TREATMENT I75 



ondly, much fluid may be withdrawn from the body by inducing sweating. In 

 regard to this I need only mention the sun baths advised by Celsus for the 

 obese. These depletion cures cause a loss of body albumin. Some of the 

 reports of the so-called Oertel cure may be given here. Oertel permits the 

 obese 156 to 170 grams of albumin, 75 to 120 grams of carbohydrates, 25 to 

 45 grams of fat. The upper limit Oertel allows only for those persons in 

 whom the craving for food is great owing to hard muscular work, for example, 

 mountain-climbing. On account of the importance which Oertel attaches to 

 the ingestion of fluid, he has fixed the amount at 973 to 1,414 grams. 



A sample diet list given by Oertel is as follows: Breakfast: fine wheat bread 35 

 grams, coffee 120 grams, milk 30 grams, 2 soft-boiled eggs 90 grams ( 100 grams of 

 broiled meat), sugar 5 grams {butter 12 grams). Second breakfast: mild Rhine wine, 

 or bouillon, or water 100 grams, or Port wine 50 grams, solid food 50 grams of cold meat 

 and 20 grams of rye bread. Midday: light Rhine wine 250 grams, broiled beef 150 to 

 200 grams, salad or vegetables (cabbage) 50 grams, cereal 100 grams (bread 25 grams), 

 fruit 100 grams. Afternoon: coffee, with milk and sugar as in the morning. Evening: 

 mild Rhine wine or water 250 grams, caviar 12 grams (Kiel sprats 12 grams, smoked 

 salmon 18 grams, 2 soft-boiled eggs = 90 grams), game 150 grams, cheese 15 grams, rye 

 bread 20 grams (fruit 100 grams). 



The preceding diet list of Oertel's contains : 



Albumin. . Fats. Carbohydrates. Water. 



160 grams 43.5 grams 117.5 grams 1,440 grams 



The withdrawal of fluid in the treatment of obesity appears to have found 

 no favor in this latest plan. It is of especial interest to note that this method, 

 originating in Munich (where it was ostentatiously advertised) is now vigor- 

 ously condemned, as is evident in the criticism of E. v. Hoesslin based upon 

 a very rich experience. 



As the result of his observations v. Hoesslin arrives at the conclusion that 

 in the so-called Oertel cure we are using in fact a true hunger cure. v. Hoess- 

 lin even believes it questionable whether in antifat treatment the reduction 

 in the amount of fluid plays any part. He does not regard Oertel's method 

 as a commendable one, and holds the same view in regard to the Banting cure ; 

 for though he looks upon its effect in depleting fat as good, its action upon 

 the general condition he designates as bad. His method in the treatment of 

 obesity consists of four parts, and depends upon nutrition by a pure fat-albu- 

 min diet, modified according to the principles proposed ly me. Without here 

 going into detail in regard to the modifications in v. Hoesslin's diet lists, I 

 will simply emphasize the fact that he does full justice to fat in the treatment 

 of obesity, and that he pronounces the results obtained by him through diet 

 alone to be very satisfactory. It is true he lays stress upon the fact that these 

 results do not equal those attained by diet combined with the other three com- 

 ponents of his obesity treatment. These consist in the simultaneous stimula- 

 tion of metabolism by hydrotherapy, the augmentation of oxidation processes 

 by increased muscular exercise, and finally, the administration of thyreoidin 

 tahlets. 



What of the treatment of obesity with thyreoidin tablets as mentioned by 

 V. Hoesslin ? I have subjected this method to an accurate test, and have pub- 



