th of October, 196 pounds (health decidedly 

 Improved, can walk well); upon the 14th of October, 193 pounds; upon the 21st of 

 October, 193 pounds; upon the 28th of October, 191 pounds; November 3d, 190 pounds; 

 upon November 11th, 189 pounds ; upon November 18th, 187 pounds ; upon November 25th', 

 186 pounds; upon the 4th of December, 185.51 pounds. The total decrease in weight 

 amounted to 18.35 pounds. The patient lost weight slowly and steadily, about one 

 pound a week. At the same time the general condition and bodily activity had greatly 

 improved. The psychical depression had disappeared except for a few slight relapses. 

 The gouty difficulties were present to only a slight extent, if at all. Later reports 

 regarding the health of this patient have been very favorable. 



A more or less slow result which in the end may perhaps prove fairly sat- 

 isfactory occurs in those cases in which the patients do not exactly follow the 

 regulations, but make changes of their own accord. I shall mention only one 

 case of this kind. A high government official (lawyer), forty-five years old, 

 weighing 331 pounds; circumference of the abdomen at the height of the 

 navel 123 cm. He believed that he could not get along without beer and a 

 larger amount of bread — and so increased this to 160 grams of rye bread — 

 and took one liter of beer daily. In the main he followed directions, and to 

 compensate for his deviation he walked every afternoon for an hour and a 

 half. In the first six months he lost 31 pounds, in the second six months 6^ 

 pounds, in the third six months 3.2 pounds, a total of 39^ pounds. The cir- 

 cumference of the abdomen diminished 34 cm. Entirely satisfied with these 

 results, the patient continued to live according to the principles under which 

 he had gotten rid of his numerous difficulties. 



Any one desirous of success with this method must have a certain knowl- 

 edge of the modern physiology of nutrition, and must recognize the necessity 

 of changes to meet the pathologic conditions peculiar to each individual and 

 his general circumstances. 



These are essentially the rules according to which an obese person must 

 arrange his diet if he desires to rid himself of superfluous fat and prevent its 

 reaccumulation. To carry out this regime does not give rise to difficulties; 

 the privations which are caused by it are as nothing in comparison with those 

 which are caused by obesity and with the dangers which may in this way be 

 avoided. It is presupposed that while carrying out these dietetic rules a 

 suitable amount, of exercise must be taken. One of the advantages of my 

 method of treatment is that the patients may follow their usual occupat-ions, 

 and that thus the ordinary movements of the body may be made serviceable in 

 the treatment. Especially exhausting muscular movements are inadvisable 

 for persons who are both fat and anemic, since they give rise to certain diffi- 

 culties, are almost always impossible to carry out, and are by no means so 

 successful in reducing fat as they are often claimed to be. Banting in his 

 letters upon corpulence relates very entertainingly how an excellent physician 

 well Imown to him had advised, to prevent the increase of his corpulence, that 

 before beginning his usual daily work he should take extra exercise. As the 

 physician considered rowing very good for this purpose, Banting rowed a few 

 hours early in the morning. He relates that by this means he gained muscular 



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