174 



OBESITY 



power — ^but simultaneously a voracious appetite, and adds ingenuously " As I 

 yielded to this, I constantly increased in weight until my dear old friend (the 

 previously mentioned physician) advised me to give up this kind of exercise." 

 What I have previously advised in regard to exercise for the obese patient 

 (Observation I) may in general be looked upon as sufficient. 



Quite a number of other diet rules have been proposed by various 

 authors according to the methods advised by me in the nutrition of the obese. 

 Of course, I cannot and will not enumerate all of these, for in the treatment 

 of obesity the most varied diet schemes may be based upon the foundation 

 given. But I shall mention the regime proposed by Hirschfeld, which is 

 elucidated by two illustrations. As is evident from these, Hirschfeld requires 

 a " uniform " limitation of all kinds of food, and maintains that the appetite 

 can be satisfied without any excess of food. 



Example I. 

 Breakfast : Coffee, without cream or sugar ; 



1 roll (50 grams). 

 2d Breakfast : 2 eggs. 

 Dinner: Bouillon with about 30 grams of 



rice weighed raw ; 250 grams of lean 



meat, weighed raw, either boiled or 



broiled with a little fat. 

 Afternoon : Coffee, without cream or sugar. 

 Supper : 50 grams of cream cheese ; 100 grams 



of bread ; 10 grams of melted fat (goose 



fat). 



Example II. 

 Breakfast : As in Example I. 



2d Breakfast : Bouillon and 2 eggs. 

 Dinner: Potato soup, 300 grams of meat, 

 weighed raw. 



Supper : 200 grams of lean ham, 100 grams 

 of bread. 



There is contained : 



In diet No. 1. 

 In diet No. 2. 



Albumin, Fat. Carbohydrates. 



95 grams 43 grams 106 grams = 1,224 calories 

 134 " 46 " 123 " = 1,478 " 



In women it will be possible to get along with even less food. 



Incidentally, in speaking of " no-fat " cures, I mentioned that they (in 

 contrast to my method of treatment) necessitate that the patient learn to endure 

 his thirst. The withdrawal of water played a role in antifat cures even in 

 antiquity. Pliny the Younger advised those who desired to become thin to 

 refrain from fluids while eating, and even afterward to drink but little. This 

 is not the place in which to follow in detail the history of these thirst cures. 

 It may be only mentioned here that the father of the latest movement in this 

 direction, which originated in Munich and for a time gave rise to much dis- 

 cussion, was the founder of the Naturheilansstalt Brunnthal, near Munich, 

 Ur. J. Steinbacher (died 1868). In his booklet, "Asthma, Fatty Heart, 

 Corpulence, etc.," he has kid special stress on ridding the body of a part 

 of its fluid in the cure of obesity. Oertel, following him, has developed this 

 method in great detail, and it has been named after him the " Oertel Cure." 

 The withdrawal of fluid, upon which the greatest stress is laid, in this method 

 may be attained in various ways. First, by the limitation of the fluid intake. 

 This is hard. Thirst is much more difficult to endure than hunger. Most 

 persons very soon become nervous under it, and will not listen to reason. Sec- 



