IMAGE EVALUATION TEST TARGET (MT-3) / S.v s? 1.0 I.I 1^ 145 IIM IIIIIM IS 1^0 IM 2.0 1.8 111.25 1.4 = — 1.6 1 — .^ 6" - ► niL _A U:^ rliUlugidpiiiL; Sciences Corporation « 1>, CLARK & CO., FRONT STREET EAST. IS'ZS. <^::-« 4 E3 ¥ t; X . OBESITY, OE EXCESSIVE CORPULENCE THE VARIOUS CAUSES AND <^ THE EATIONAL MEAKS OF CUKE. X • *.r jfxom t^t Ittnc^ of JJanccL TRANSLATED AND EDITED BT M. BAKRETT, M.A., M.D. TORONTO: W. C. CHEWETT & CO., KING STREET EAST. 1864. //v . i PEINTED BY W. C. CHEWETT A CO., KINO 8TREET EAST, | TORONTO. PREFACE. I EAST, I 4 The subject of " Obesity," including its cause and treatment, has received during tbe past few years a great deal of attention both . in England and on the Continent. Thousands of persons have realized the extraordinary bei jfit to be derived from the simple treat- ment laid down in the following pages. Some members of the medical profession have, in the course of their practice, availed themselves of the theory first propounded by our Author, but have failed to acknowledge — either through ignorance or inadvertence — the source of their information. Under these circumstances it has been deemed an act of justice, though tardy, tq place before the profession and the public a translation of the prigint^l work of Dancel, IV. PKEFACE. published at Paris, in 1854. Some slight modifications in matters of theory have, hov7- ever, been introduced, which the progress of Bcience imperatively demanded. The invariable success which has attended the treatment of several cases of obesity in this city, in accordance with the principles es- tablished by Dancel, warrants the assertion that the system is in every respect worthy of public confidence. I hi I ight LOW- IS of ided f in 3 es- tion y of AUTHOR'S PREFACE. 11 To the many individuals of both sexes who are afflicted with an excessive development of fat, rendering the ordinary duties of life not only irksome but ofttimes impossible, — an easy method of reducing obesity, in nowise interfering with the ordinary daily avocations of the patient, nor demanding any. diminu- tion in the actual amount of food consumed ; requiring the use of none but the mildest and most harmless medicinal agents; improvi.ig at the same time the general health, and aug- menting bodily and mental vigour, — must prove acceptable. The process will be found not a mere specu- lative theory, but one based upon the great laws of Nature, as manifested throughout the whole of the animal kingdom. i M Ml i AUTHOR'S PREFACE TO TUB THIRD EDITION. .\ I /T^ Can corpulence be reduced without inju- riously aifecting the general health ? This is the grand question, and it is suggestive of an- other, which is: — an inordinate amount of fat once having been deposited in and among the living tissues, is its presence necessary for the preservation of the health and life of the individual? My answer is, — most assuredly no ! Every one knows that an undue degree of corpulence is. not only accompanied with great inconvenience to the individual, but is, in most instances productive of ill health, and too frequently of positive disease. Having answered this question, another occurs : — are there any substances generally known to the profession which have the DOwer Viii. PREFACE TO TIHRD EDITION. either to destroy fat or to cause its disappear- ance, and wliich, at the same time, will have no action upon the other tissues of the body ? My reply is most assuredly there are such ; and I will prove my assertion in this respect to be correct, without resorting to the use of subtle reasonings or invoking the aid of learned theories, but will be content to rest it upon the sure foundation of chemical science, —on that science which teaches the action of one body with another, which shews us that in some cases no change whatever is effected by the mechanical combination of two or more indifferent substances ; and that in other . instances, the chemical union of two bodies will be productive of a third, having proper- ties wholly dissimilar from either of the two original substances :— thus, that one or more elementary substances or chemical compoimds may enter into combination with a fatty body to produce a third, and yet have no power of action whatsoever upon the muscles, the # PEEFACE TO THIRD EDITION. IX. ppear- L have body? siicli ; -espect use of aid of rest it cience, tion of IS tliat effected two or n otlier bodies proper- the two )r more ipounds ty body lower of les, the bones, the nerves, or any other than the fatty tissues of the living organism. Knowing, therefore, the chemical consti- tuents of fat, and also those entering into the composition of the several articles of diet which are principally made use of in the civi- lized world, we are enabled to say of a certain class of alimentary substances, that such con- tain the elementary ingredients ef fat; and that if you desire to escape the inconveniences and evils attendant on corpulency, it will be well to abstain from them ; and that, on the other hand, by making use of such and such alimentary substances, and that too in any quantity the appetite may prompt, there will be no danger of suffering the inconveniences alluded to, because such substances contain but a minute portion of those elements which enter into the composition of fat. In the following treatise, a system for the reduction of corpulence, based upon the above X. PREFACE TO THIRD EDITION. well-recognized truths, will be found fully developed, and its correctness established by means of numerous cases brought forward, in which the results have been entirely satisfac- tory, and where the patients have kindly per- mitted me to state their names and addresses. i^E i fully Led by ard, in itisfac- [y per- resses. 1, CONTENTS. — « — PAGE. Translator's Preface iii. Author's Preface y. Author's Preface to Third Edition vii. CHAPTER I. Introduction j CHAPTER II. Sterility ^ Virility g CHAPTER III. Hernia 9 Umbilical Hernia 10 Medical Theories 14 Medical Specialism ig Periodic Headache I7 Effect of loss of blood ig Apoplexy 19 Sanguineous Apoplex^ 20 Pulmonary Affections 21 Fatty Liver 22 Abdominal Dropsy 23 Hepatic Obstruction 24 Broussais, his Theory 25 Signs of Hepatic Obstruction 27 Uterine Affections 28 Skin Diseasfe 29 It 1! -i Dili I ii ^- , CONTENTS. PAGfi. 30 Cause of Obesity ' " gj Hysteria 32 Sudden Death * CHAPTER IV. 35 ^Quantity of Fat ' * ' gg Case in Java '^ 37 Appearance of the Obese ,..[. 38 Pallor • 40 Yaricose Veins ' ^^ Somnolence ^ ^ 43 Effects of Exercise ••** ^^ Pre-disposition to Fat ^g Intestinal Tract "^ ^^ . Composition of Fat ^ ^ ^g Chemistry of Fat ....•• ^^ Experimental Feeding " g^ Effects of Fluids *'**' g^ Nitrogenous Food gg Carnivora ^ g^ Hippopotamus ^ gg Whale Tribe * * gg Insufficient Exercise g^ Active Exercise * gg Jail Prisoners ' * gg Carbon of Plants • • • • CHAPTER V. Art Treatment of Obesity ^^ Delarding * ^2 Compulsory Abstinence ^^ Use of Acids • Use of Iodine ^^ Similarity of Fat and Water - * 4 I " I I C0NTE.4TS. Xlll. 35 86 37 38 40 41 43 44 46 47 • 48 50 51 52 53 64 65 56 , 57 , 58 . 69 60 61 62 63 64 65 I PAGE. Alkalis 66 Bi-Carbonate of Soda 67 Alkalis alone not sufficient 68 Increased Tone 69 CHAPTER VI. Cases of Reduction of Corpulence 70 Case of Gu^naud 71 In'^reased Muscular Power , ■. 73 Unimpeded Respiration 74 Diet 75 Case of Widow Rollin 76 Case of Chauvin 77 Case of Roberts ... 78 Swelling of the Legs 79 Palpitation 80 Cardiac Sjmiptoms 81 No excess of Blood 82 Case of Madame Meuriot 83 Case of Madame Pecquet 86 Loss of One Hundred Pounds weight -. 88 Case of Madame de M 89 Case of Lncian Ete . . . , 92 Case of Madame d'Hervilly 93 Case of M. Desbouillons 94 Systematic Opposition 96 Trembley 97 Not a matter of Faith 98 Fat and Fatigue 99 Case of Madame C ^ 100 Change of Temperament 101 Case of Albert C 102 Case of Mr. L 103 Case*of Dr. Halberg 105 Case of Jules Wimy 107 ^^y CONTENTS. PAGK. 109 The Postmaster at Orleans Constancy of Result * • ' Resolution necessary The Fat Professor ^^^ Cases of Skin Disease ,^ 115 Prejudices Overcome • CHAPTER VII. On the selection of alimentary substances favorable to the reduction of Corpulence J J^ Man Omnivorous ^^^ Power of Selection ^^^ Of Meats ^.^^ Of Fish 121 Of Milk CHAPTER VIII. 122 Of Beverage ^^3 Beer and Cider ^^^ Alcoholic Drinks Wine and Water ^^^ Of Tea and Coffee • Strong Cofifee .*'* •♦'/I OBESITY ; OR, EXCESSIVE CORPULENCE, CHAPTER I. INTRODUCTION. M The pliysician has a twofold duty to perform. He is called upon not merely to alleviate pain, and to undertake the cure of disease, but he is, moreover, required to lay down rules for the preservation of health, the prevention of dis- ease, and its too frequent concomitant, pain. Now, health being dependent upon the due and regular performance of the vital functions by the several physiological organs of the body, any excessive development of these organs, or undue manifestation of force on their part, must, of necessity, be contrary to the general health of the body, and be productive of dis- ease and pain. In many persons there exists a constitutional tendency to the excessive formation of blood, occasioning a plethoric condition, and thereby rendering the hidividual liable to a great many diseases ; others again suffer from an exalted or diminished sensibility of the nervous system, >:) INTliODL'OTIOxV. inducing some of the greatest woes to which humanity is liable. Many different elements are combined m the structure of the various organs of the body, and among these fat, in' suitable proportion, must be recognized as necessary for the due and equable performance of the several orgamc functions. This fat, however, often becomes excessive, givino- rise at first to great inconvenience, after a time inducing debility, and finally constitut- ino- a disease (hitherto deemed incurable) termed obesity. The possession of a graceful figure may be ot little importance, in so far as the happiness of most men is concerned ; but as regards the gentler sex, sucai is by no means the case. "Women are too apt to believe that, m the absence of physical beauty, the possession of mental and worldly treasures can only sufiice to render them endurable in their social rela- tions. Beauty, the richest gift of nature, deserves to be carefully guarded by those who happily possess it ; corpulence, its enemy, is destructive to the finest organization. It is a painfid sight to witness the many instances'of women, who, though still of youth- ful years, and whose elegance of form, but a short time since, did but enhance their unsur- 1 4 ^ t-i IKTlionUCTtuN. 8 wliicli id in the le body, ►portion, tlie dne L organic xcessive, ice, after onstitnt- i) termed nay be of ipiness of ;ards tlie the case, t, in the icssion of \j snffice icial rela- nature, liose who inemy, is :he manv of youth- rm, but a cir unsur- passed loveliness of countenance, lose by de- grees, in the midst of an overwhelming fat, all this relative and graceful harmony, and ^ hose ever increasing corpulence serves only to rci^der them ill-lavoured and repulsive. In all cases, so detrimental a change is nmcli to be regret- ted ; but for ladies mingling in the fashionable spheres of life, it is to be borne only when such a condition can be shewn to be utterly beyond all hope of relief. Excessive corpulence has destroyed the prospects of many, both men and women, by rendering them incompetent to discharge the duties of a profession by whicli they had hith- erto gained an honourable livelihood. Super- abundance of fat prevents an infantry officer from following his regiment — a cavalry officer from being long on horseback ; and thus both are alike compelled to retire from the ser- vice. The operatic artiste, whose voice or personal beauty had been hitherto a mine of wealth to the theatre, falls into indigence, because an excessive development of fat now embarrasses the lungs or destroys her per- sonal charms. Every one engaged in intellectual pursuits will say that since he has increased in fat he finds that he cannot work so easily as he did when he was tliin. The painter feels the want N ft 4: INTRODUCTION. of that vivid imagination which was wont to guide his brush. The sculptor hihours with indifference upon the marble. The literary man feels heavy, and his ideas no longer flow in obedience to his will. The clerk in his office is ever complaining of the efforts he is obliged to make to resist an overwhelming drowsiness which interferes with his calcula- ting powers, rendering him unable to compose a letter, or even to copy one. Obesity, in fact, lessens both physical and moral activity, and unfits man for the ordinary business of life. It was in conformity with this opinion, no doubt, that the Komans at one time, wishing to have no drones among them, banished those of their fellow citizens who laboured under an excessive development of fat. One can con- ceive of the existence of such a law among a people who condemned to a like punishment any citizen known to be indifferent to the public welfare. We must admit, however, that it would be a irrave error to assert that all persons suffer- ing under ah excess of fat are invariably want- ing in the finer feelings, or even in moral energy. There are many living proofs to the contrary. But it is among women chiefly that we witness instances of great mental refine- ment and susceptibility, in union wnth a body steadily increasing to a lamentable size. s INTRODUCTION. ivont to rs with literary !^er flow : in his 'ts lie is lelming calcula- jompose in fact, ty, and ' life. :iion, no wishing ed those Lnder an 3an con- imong a lishnient t to the ^ould be IS sufier- ily want- n moral fs to the efly that 1 reflne- Li a body '* M ! I Moralists have written that obesity is a sign of egotism ; of a good stomach, ])ut of a bad heart ; and many may be found to endorse the sentiment. Unhappily people are easily daz- zled with high sounding words, and the sen- tentious phrases of moralists. This is WTong ; for if we take the trouble to adopt for a moment the opposite to that which they ad- vance, we shall often find that this opposite is not void of reason. In support of this remark many reasons can be advanced why a fat per- son should have a good heart, and be endowed with most excellent cpialities. Corpulence, it is true, usually indicates good digestive powers ; ' but good digestion is not incompatible with goodness of heart. One who digests his food easily ought to be better disposed towards those around him, than the sickly creature labouring under dyspepsia. What amount of temper can be expected in those who daily experience pain in the stomach while the digestive process is going on ? they can have no joyousness of heart, but must continually be in bad humour, too often seen in their con- tracted and jaundiced features. It is a great mental eflbrt on their part to receive you with even a seeming cordiality. We may always accost a person with a degree of confidence, whose skin is gracefully spread over a sufl^i- ;c. m n C INTRODUCTION. cient Layer of fat. I may be iiiistalvcn, but in my opinion we need not expect to meet in r such persons great mental anxiety, or intense ^ egotistical feelings. Julius Ciesar was warned a few days before ^ his assassination that an attempt would be ]. made upon his life :— Antonius and Dolabella ' j were accused of being the conspirators. " I have but little dread of those two men," said he, " they are too fat, and pay too much at- tention to their toilette ; I should rather fear Brutus and Cassius, who are meagre and pale- faced." The end justified Ca3sar's opinion. With respect to lean persons, I shall not undertake to oppose the general opinion that a delicate Oi rfiMization is emblematic of a mind endowed with a great member of most precious and good qualities, frequently used wth such energy, as by its very strength to be the cause of bodily weakness. But let us beware of I entering the domain of Lavater, Gall and ^ Spurzheim. We would rather say that the emblem of health is a sufhcient but not too great rotundity of person — mens sana in cor- pore sano. T STKUILITY. , but in licet ill intense 5 before mid be Glabella rs. "I n," said inch ac- lier fear lid pale- iiion. lall not in that a a mind precious *^tli sucli lie cause iware of rail and tliat the not too I in cor- t t CIIAPTEIl IT. Sterility must be numbered among tln^ Infir- mities induced by excessive corpulence. Tins is a well attested fact in reference to tlie human species, and also fis to the females of the lower animals. One of the professors in the Medical FacuLy of Paris, while explaining in his lectures how fat could interfere with conception, never ftiiled to cite the practice of the peasantry, who hastened to send to market those hens which became excessively fat, be- cause they then ceased to lay eggs. Even plants lose their fertility by excess of fat. A plant growing in a cultivated soil where it finds a superabundance of food becomes sterile, because the stamens are transformed into petals, causing double flowers. The rule is, in order that a woman should be capable of conception, that she should be regular — that is to say, that she shorid lose each month a certain quantity of blood. Now it is asserted by medical men tliat, in general, those women who are thin, and who are almost without exception iiirtile, lose much more blood than fat women. Menstruation lasts with them from five to ten davs, whilst fat women lose but s VIRILITY. fiiiif m very little blood during two or three days at the most. It may be added that in the first of these three days the loss is considerable, the v second day there is scarcely any, and on the , third day there is more, but it then ceases. ^ Just in proportion as a thin woman becomes fat, her menstrual flow diminishes, and so much tlie more speedily, the quicker she be- becomes fat. Some women wdio have thus increased in fat have ceased to menstruate at thirty-five, at twenty-five, and even at twenty years of age. Some young girls, regular at twelve or fourteen years of age, on becoming fat, have ceased to menstruate and become chlorotic. One great result of the anti-obesic treatment is, that while destroying the excessive amount of fat, it causes w^omen to become regular, and thus favours conception. -§. Thin men in general possess greater virility than those surcharged with Ikt, and in proper- ^ tion as this fat is developed virility is impaired and finally lost. This infirmity happens to many corpulent men at fifty, forty-five and ^ even forty years of age. Some who were very very fat at the age of puberty, have been im- potent throughout life. There are facts which prove that virility in man, like fertility in woman, may be restored on losing a super- abundance of lat. ■# ™ HERNIA. 9 dajs at 3 first of ible, the 1 on tlie ases. becomes and so she be- Lve thus Tiiate at fc twenty ^ular at ecoming "become :eatment 1 amcunt alar, and r virility 1 propor- impaired ppens to five and ^cre very been im- its which rtility in a super- f CIIAPTEE III. The human skin is capable of great exten- sion. It may be distended to four times its size, yet is not endowed with much elasticity. On this account we may notice, in very fat persojis, rolls of fat about the neck, back, buttocks, arms and pubis. The epidermis, which constitutes the external layer of the skin, is but slightly capable of extension. When distended beyond a certain point, it tears, and produces those white streaks which are to be seen on the abdomen of pregnant women, or of those who have borne children, and also of those who have laboured under severe dropsical ascites. These white streaks may be formed upon all parts of the body, wlien the skin is considerably distended : thus they have been seen in a young woman twenty- eight years of age, who weighed three hundred and four pounds. In her case these wdiite streaks were to be seen upon the 'arms, the shoulders, the breasts, &c. The skin of the abdomen would not be suffi- cient to retain the abdominal viscera in sitti^ I 10 UMBILICAL HERNIA. Kfiii ii were it not that between these organs and the inteiinment there exists a iil)rous or ninscular Layer, in some places double, consisting of a stronger and less extensible tissue than the skin, in order to strengthen the abdominal walls. It sometimes happens that this fleshy layer, having yielded to a certain amount of distension, occasioned by the volume of the intestines, and of their surrounding fat, and being thereby unduly stretched, permits the passing between its fibres of a certain portion of intestine or of fat, which, lying immediately under and pushing the skin before it, consti- tutes what is termed a hernia. Dropsy or pregnancy are frequently the primary cause of the various descriptions of hernia, termed in- guinal, crural, &c. Umbilical hernia is that which is usually produced by a too great development of fatty tissue in the abdomen. The umbilicus is that part of the abdomen which is the least suscej)tible of dilatation. When the belly becomes enlarged to a mode- rate extent, the navel becomes depressed, shew- ing that this part does not easily yield to the pressure from within ; but it is supported by the recti muscles, those two bands of fleshy fibres lying innnediately beneath the skin, and passing from above downwards, on each side aiid close to the navel. In extreme develop- v^ « UMBILICAL HERNIA. 11 and tlie iiuscular iiig of a lian tlie clominal is fleshy loiint of ) of tlie fat, and nits tlie . portion lediately t, consti- ropsy or cause of •med in- , is that )o great bdomen. ibdoinen latation. a mode- 3d, shew- Ld to the orted by )f fleshy ikin, and iach side develop- 'I ment of the abdomen, these muscles arc dis- placed from their normal position near the nnibili(iiis, and no longer lend it support. The fibres of the umbilical ring are thus separated by the pressure exerted by the abdominal fat, and a portion passing through the fibres pushes the skin before it. A small protrusion takes place, which is not yet outwardly apparent, because the remaining fibres of the umbilical ring still afford considerable resistance, and retain the ring concealed in the deep hollow which is observable in the navel of fat persons. In order to determine the existence of umbilical hernia at this early stage, the patient should be placed in the recumbent position. On intro- ducing the little finger into tlie navel depres- sion, and directing the patient to cough, we feel an impulse against the finger which is not to be felt, under the same circumstances, over any other portion of the abdominal walls. In some cases of hernia it is not absolutely necessary to i^lace the person in the recumbent position, but in this case it is indispensable : unless we do so the impulse cannot be felt, since it cannot take place in the upright position. In the year 1851, a lady consulted me. She was then very fat, and the abdomen was greatly enlarged. I said to her, "You have probably umbilical hernia," " I have long feared that 12 UMBILICAL IIEENIA. such was the case," she replied, " but happily I have not. Only a few days ago my own physician examined me, and he declared that I had not. He has advised me to wear an abdominal supporter." Noticing her great enlargement, I was not satisfied of the non- existence of hernia. I begged to be allowed an examination. Having obtained her consent, I immediately detected, by the means I have previously pointed out, a small hernia in the dej th of the navel cavity. She had great confidence in her own physician, and told me positively that I was mistaken. I recom- mended her to see her own physician, and to be examined again by him in the same manner as I had examined her. There was no doubt in my mind but that he would detect it, and such was the case; but he said that it had occurred since his previous examination : pos- sibly so. An umbilical truss was immediately adapted ; for it is only in hernia at its early stage that we can hope for a cure by means of a truss, and by removing the cause, that is to say, by reducing the ma^s of fat existing in the abdomen. If the development of a small hernia is not prevented, it gradually increases, and makes its appearance upon the walls of the abdomen. At first it is of the size of a small pear, a hen's 1^ UMBILICAL HERNIA. 13 ; happily my own ired that wear an er great the non- allowed ' consent, s I have ia in the ad great I told me I recom- 1, and to e manner no doubt 3t it, and it it had ion: pos- nediately its early means of that is to ng in the [lia is not id makes abdomen, ^r, a hen's ^■ Q^^ ; afterwards it increases to six, eight, ten, fifteen or twenty pounds weight. It then as- sumes more or less the shape of a mushroom, which is exceedingly troublesome, as it requires to be supported by means of a hollow truss, a species of box with springs. Umbilical hernia is to be met in more than one half the number of persons who measure fifty-five inches round the abdomen. Such is the progress of medical science, that the following ideas as to the diseases which may be engendered by excessive corpulence, would have been deemed, twenty-five years ago, un- worthy of a doctor of medicine : a hundred and fifty years ago they would have obtained the applause of the physicians of those days. At the present time I foresee— I am indeed sure, tliat the medical profession will aclmow- ledge these same ideas to be founded upon reason and observation, two indispensable requisites in all that concerns the healing art. When the system of medicine founded by Borelli was in vogue, called the " latro Mathematical," it would certainly have been acknowledged that a superabundance of fat, when developed in the human body, could interfere witli the vital organs in the perfor- mance of their functions, and thus be the cause of much disturbance and of many diseases. u MEDICAL TlIEUlilKS. V 1 But this would no longer have beeTi admitted, when Broussais, the distinguished author ot "Clironic Phlegmasia," in our own day, in harsh and severe language, and with an air of conviction, loudly proclaimed that all disease resulted from local irritation, whence it was irradiated throughout the organism, as in the case when a sharp instrument pierces the flesh. This theory was the very opposite to the teacli- ings of the majority of medical men of a pre- vious age, who maintained that local disease resulted from a general disturbance of the w^hole system. Thus, if the stomach were affected, Lroussais called the disease a gastritis (or inflammation of the stomach), which might induce distur- bance of the system at large ; while many of the old school would have said that if the stomach were especially diseased, it was because nature chose that channel in order to eliminate from the body the morbid principle which in the outset had attacked the entire system. It belongs not to the subject on hand to endeavour to signalize all the errors of the old school, nor to set forth what truth there mav be in the system ; but I would ask one simple question. It has happened to every medical practitioner to be called in to see a person recently taken ill, and tluit he has said, " The ^ MEDICAL TIIEUIUES. .5 admitted, antlior ot n day, in L an air of ill disease ce it was , as in the 1 tlie flesli. the teach- L of a pre- al disease oe of the , Lroussais animation Lce distur- e many of lat if the as because eliminate 3 which in ^stem. 3. hand to of the old :liere may >ne simple y medical a person aid, "The ^ ^r^- "',? disease is not yet well characterized ; by-and- bye, or to-morrow, I shall be able to form an opinion, and say what the disease is." Ihit.nntil this " by-and-bye," until this "to-morrow," what happens to the patient ? for it is evident that there is sickness, a general ailment. And when one particular portion of the body, an oVgan, is principally affected, when the disease has there manifested itself, as we say, shall we be far wrong in saying that it is a kind of crisis ? It would be just what happens, only more evidently, in those fevers which termi- nate in a critical abscess. Nor is it advisable that I should speak of the founder of physiological medicine. His vast labours are the result of great genius, and luive long influenced the medical world with all the weight of a master mind. Having been his pupil for many years, I shall never cease to admire his life of scientific labour. Neverthe- less, I cannot refrain from remarking how much he has done to lessen the spirit of medi- cal enquiry. By localizing all diseases, and by his system of irritation, without taking into account the constitution as a whole, how greatly is tlie labour of the physician reduced ! iiow little knowledge is necessary on his part to be deemed worthy of tlie title of Doctor of Medicine ! Once upon the highway of locali- ■W 16 MEDICAL SPECIALISM. ill zation, once engaged in this contracted study, there is no stop. It is no longer necessary to be acquainted with all the organs, both in a state of health and of disease ; the extent of territory to be explored is reduced. The fashion at the present day is, tliat a physician of this school should know only how to treat the diseases of one particular organ, and rarely of two ; that he should be, in fact, a specialist. But are not the principal organs of the body, for the most part, mutually dependent on each other, and all of them subject to a general consensus f What is the consequence of this medical specialism? Why, that every physician so engaged thinks, and most conscientiously, that the patient before him labours under that par- ticular disease to which he particularly devotes his attention. This is perfectly natural. The mind of man is so formed, that it is narrowed, and loses its powers of comparison and of judgment, w^henever it is concentrated and brought to bear solely upon one subject, one single object. Man is no longer capable of reasoning upon a science or an art, w^hen he puts it out of sight as a whole, in order to devote himself entirely to one of its parts; but ends by making the subject of his study the principal point, the all-important one, whence flow, in his opinion, all the rest ; and « PERIODIC HEADACHE. 17 ;ed study, sarv to be in a state P territory ion at the lis school liseases of two; that But are y. for the nch other, msensus f medical ^sician so )usly, that • that par- ly devotes iral. The narrowed, )n and of rated and ibject, one japahle of ;, wdien he L order to its parts; his study •tant one, rest; and finally assumes that a part is equal to the whole. When a patient complains of palpi- tation of the heart, he prescribes a bleeding, leeches, digitalis. If another complain of sense of weight or oppression, bleedings, soft- ening syrups, troches, &c., are prescribed. If another complain of headache, dizziness, with threatening apoplexy, he is bled. Everything is treated locally, without in- quiring whether the evil be or be not the efi'ect of some general cause. Among a vast number of general causes, giving rise to disease, I purpose to treat of one, and that is excessive corpulence, termed obe- sity. In our recent medical works, no refer- ence is made to this morbid predisposition, in regard to the diseases occasioned by it. I do not mean to say that superabundance of fat is the cause of all the ills that flesh is heir to ; but I am persuaded and do affirm that it is often the primary cause of many diseases. Thus, in cases of headache, there are assu- redly many which are produced by superabun- dance of fat, because they commenced when that superabundance began to appear, and ceased on its being diminished. Frequent headache, becoming periodic, is constantly met with in fat people. IS'othing is more common among such persons than dizziness. In these A 2 u 18 EFFECT OF JiOSS OF BLOOD. cases, are not the blood-vessels oppressed with fat interfering with a free circulation of the blood, and is not fat therefore the cause of all these troubles ? But it may be said that the blood produces these affections, since, after loss of blood, the patients are relieved. I do not agree with this, and I say that the blood is not in such cases the cause of these ailments ; because fat people, both men and women, have no more blood than thin persons : I maintain that they have even less. It is granted that loss of blood in cases of headache, vertigo, alleviate and even cure these affections ; but only for a time ; for eight days, or a month or two at the most, and then gra- dually reappear, and bleeding is again required. This amelioration, these momentary cures, produced by blood-letting, are to be explained in such cases by saying that the quantity of blood, although not so great in fat as in tliin people, is impeded in its circulation, and that loss of blood, by still further diminishing the quantity, facilitates for a while its passage through the blood-vessels. This method is consequently only palliative ; it does not attack the root of the evil. Bleed- ing takes away blood which is troublesome only in consequence of the excess of fat; for every physician is aware that repeated I ^- 4 s 4 APOPLEXY. 19 iBsed with on of the ,UBe of all . produces Dlood, the with this, Buch cases fat people, blood than have even in cases of cure these jight days, I then gra- Q required, tary cures, ) explained ][uantity of : as in tliin a, and that lishing the ts passage palliative ; •ril. Bleed- roublesome ess of fat; it repeated bleedings tend to the development of fat in an extraordinary degree. Fat people insist upon being bled at more frequently recurring periods, because their corpulence continues to increase, and headaches and dizziness become more frequent. The seemingly useful remedy increases the cause of the trouble. Notwithstanding the temporary relief, and apparent cure, corpulence finally produces such a distiirbance of the brain, or of some other vital organ, as suddenly to produce death in the course of an hour or two, with every appearance of excess of health. Usually an attack of serous or sanguineous apoplexy is the cause of death in persons labouring under excessive corpulence. It is an important fact, and one which I have noticed throughout twenty-five years of medical practice, that wherever I have been called to a case of apoplexy occurring in a fat person, death has ensued in spite of every care both on my part and of the other physicians summoned together with myself to attend the case. Bleedings, repeated three or four times in the course of twenty-four hours, leeches applied to the temples, mustard poultices, blis- ters — everything has failed to prevent a fatal termination. On the other hand, I can flatter myself that I have successfully treated, by #T^i 20 SANGUINEOUS APOPLEXY. m means of bleeding, leeching, &c., persons of a spare habit of body, when seized with apoplexy, some having made a perfect rjco- very, and others retaining only a partial para- lysis. I am persuaded that physicians, if they will reflect upon the results of their practice, will acknowledge that this is their experience also. In these cases an excess of fat is pre- judicial, therefore, to life. The existence of an apoplectic tendency in certain persons is admitted by all physicians, that is, in the cor- pulent, with a short neck. Fat plays a most important part in such a constitution. Many persons have natural'/ a short bony framework of the neck ; but these persons, on becoming fat, have scarcely any neck; and those in whom the neck is naturally long, on the super- vention of fat about the shoulders, chest, and lower portion of the face, become short-necked. The much-dreaded predisposition to apoplexy is consequent upon the development of fat. It will be seen, on reading the remarks upon the cure of obesity, that in those cases where there has been a reduction in the amount of fat, this tendency to apoplexy and cerebral disturbance has disappeared. Asthma, bronchitis, bronchorrhoea, pulmo- nary catarrh, in fat persons, both male and female, do they terminate favourably ? If so, PULMONARY AFFECTIONS. 21 persons izcd with feet r jco- 'tial para- is, if tliey practice, xperience at is pre- istence of persons is n the cor- yQ a most n. Many ramework becoming those in the super- chest, and )rt-necked. D apoplexy 3nt of fat. larks upon ases where amount of d cerebral ea, pulmo- male and ly? If so. it is only for a while, to return, again to disap- pear, and finally to remain pennanently, with a more or less constant cough, expectoration and oppression. In such cases, permanent cure becomes impossible, unless assisted by a reduction of fat. How are these phenomena to be explained? Some physicians will say that the lungs, being oppressed, and thei^ movements constrained by neighbouring parts, and by the abdominal viscera, become obnoxi- ous to inflammation ; while others will main- «;t tain that these bronchial and pulmonary affec- tions of fat people, are due to an afflux of humours to the part. Explain the presence of these affections in either way, I am persuaded that a reduced corpulency will be favourable to the restoration of health. The cases which I shall hereafter adduce will sustain my views. Let us enquire into the cause of those frequent palpitations and dull pains in the region of the heart so common in persons of excessive corpu- lency. Pharmacopoeal remedies are for the most part unavailing in these cases. "We shall find, further on, in our cases of recovery, that they have disappeared simultaneously with the undue e?7ihonpoint, a proof that they frequently arise from obstruction to the motion of the heart. The fat which overloads it and the neighbouring viscera, occupies too large a por- 22 FATTY LIVEiJ. itel WM\ tion of the space necessary for the free execu- tion of the heart's movements, and hence the spasms, sense of oppression, &c. The fatty liver is well known to be a liver containing in its substance more than the nor- mal amount of fat ; a morbid condition inten- tionally induced in certain animals for the purpose of gain. In man the liver often be- comes surcharged with fat, giving rise to obstruction of the liver. The term, obstruc- tion, conveys an idea of the disease arismg from this cause. The liver secretes bile, which, in order to reach the duodenum, flows through a small duct. If this duct be compressed, the flow of bile is impeded, and the result is unea- siness and disease. The liver is traversed by a vast namber of arteries and veins, through which, in a condition of health, the blood finds a ready passage. If, however, an undue de- velopment of fat should take place in the tissue of the liver, these vessels become compressed. The inferior vena cava receives all the blood emerging from the liver, and conveys it to the right side of the heart, thence to be sent to the luno-s, to undergo that aeration which, by cifanging it from venous to arterial blood, renders it fit for the nourishment of the vari- ous parts of the body. Any obstruction to the circulation through the liver must necessa- 1 i i \^^ ABDOMINAL DROPSY. 23 ;ee execu- lience the be a liver n the nor- bion inten- Is for the • often be- ig rise to 1, obstruc- ise arising )ile, which, ws through •ressed, the lit is nnea- aversed by as, through blood finds undue de- in the tissue jompressed. I the blood jys it to the sent to the which, by 3rial blood, of the vari- struction to .list necessa- rily give rise to the most serious consequences ; for the blood which it contains is in no wise fitted for nutrition. In case of obstruction to the circulation through tliis organ there ma;y arise swelling of the legs, thighs and of the abdomen. It is one of the recognized causes of abdominal dropsy, ascites; of dropsy of the lower extremities, anasarca. Hence arise those frequent swel- lings of the legs, with their attendant incurable ulcers, so often met with in fat people. And when we reflect that the venous circulation is carried on by means of a vital power which has to overcome the force of gravity, causing the blood to flow from below upwards, from the feet towards the heart, we can readily un- derstand how easily any slight obstruction in the liver may give rise to serious consequences, while on the other hand it will be manifest, that the liver being freed from its excess of fat, the venous circulation will be re-established, and those troublesome affections alluded to, therewith got rid of. However, every medical man does not see, or is not willing to see matters in this light. Many will insist that this hepatic obstruction is a chronic hepatitis, or chronic inflammation of the liver, which is to be subdued by the lancet, leeches, blue pill, Yichy water and 24 HEPATIC OBSTRUCTION. ['■If iir iilii If ■1 ', .''j-i'ii vegetable diet. And what becomes of the patient ? I know I shall always remember a circumstance which occurred in 1829. I was at that time a surgeon attached to the military hospital of the Val-de-Gr^ce, where Broussais, the illustrious founder of physiological medi- cine, wa^- head physician. It was my duty to make the post mortem examinations, to record, the several abnormal conditions found to exist, and which had been the cause of death. Upon one occasion, while thus engaged, Broussais entered the amphitheatre, saying, "Bring your instruments with you, we are going to hold a post mortem in the city." We went to the house. A statement was required to be put on record, as to the organic lesions which had produced death in the case of a young woman, about 25 or 26 years of age, belonging to a wealthy and noble family. I' was of import- ance to Have such a document, because the mother of this young woman had died at an early age, and the family widied to be able to prove in a court of law that death had not occurred in consequence of any hereditary dis- ease. Broussais and I entered the room where lay the body of the deceased. We met there two of the professors of the Faculty of Paris, another physician, and the usual medical at- tendant of the family. A few words passed :., H ! ■ .11 1 .11 BKOUSSAIS, HIS THEORY. 25 BS of the tnember a ). I was e military Broussais, ical medi- ly duty to , to record id to exist, ith. Upon Broussais 3ring your ; to hold a ent to the > be put on whiah had ng woman, nging to a of import- >ecause the died at an ) be able to th had not editary dis- room where e met there ty of Paris, medical at- ords passed in reference to the previous ailments of the deceased. The family physician, a young man ^ imbued with the principles of Broussais, told us that he had been in attendance upon the deceased lady about a year before, for a dis- ease other than that which had caused her death ; that he had cured her by means of bleedings and leeches, and that after her reco- very she had enjoyed the advantages of sea bathing; that in the illn-ss which had just terminated fatally, he had made use of bleed- ings and an antiphlogistic regimen. The body of the deceased being removed from the bed and placed upon a table was remarkable for its excessive development of fat. The head having been opened, the brain was submitted to inspection and acknowledged to be healthy ; and the same of the tongue, the oesophagus, the larynx, the bronchi, the lungs, the heart, the spleen, the kidneys, the bladder : the womb was somewhat engorged, and larger, heavier than normal, but without any trace of inflam- mation. All the principal joints were opened and found healthy ; likewise glands, arteries, veins and lymphatics. The alimentary canal was carefully examined throughout, without discovering any organic lesion in the stomach or large intestine. A few reddish brown spots were, however, to be seen in the small intestine. B f% 26 I'ATTY LlVEf?. I ( Broussais upon tliis pronounced death to Iiave been caused by enteritis. Several of the medi- 'cal men, on the other hand, were unwilling ta admit that these reddish brown spots could have caused death. The liver was then exam- ined. On separating one of the lobes a layer of grease was left on the blade of the knife, as- is the case always in cutting into a fatty livery but which phenomenon is never manifested in the case of a healthy liver. Those gentlemen who had demurred to the reddish brown spots- as being the cause of death were of opinion that the fatty liver, or which is the same thing,, the obstruction to the hepatic circulation had produced death. Broussais could not agree with this opinion, but dwelt upon the import- ance of the testimony revealed by the reddish brown spots, and a warm discussion ensued, The^^^ mortem being over, I returned to the hospital, leaving these gentlemen in the midst of a discussion as to how the medico-legal statement accounting for the death should be drawn up. At this time I was scarcely able to arrive at a satisfactory conclusion, although I had already spent several years in ths hospi- tal as assistant to M. Fouquier, and had fre- quently listened to the teachings of Broussais, which explained all diseases as due to irritation dftnpndent iiT>on orjranic lesion: and always s,; glGKS OF HEf ATIC OBSTRUCTION. 27 to Iiave he medi- illing to- ts could ;n exam- B a layer knife, a& tty liyery fested in mtlemen wn spots- * opinion ne thing,, ition had ot agree? B import- e reddish i ensued, ed to the :he midst iico-legal should be •cely able although ;h3 hospi- had fre- 3roiissais, irritation d always ended by shewing that the only rational treat- ment for every morbid affection consisted in blood-letting, leeching and low diet. It may be mentioned as somewhat remarkable that at the post mortem held upon the corpse of Bronssais, no organic lesion sufficient to ac- count for death was discoverable. In his own person, the greatest possible contradiction to his theory Was thus presented. Since that time jny attention has been particularly directed to this subject. In my own practice I have con- stantly observed that when any obstruction occurs in the liver no progress is ever made towards the cure of diseases arising from this cause, until the obstruction is overcome, and if not overcome, that death supervenes ; and the cause of this death is to be found only in the liver, as in the case of the lady just men- tioned. One of the earliest signs of obstruction of the liver, is swelling of the legs and ankles, appearing at first only towards evenirg, and not to be noticed on the following morning, but again appearing during the day. It dis- appears during the night, because the horizon- tal position favours the circulation in the lower extremities. In this position fluids have not to contend with the laws of gravity. It is highly important that this evil should be at once remedied. The treatment for the reduc- 28 UTERINE AFFECTIONS. iliii In tion of enibmjpoint we shall find to be infallible in sucli cases. It is indubitable tliat almost all fat women labour under some uterine affection. Some are troubled with engorgement of the organ, with a continual sensation of weight, and a drag- ging of the sides and back. Others suffer from falling of the womb and displacement. These disorders are frequently attended with granu- lations of the neck of the womb, menorrhagia, leucorrhea, &c. Pessaries were formerly the usual remedies in such cases, but latterly it has been well understood that in fat women these conditions are due to the fact that the womb, a body floating within the abdomen is depressed, displaced by the large mass of fat collected about the intestines. In order to prevent this intestinal mass of fat from pressing upon the womb, abdominal supporters have been contrived ; but this intestinal mass cannot be so lifted as to set the uterus free, without making pressure upon the stomach and lungs, and so giving rise to a sense of oppression and suffocation ; and even should such means afford some relief, it would prove but temporary : the cause of the trouble would be still persistent. In order to effect the replacement of the uterus, the mass of fat must be got rid of. 1 m§- I SKIN DISEASE. 29 nfallible , women iome are an, with a drag- fer from These 1 granu- )rrhagia, erly the utterly it b women that the abdomen mass of order to pressing ers have ss cannot , without id hmgs, 3sion and ins afford •ary : the ersistent. le uterus, It is a well established fact that many fat persons are troubled with skin diseases, which resist every treatment, and a cure is effected only when, from some cause or other, the per- son has become thin. Would it be wrong to say that in such cases the disease of the skin is due to its over distension by fat, causing a partial stagnation of venous blood and serous fluid? Among female patients who consult me in reference to their obesity, many complain of a general sense cf uneasiness, with frequent pains in the stomach, kidneys, headache, &c., asserting that their excess of fat came on after a confinement and when they had not suckled the infant, and thence infer that their obesity is owing to a decomposition of milk within the system. I am not aware that this explanation has ever been accepted, yet I do not under- stand why it should not be received as valid, since it is well known that any deteriorated secretion may be absorbed and prove noxious to the general system. Pus from an inflamed vein may be thus re-absorbed, and the patient under such circumstances almost invariably dies. Why may not the secreted milk be like- wise re-absorbed ? I have met with many fat women from whose breasts milk constantly flowed, although they had not borne children 30 CAUSE OF OBESITY. "M u !!! 1 inii I for the last ten years. A lady who has fol- lowed my method of treatment for obesity, says that she is certain that her excessive fat arose from her not suckling her last child, and that her milk turned into fat. She has had no children for the last eight years, and whenever she takes a child in her arms a peculiar feeling and was About man in ras then ur hun- ence he . corres- '•as poor, id milk obesity, Che face ied, and tnetimes 89 suffer e spark- blood, irless in in those culation through mpeded, th great b people 3red; in As this ough to he blood mes wa- iPALLOfi. m > iery ; such persons are pale and flabby. The integument of the lower part of the face is capable of great distension, and here, in obe- sity, fat accumulates, and forms on both sides an unsightly mass, sometimes reaching to the chest. A roll of fat is often found on the back of the neck. The trunk becomes enormously developed, and the breasts particularly en- larged. The arms are very fat; and as the areolar tissue which surrounds the wrist is of a close texture, fat cannot accumulate there, and the skin not being distended, a deep groove or furrow is formed, as is the case in very fat children. The hands usually participate in this excess of embonpoint, but at a later period than other parts of the body. The abdomen attains a vast size, and impedes walking; so that a person labouring under obesity carries the head erect, and the body thrown back, as in the case of a pregnant woman, in order to pre- serve the necessary equilibrium and not fall for- ward. The intestinal mass, with its surrounding fat, being connected with the kidneys, by its weight gives rise to a dragging sensation, and causes pain on walking. It also pushes up the diaphragm, compresses the lungs and the heart, and becomes one of the causes of the sense of oppression complained of by fat people. Many such, especially females, have between the 40 VARICOSE VEINS. ii ill abdomen and the thighs deep furrows, which become scalded, and require the application of starch, or of some other powder, as is the case with infants when very fat. The integument of the thigh is readily distensible, and allows the deposition of fat as far down as the knee joint. At this point the areolar tissue is more dense, and less in quantity. The skin of the thigh, being thus distended, forms large folds, falling over the knee joint. The legs become likewise enlarged, frequently engorged, and troubled with varicosities, more especially to- wards the lower portion of the limb. Gradu- ally the feet participate in this engorgement. This general view of the outward appear- ance of the body of a person labouring under obesity, may give some idea of the disturbance which an excessive amount of fat can produce when situated within the body. On the outer surface it causes an extraordinary distension of the integument, giving rise, as we have before said, to various diseases, such as pimples, boils, eczema, prurigo, &c., which can only be cured by a reduction of corpulence. In the interior of the organism this same excess of fat causes displacement of the viscera, interferes with the due performance of their functions (as we have already explained), and leads to the sudden death of the patient, whilst occupying his arm- V . SOMNOLENCE. 41 which tion of le case ;ument allows e knee s more of the 5 folds, )ecome d, and ally to- Gradu- nent. ippear- ; under Lrbance ►reduce e outer ision of before 3, boils, 3 cured interior ; causes dth the 7e have sudden lis arm- chair rather than his bed, for he can rarely assume a recumbent position. It has been said, moreover, that excessive corpulence modifies the intellectual faculties, diminishes their power^ and may even com- pletely annihilate them. The incessant desire for sleep, the somnolence with which fat people are tormented, is sufficient proof of the cor- rectness of the assertion* The experience of all medical men goes to shew that when persons of obesity are attacked r by any acute form of disease, they succumb more easily than those possessing an ordinary emhonpoint. Death usually occurs in such cases unattended with great suffering. Des- truction goes on so quietly and imperceptibly, that the physician becomes aware of it only when it is too late to grapple with it. Excessive corpi lence is promoted by want of sufficient exercise, riding in a carriage, lying in bed too much, and the continued use of the warm bath. Having been told by many females, as I have said before, that their emkm- point had commenced after giving biith to their last child, which they had not suclj:led, and that they attributed the development of this embonpoint to their not having .Ruckled the child, it may be asked, can th.is^^Je assigned as one of the causes of excessive corpulence in b2 . -ii U,E^:w«— * 42 CAUSE OF OBESITY. liifi^i* Ml females ? I mention tliese facts without ven- turing at present to give an opinion. Some physicians, and many of tlie laity, think that repeated bleedings tend to the development of fat. For my part, the fact is indisputable, both theoretically and as the result of experience. Bleeding removes a por- tion of the blood, which is flesh in a fluid state, having for its object not only the nutrition of the several organs, but also the stimulation of the heart's movements, and thus the mainte- nance Oi life* Taking a little blood, is taking a little of that which maintains life, and is therefore a weakening of every organ of the body. Areolar tissue, which becomes more extensible in proportion as the body becomes more feeble, must have its power of resistance diminished b} the bleeding, and more readily permit the deposition of adipose matter. This affords an explanation of the fact stated by many of my female patients, that their exces- sive corpulence had manifested itself subse- quent to repeated blood-lettings. Bleeding encourages the development of fat in the lower animals, as well as in the human species; a fact well understood by cattle-breeders, who put it in practice in the case of cattle which they wish to fatten. The only exception made by them to this rule, is in li iiFFECTS OF EXERCISE. 43 reference to those animals which have a soft and yielding skin, as more frequently happens with beasts of a red-and-white colour, which are said to fatten readily. With this intension, a2;ricultural writers recommend the use of blood-letting. An article which appeared in an agricultural journal recommends that every animal intended for fattening should be bled twice, at an interval of a few days. Some people think that exercise on horse- back is apt to produce corpulency, while others entertain a different opinion. The former maintain that persons whose business requires them to be much on horseback, are frequently fat; a remark which is made especially in reference to cavalry officers, and which is quite true. But the following explanation may be offered: A man on horseback undergoes severe exercise ; and if he possesses a strong constitution, and takes a sufficient amount of food, this exercise will facilitate the digestive function, and the volume of his body will be increased. But it is necessary that the horse- man should be of a very vigorous constitution. In truth, few cav^alry officers are corpulent, and these few are to be met with among those who are somewhat advanced in life, and who are by nature well adapted to the profession. Tlie i^-reater number of cavalrv soldiers, whe- u PRIiDlSPOSITION to B'At. m 'I ther officers or privates, suffer much at first from fatigue. The young men who join a cavahy regiment soon gro^v thin, and, with but few. exceptions, remain thin so long aS they arc in the service ; and indeed it has happened that both in the case of officers and privates, in consequence of not being able to endure horse exercise, they have been obliged to be transferred to the infantry. It is therefore incorrect to regard this kind of bodily exercise as favourable to the development of corpulence. For the development of obesity, there must exist a certain predisposition. We meet with many who do all in their power to grow fat, and who still remain thin, because, no doubt, they possess some peculiarity of organization which prevents the development of fat. Obesity may be hereditary ; that is to say, the father or the mother may transmit to their children a peculiar formation, having a ten- dency to make fat. From certain physiological conditions, we may recognize at an early age a natural tendency on the part of some per-^ sons to become corpulent. In the young of both sexes, where this predisposition exists, the face is broad and short, the eyes round, and the nose short and thick ; the hands and feet are small, and there is a general roundness of limb. When possessed of such an organiza- ^11 l^REDISPOSITION TO iJ'AT. 45 tloii, obesity may be warded off by a rational system of diet, to be indicated in the following pages. But the immediate and producing cause of corpulence is to be sought and disco- vered in the character of the food. The pre- sent system is founded upon this principle. Medical authors assert that food has a most important bearing in the production of corpu- lence. They forbid the use of meat, and recommend watery vegetables, such as spinage, sorrel, salad, fruit, &c., and for beverage water ; and at the same time they direct the patient to eat as little as possible. These instructions, like too many others, are given because they are asked, and that in every disease, curable or incurable, the physician is bound to offer some advice. Medical men themselves put no faith in them, since they pronounce obesity to be incurable. Having devoted a great deal of attention to. this enquiry, I have arrived at the conclusion that it is not to be wondered at that obesity should be incurable, because the very means which have been recommended to overcome it, are exactly those best fitted to induce and maintain it. I lay it down as an axiom, in opposition to the received opinion of centuries, that a very cni^ofm-ifiol rliof auch pa ir ■ SO PALPITATION'. ta winch I am otlierwise subject, &c. You Tvill oblige me bj sending the necessary in- structions, if you can take charge of my case, by the bearer of this letter, together with such medicines as you may direct. "Yours, &e. K'" In answer to Madame K., I sent her the medicine, together with the necessary informa- tion. On the 25th of February I received a letter, from which the following extracts are made :— -" Your directions have been scrupu- lously observed for the past fifteen days. I take a daily walk in the mountains, and to- day was weighed. I have lost but four pound3 : too small a reduction I fear ; but perhaps c„ae partly to my temperament. The medicine requires to be taken in larger doses, I think, Nevertheless I am well satisfied with the result thus far, being now free from those trouble- some palpitations of the heart to which I have been hitherto subject." The 9th of April following this lady wrote : " My legs do not swell as they used to do, and the palpitations have ceased. I am delighted with this good result of your method of treat- ment." l^othing more was heard of Madame K. until the month of August in the following year. She then writes that in accordance with CARDIAC SYMPT0M8. 81 case. I the advice of the medical men of Saint Di^, she, together with her family, went to take the waters of Flombieres. That on her return her legs were again swollen, and that she suf- fered from palpitation of the heart, which gave rise to a choking sensation. She was desirous of again undergoing the anti-obesic treatment. On the 30th of September following she wrote that she had followed my instructions during the last three weeks, and had lost only four pounds in weight ; but added, I have obtained a much more valuable result, and that is, the almost total release from my troublesome heart palpitation. I have not since heard from this lady, but I have no doubt that she has been once more cured of her palpitation, and that she is no longer troubled with swellings of the feet and legs. The loss of fat in this case has been attended with freedom from palpitation of the heart, from shortness of breath, and from swelling of the lower extremities. What ex- planation can be given as to the cause of these results? As to her ailments, did they arise from an excess of blood in the system, or was she suffering from cardiac disease ? Physicians thought so and bled her, administered sedatives and alteratives, and restricted the diet of the patient. Still they did not cure her. On the other hand I recommended her food should 82 NO EXCESS OF BLOOD. consist of meat principally ; that she should be allowed strong coifee and wine ; which, toge- ther with the employment of alkaline remedies, reduced her fat and effected a cure. The fol- lowing season she goes, together with her family, to the springs, and returns thence afflicted in the same way as before, and again my mode of treatment produces the same result. It is manifest that this heart affection, this shortness of breath, depended upon obstruction to the heart's action, and not upon any excess of blood in the system, since I abstracted no blood, but on the contrary, administered stim- ulants, together with the use of full meat diet. The swollen limbs arose no doubt from a par- tial portal obstruction, and ceased when the reduction of fat was effected. It may be urged that the patient was better, or even cured, of heart palpitation, before she had lost much in weight. She had lost, however, four pounds ; and four pounds of fat occupy a large space. The fat in a living body is fluid and very light. A pound, therefore, is a large quantity. When a person begins to lose his corpulency, the re- duction takes place first in the interior of the body, and consequently there is a great im- provement during the first six or eight days in the general health of obese patients, when CASE OF MADAME MEURIOT. 83 uld be , toge- fiedies, he fol- ;h her thence . again same n, this notion excess ted no I stim- it diet, a par- en the urged red, of iich in mnds ; space. ' light. When the re- of the at im- iays in when treated in accordance with the principles now advocated. An English lady wrote to me from Dieppe, on the 15th of July, 1852. The following is an extract from her letter : — " Arrived here only a short time ago. I at once made trial of your plan for the cure of obesity, and have already experienced considerable improvement. I have not yet had an oppo 'tunity of being weighed, and therefore cannot assert positively that my actual weight is less than it was, but I certainly feel lighter, and my hands are neither so red nor so fat as formerly." Madame Meuriot, an actress, then staying at Chatellerault, addressed me under date the 21st of August, 1851. Her letter is exceed- ingly lengthy and full of minutiae, that would be improper to lay before the public. But she informs me that her weight in the course of a single year had increased from one hundred and twenty to one hundred and seventy-five pounds. In order to retain her theatrical engagements, she determined to use every pos- sible means to overcome this troublesome em- honpoint. She took her food in quantity barely sufficient to sustain nature ; made use of sea biscuit instead of bread that she might eat less. For some time past she has been taking daily forty drops of the tincture of iodine, under the 84 CASE OF MADAME MEUKIOT. direction of a physician, but without apprecia- ble benefit. Every portion of the body was loaded with fat, and the lower part of the legs were swollen. Having met with my book and dreading the effects of the iodine upon her general health, she was anxious that I should advise her. I did so ; and sent the medicine, together with necessary directions from Paris to Perpignau, where she was then staying. I received a letter from her on the 9th of Octo- ber following, in which she says : — ^' I am happy to inform you that your treatment has been attended with the most satisfactory results. My legs are no longer swollen. I walk with greater ease than formerly, and my breathing is no longer oppressed. I am unable to say how much my weight has decreased, not having ready access to platform scales; but my gowns tell me that my size is less than it was, yet not as small as could be desired." In conclusion she wished to know whether she might continue the treatment a month or two longer, and if I thought so, to please send her the requisite medicine. I did so, and heard nothing further from Madame de Meuriot until the month of August in the following year. She was then on her way to fulfil an engage- ment at Lille, and called to see me. She ex- pressed great delight in having got rid of her CASE OF MADAME MEURIOT- 85 ►precia- \y was lie legs ok and on her should jdicine, I Paris ing. I ' Octo- ' I am jnt has factory ien. I ,nd my unable ed, not is; but than it l." In er she or two nd her heard t until : year. Qgage- >he ex- of her troublesome embonpoint, and said that she had not been afflicted with swelling of the legs since placing herself under my treatment. " But something has occurred which I did not in the least expect : since my corpulency has left me, I have become enceinte.'''^ A letter from this lady, dated Lille, the 13th October last, begins thus : — " Since I last had the pleasure of seeing you, on the occasion of my departure from Paris, I have become fully satisfied that I am in the family way, and have been so for the past eight months." My ad- vice was requested on some points having reference to her then condition. The preceding facts tend to shew that re- duced corpulency is favourable to conception. Towards the latter end of 1850, the wife of Dr. Pecquet, of Pars, purchased my work on Obesity. Having read it, she spoke to her husband about it, who said that, like most medical men, he was persuaded that the only way to reduce corpulency, is to eat less than the system demands. Madame Pecquet, then about sixty years of age, had long been troubled with excessive corpulency, and weighed two hundred and fifty pounds. She had, in consequence of this afiliction, passed the greater part of the last eighteen years either in her arm-chair or in 80 CASE OF MADAME PECQUET. ' ! ill ■ •|i i^' bed. According to some of the most cele- brated physicians of Paris, and also of her husband, her disease at one time was said to be pulmonary catarrh — at another time, dis- eaee of the heart — and again, something else ; till at length Madame Pecquet had no rest, day or night. If she attempted to go to sleep in the hori- zontal position, she was immediately troubled with a rush of blood to the head, accompanied with the most distressing hallucinations, which utterly prevented her from sleeping. She was unable to take exercise on foot, even when her ailments allowed her any respite, owing to the excessive pain she experienced in the region of the kidneys, and the abundant perspiration of the head, which a walk of even a few steps was sure to induce. It was consequently im- possible for her to go out, unless in a carriage. Those only who are unable to enjoy this plea- sure, know how great a privation it is not to be able to take a walk on a fine day, and how wearisome it is to be compelled to make use of a carriage in order to enjoy the advantages of fresh air, or to move from place to place. Madame Pecquet was so situated, and many a time she has said, — "Eighteen long years hate I been in this condition ! Eighteen years of suffering and misery, in spite of every CASE OF MADAME PECQUET. 87 medical aid wliicli has been bestowed upon me ! " Under these circumstances, we can readily understand how anxiously she must have sought a means of cure. One day, with- out the knowledge of her husband, she took a carriage, and called to consult me. Those who believe as I do, that an excessive development of fat may induce and sustain a generally diseased condition of body, will readily admit that the diminution of excessive obesity is the only rational means of cure in such a case. Impressed with this idea, Madame Pecquet called upon me, and placed herself under my care. I prescribed some medicine, which she took without the knowledge of her husband, who, although eating at the same table, did not perceive that she partook of less vegetables and ate a larger quantity of meat than usual. Having continued the treatment four months, Madame Pecquet said to her husband, — "I have been following the anti-obesic treatment, and weigh at the present time one hundred pounds less than 1 did before commencing it. Formerly I was confined to my arm-chair, in consequence of catarrh or something else. I could not walk fifty yards without stopping to take bre'ath ; and now I can go out every day if I please, when the weather is fine. Night, ( i 4 :;aa.i:||. mw I '■', n! 88 LOSS OF ONE HUNDRED POUNDS WEIGHT. formerly so wearisome, is now a season of delightful and refreshing repose ; and, in fine, I have recovered my health, after eighteen years of continued suffering." I again met this lady last year, and found her in the enjoyment of perfect health. She had not regained her embonpoint, but was in all respects perfectly happy, and gratefully ascribed her recovery to my system of treat- ment. On the recommendation of this patient, Madame de M., in the month of June, 1852, requested me to call upon her. She was be- tween thirty and thirty-five years of age, and during the last eight years she had become enormously fat. She was ailing, and had been under treatment for almost every variety of disease. Most of the medical men whom she*^ had consulted, owing to the pain she com- plained of, ascribed her trouble either to or- ganic pulmonary lesion, to bronchial affection, or to disease of the heart. She had tried every means of cure. Had been under the care of many of the principal physicians to the hospitals of Paris, and also of professors of the faculty. Deriving no advantage from these, she had consulted homrjeopathic practitioners, and had been treated by them unavailingly. In her despair, she had sought the advice of a female clairvoyant; and in order that she CASE OF MADAME DE M. 89 might obtain every possible benefit from the treatment, had taken her into her own house — but her sad condition was in no wise ameli- orated. Possessed of a naturally active and energetic temperament, she was nevertheless compelled to remain seated in an arm-chair, yet could not lean back in it, owing to a sense of suiFocation which such a position was sure to induce. When weary of this erect position, the only relief she could obtain was by leaning upon her left elbow, resting on the knee of the same side. If she attempted to recline upon the right side, she was subject to fits of coughing and suffocation. Her days were passed in this position : at night she was obliged to sit up- right, without any support to her back ; and when overcome with weariness, would fall for- ward upon the left elbow, the only support she could endure. Finally, however, in conse- quence of tin great and continued pressure of the weight of the body, the elbow became in- flamed, an extensive sore formed upon it, and a pad for the elbow became necessary. She had scarcely any appetite, and had long since given up the use of meat. She could walk ^, little about her apartment, and although her sister had lived for the last six years in the house on the opposite side of the street, she D 2 i. I tm\ m Mi il li Hlfill Ihl.tll ill, 90 CASE OF MADAME BE M. had not been able to visit her. Madame de M* although by no means tall, weighed between one hundred and eighty and one hundred and ninety pounds. Under percussion the chest proved resonant throughout, and air entered freely the whole extent of the lungs.- By the aid of the stethoscope a r^le was heard in both lungs. Beneath both clavicles there existed scars, the result of blisters and cauteries. And the whole surface of the chest and the pit of the stomach were covered with the marks of leech bites. There were no febrile symptoms. Complexion blonde, with a remarkably fair skin and large blue eyes, which seemed never to have known pain. Under such circumstan- ces no organic lesion either of the lungs, the bronchi, or of the heart could be suspected : and I was satisfied that the great disturbance of health in the case of this lady arose from excessive obesity. Having placed herself under my treatment, she experienced relief the first week, and, at the end of a fortnight, Madame de M. had perceptibly grown thinner. One morning, when calling to see her, I was told that slie had gone for a ride to the Bois de Boulogne, and that she had been out also the day before, and was able to get in and out of the carriage without assistance. She continued to lOse ucr C7noo'n/point and her health became CASE OF MADAME DE M. 91 ;deM, Btweeii ed and ; chest entered Bjthe in both existed . And 1 pit of irks of ptoms. ly fair never mstan- ^s, the ected : rbance 3 from under le first adame One IS told ois de Iso the out of tinned Bcame thoroughly re-established. She was able to lie down in bed, and upon either side. At the end of the month she visited friends whom she had not called upon for the last six or eight years, and six weeks or two months after com- mencing my treatment, she danced repeatedly at a ball given by her sister upon the occasion of her recovery. Until then she had not worn corsets for the last six years. It was not until the month of October fol- lowing, that I again had occasion to see Madame de M. Kot feeling well, she sent for me. She had caught cold the day before, when returning late in the evening from the country, and was slightly feverish. She was, however, quite well again in a day or two. The last two years she has enjoyed excellent health, although, like most other ladies, she is occasionally subject to trifling nervous attacks. In the enjoyment of health and riches, she leads the fashionable life of a gay young lady. How forcibly does her present condition contrast with the previous eight long years, passed in weariness and suf- fering ! In the month of June, 1852, Mr. Lucian Et^, cliief operator in the chemical works of Mr. Christofle, silverer and gilder, Kue de Bondy, sought my advice in reference to his corpu- lence, which gave him much anxiety, as iies 92 CASE OF LUCIAN ETE. 'li i ii feared that he would be obliged to give up work. The sole support of a numerous family, it required his utmost efforts to go through the duties of the day. Obliged to be constantly in motion, and frequently to go up and down stairs^ he suffered great pain in the kidneys, and was often so much out of breath that it was almost impossible for him to speak when giving his orders or explanations. His head was constantly bathed in perspiration ; and if he attempted to sit down for a moment, he was immediately seized with an irresistible drowsi- ness. He had been repeatedly bled and purged, but without any salutary effect. Lucian Et^ followed my plan of treatment for two months. During the first month he lost from fifteen tc twenty pounds of fat. I do not recollect how much he lost in the second month, but at the end of this time he was so far reduced that further treatment was unneces- sary. Let it be observed, that during the two months he was under treatment, he was not absent a single day from his duties in the factory. I heard from Lucien d'Et^ last year. He was then in the enjoyment of perfect health, and his corpulence had not returned. Mons. Desrenaudes, living in the Eue du ot. lionore, oecame very corpulent CASE OF MADAME D^HERVILLY. 93 in a comparatively short time. This was a source of great inconvenience to him, from the fact, that being much devoted to the pleasures of the turf, his increased weight unfitted him for the saddle. During the year 1852, he fol- lowed my system of treatment for two months, and obtained most satisfactory results, and, as in every other case, without necessitating the slightest interference with his daily avocations. Madame d'Hervilly, residing in garrison at Elboeuf, with her husband, a captain in the 2nd regiment of the line, having met with my treatise on Obesity, came to Paris in order to consult me. After her return to Elboeuf, she adopted my system of treatment, and a fort- night afterwards wrote as follows : "6th July. — Your predictions have been verified. I am now in excellent health, and no longer suflfer from the great oppression to which I was formerly subject during hot wea- ther. Your medicine, according to my expe- rience, is everything that can be desired ; but I have been a sufferer for the last thirty years, and it will take some time to effect a perfect cure. I have not perceptibly diminished in size, but am sensible of a peculiar freedom of motion of the internal organs. My husband also intends shortly to put your system in practice." 94 CASE OF M. DESBOtTILLONS. On tbe 11th August, this lady wrote again, to say that she was still pursuing the treat- ment ; that she had not weighed herself, but was then several inches less in circumference than before. The treatment was continued, and she be- came thin. Her husband subsequently adopted the system Tor a month, and derived great advantage from it. I cannot say how much his weight was diminished; but his great desire was to get rid of an unsightly cushion of fat, situated upon the back of his neck. I learn from Madame d'Hervilly that this unmilitary- like appendage has disappeared. On the Tth August, 1852, M. Alcide Des- bouillons wrote to me from Brest, to the effect that his corpulence was a source of great in- convenience ; that his duties required him to be much on horseback, and consequently in hot weather he suffered greatly from fatigue. He weighed two hundred pounds, and mea- sured forty-nine inches in circumference. On the 2nd September, after twenty days' trial of my system, and, as he says, perhaps not as rigorously carried out as it should have been, he weighed himself again, and obtained the following result: Weight, one hundred and eijrhtv-nine pounds: circumfftrRTipp.. fortv-fivp. mcnes. Twenty days after this he weighed CASE OF M. DESBOtJILLONS. 95 one hundrel and eightj-seven pounds, and measured forty-three inches in circumference. This was but a slight difference ; yet M. Des- bouillons, after the first few days of treatment, could walk with less difficulty, was more active, and was no longer bathed in perspiration. In his last letter he says, " I am continuing your plan of treatment, and expect to find a notable amelioration both in size and weight. The effects produced by your medicine have been in perfect accord with what you had led me to expect. The experiment appears so far con- clusive, and I trust that my case will prove thoroughly demonstrative." If free from prejudice, and willing to ac- knowledge the truth of that which is manifest, the cases we have just cited ought to satisfy any candid enquirer that obesity may be en- tirely overcome without prejudicially affecting the general health. At first sight, this vfould appear undeniable ; yet medical writer-^, who have hitherto insisted that a meat diet is conducive to the development of fat, and that vegetables have an opposite tendency, will not frankly acknowledge their error. Physicians who have derived their know- ledge from books, and fr m the lectures of their teachers, must find it difficult to change their opinions in referenrje to obesity. With 90 SYSTEMATIC OPPOSniOK. I 1! mm the public, when any one is told that the imbibition of large quantities of water is pro- ductive of fat, and that feeding upon animal food induces leanness, a similar degree of doubt is excited as when Galileo asserted that the sun did not revolve around the earth. On the publication of the first edition of my treatise upon Obesity, I expei enced a degree of impatience, and even irritation, in view of the systematic opposition which a self-evident truth received at the hands of the medical profession. At the present time, however, I calmly recognize that the same happened in the case of every attempted innovation. I call to mind how Galileo endangered his very exis- tence. Yesalius, the founder of anatomy, was saved from the stake only by the interference of his sovereign. Harvey, the discoverer of the circulation, was compelled to seek royal protection from the attacks of the medical men of his day. Peysonnel, a physician of Mar- seilles, and a great naturalist, devoted himself to the study of corals and madrepores. In 1727, he laid before the Academy of Science a monogram, proving to demonstration that corals and madrepores are structures due to animal life ; that what Dioscorides, Pliny, Linnaeus. Lamarck. Tournefort. &g. &g. had / / 7 " thought to be flowers, are in truth animals; TREMBLEY. 97 and tliat these living creatures constriieted and augmented their abodes; the Academy, like most learned bodies, admitted as trutli only that which it taught, and consequently paid no attention to this memoir, which, neverthe- less, was destined to produce an entire change in a large department of natural history. When, long afterwards, Ticubley published his discoveries on fresh- wa^r polypes, the stu- dies of Dr. Peysonnel in this direction were remembered, and naturalists were forced to admit that the physician of Marseilles was right in maintaining that wliat had been taken for flowers are in reality animals. His claim as the discoverer of a fact which was destined to effect an important revolution in an exten- sive department of natural history, has since then not been disputed, nor could it be. All men, and men of science especially, require time before yielding to evidence, when that evidence is in opposition to preconceived views, and interferes with personal interest. The system I have introduced progresses, and, as some might say, works wonders, and effects cures in France, in England, in Bel- gium, in Austria, in Eussia, in Turkey, in Africa ; and in almost every instance, my patients are persons occupying prominent posi- tions — magistrates, state authorities, o-eneral E ii: ds Not a MATTKft OF FAITH. H'l^.^il ■ officers, or men of wealth, v;ho have enjoyed the advantages of a good education, and are able to judge of and appreciate the merits of my mode of treatment. Tlie judgment of such a tribunal should convince the incredu- lous. Tliis is no matter of faith. I lay claim to the possession of no revelation, which is not to be explained, or which is to rest solely upon my assertion. I do»not say that my discovery is a mystery, and that it is your part to believe in it. Under such circumstances, disbelief would not astonish me, notwithstanding all the cases of cure brought forward ; but when the nutrition of the body is explained in accor- dance with the laws of nature, when it is shewn to be in conformity with the well understood laws of chemistry, and that facts are cited, in ieference both to man and the lower animals, in support of these phenomena, I confess that opposition to this system excites my astonish- ment. Physicians cannot by any possibility advance sufficient reasons against a system which, when once explained, must appear self- evident to every one. Another fact in support of this system must be submitted to my readers. What would a medical man say if I should venture the fol- lowing piece of advice: You have a horse you wish to dispose of. lie is a good beast, FAT AND FATIGUK. 09 and travels well, but lie is tliin. If lie were fatter, lie would look better, and yon could sell liini to greater advantage. Make him fat ; and if, in order to do this, I advised him to give his horse a double allowance of oats, he would only laugh at me. He would say ; why, every- body knows that if yon wish to fatten a horse, the best way is to give him, in addition to an abundance of hay, bran, mixed with plenty of water, or in other w^ords, bran mashes ; or the horse may be sent to pasture, to live upon grass, which is composed principally of water and a small proportion of ligneous matter. Under such circumstances, the horse will make fat, and his form will become more round and 'plump; but if, when he was thin, he was able to travel thirty miles without sweating and without fatigue, now that he is fat he will scarcely be able to go five without being covered with sw^eat, and without shewing mani- fest signs of fatigue. When thin, he was a good horse ; but being fat, he has lost his best qualities, which can be restored only by feed- ing him again upon less bulky food, w^ith a due allowance of oats, and a small proportion of water. I have been informed that the gentleman in charge of the stud of King Charles X. availed himself of the knowledge of this fact, and 100 CASE O^ MADAME C. allowed only li.alf the usual quantity of water to the horses under his charge, and that this plan was attended with the most satisfactory results, the horses being thereby able to endure a greater amount of fatigue than under a full allowance of water. To return to the cases of cure. Madam C, a landed proprietor, living in the line de la Concorde, at Paris, went to take the waters in Germany, in the year 1851. On her return, she made trial of my system, on account of excessive corpulence. Meeting with the usual success, she thought it would be of great advantage to a young lady, a friend, whom she had left behind her at the watering place, and who was then in bad health. This young i>q.v~ son, about twenty- three years of age, was verv fat, and irregular in her menstrual periods. She was of lymphatic temperament, very pale, and rarely partook of meat : her ordinary food consisted of vegetables, sweetmeats, cakes and sweet fruits ; water was her principal beverage. At the pressing instance of Madam C, Miss C. visited Paris, in order to be under my care. After following my directions for a fortnight, her health was much improved. Her parents then came to Paris, and I continued in atten- dance on Miss C. for three months. At the expiration of this time, she returned with her CHANGE OF TEMPEKAMENT. 101 parents to Brussels. She liad lost mucli of her fat, and had become reguhxr. She ate meat principally, both at breakfast and dinner, and drank wine. I may lay claim, in the case of tliid young lady, to have effected a complete change of temperament. With but trifling menstrual flow, and great pa.' lor, she was gra- dually progressing to a state of obesity, which would have proved entirely destructive to health, which would have ended in a total sup- pression of the menses, and ultimately in death. But now, having overcome her obesity, the menstrual flow has become normal in quantity, the digestive powers have resumed their func- tional activity, so that she can partake of meat and wine, and in every respect her constitution is fully restored. Should she marry, she will in all probability have a family, which would have been very doubtful had she married while in the previous obese condition; and if she have children, her accouchements will be com- paratively free of dimger, and her sufferings much less ; for it is well known that very cor- pulent females have more difflcuit labours than those of ordinary embonpoint ; while the off- spring of the latter are at the same time heal- thier. The same rule applies in the case of the human female as with other mammalia ; when fat, conception is of more rare occurrence ; and 102 CASE OF ALBERT C. I when thej do conceive, tliej are very liable to mis(!arry. When, however, they go to the full period of gestation, the progeny of o, very fat mother is almost always lean, and possesses little vitality. Moreover, the milk of a very fat mother is neither so abundant nor so nutri- tions as that of a moderately thin mother. M. Albert C. was an officer in the 4th Hussar regiment. He became so corpulent that he wished to ex jhange into the gendarmery. In 1852, he was appointed lieutenant in this branch of the service. His new position, how- ever, still required him to be much on horse- back ; and when required to travel any dis- tance, and to trot for a short time, he suffered much from difiiculty of breathing, and com- plained of a sense of oppression in the region of the heart. It seemed as though the heart had not sufficient space for the execution of its movements. Feeling naturally anxious about his health, he wrote to me desiring to place himself under my care. Impressed with the idea that his trouble was consequent upon his excessive corpulence, I gave him advice, which he followed for several weeks; but in conse- quence of a severe wound in tlie leg, which obliged him to keep liis bed, and undergo a surgical operation, he left off my plan of treat- ment. Some time afterwards, he fell sick ; he CASE OF MR. L. 103 was bled, leeclied, &c., and partially recovered his liealtli ; but the heart affection became ex- ceedingly troublesome, especially when' en horseback. Ilis physician advised him to re- turn to Paris. On his arrival, he resumed my system of treatment, and ai'ter a fortnight ex- perienced great relief; his appetite had im- proved, he slept well, and the pain which he had suffered in the region of the heart disap- peared. When he came to Paris, he was scarcelv able to walk, but at the end of fifteen days he could walk all over the city. His liealth became thoroughly re-established on the loss of his obesity, and he was enabled to resume his military duties. On the 18th of February, 1853, 1 received a letter from Mr. L., superintendent of a royal factory at Annecy, in Savoy, in which he says : " You were kind enough to send on the 20th of April, 1851, medicine sufficient for two months of anti-obesic treatment. Your direc- tions were scrupulously attended to during the first month, and I experienced considerable benefit — in fact I lost nine poimds in weight, and felt more active and much more fit for business. Circumstances prevented my oon> tinning the treatment during the second month and the medicine has been lost. After the lapse of two years I am anxious to resume 104: CASE OF MADAME DE L. joiir plan of treatment, &c." It is now a year since Mr. L. wrote to me, when I sent him all that was requisite. I liave not since heard from him by letter, but I know that the second treatment was equally satisfactory. Owing to . his favorable report of my system, a notary of Annecy, during the course of last summer, sought my advice. I am also indebted to him for other patients. In the month of June, 1853, Madame de L., of Amiens, consulted me on her own behalf, and also on that of her husband — both labour- ing under obesity. I gave her the necessary directions, together with medicine sufficient to last tv/o months. She wrote to me on the 2nd of July in the following terms : '' Sir, — In fulfilment of my promise, I send you a statement of the result of your treat- ment. My husband has lost eleven pounds in weight, and enjoys excellent health. As for myself, owing to severe indisposition after my return home from Paris, I have only adopted your treatment during the last eight days.' Please inform me whether the medicine you furnished to me a month ago is too old to be of any service. " I have the honour, le- some because I am obliged to talk during the greater part of the day ; cold feet, with swel- 106 CASE OF DOCTOR IIALBERG. I < ling of the legs and anldes, &c., so that I am no longer able to perform tlie duties upon which my daily bread depends. My medical attendant can do nothing for me. lie has prescribed purgatives and a vegetable diet, without any good result. I have taken thous- ands of Morrison's pills, and am worse rather than better, and now my mind is made up to make a trial of your plan of treatment, in full confidence that a cure may yet be accom- plished. " Doctor IIalbi: g, " Professor at the Imperial Lyceum of .\lsmcs." On the 8th of June Dr. llalberg wrote : " I find myself infinitely better, my breath- ing is easy, and 1 am considerably reduced in size. My great desire is that the swelling in my legs may wholly disai^pear. "Dr. IIalbero." Towards the latter end of 1851, Madame "Wimy, from the town of Marie, came to con- sult me in reference to her husband, who was labouring under obesity to such a degree as to be unable to attend to his business. I gave her the necessary advice, together with some , medicine. On the 19th of December Madame Wimy told me by letter that her liusband had already much impi'oved, that his breathing was easier, he was more capable of exertion, CASE OF JULES WIMY. 107 » ?> jnul that Ills corpulence had notably diminished. Tliis lady again wrote to nie in the following year, requesting a further su2)[)ly of medicine. She said :- — " My husband, before commencing your treatment, weighed two hundred and seventy pounds : he now weiglis oidy two hun- dred, and hopes to weigh still less. You are no doubt in the frequent receipt of letters seeking advice, for we have many mquiries for your address." In truth, the case of M. "Wimy has brought me a great many pati'^nts. Anxious to know whether he still continued my plan of treat- ment, and wishing to introduce a statement of his case in this the third edition of my work, I wrote to M. Wimy on the 16th of October last and received the following reply : " Marle, 19th Oct., 1853. " Sir,— In your letter of the 16th, you re- quested me to give a somewhat detailed state- ment of my case. I commenced the treatment under your directions, the latter part of 1851, and continued it during the early part of 1852. My weight waj two hundred and seventy pounds, and I measured sixty-one inches in circumference. I walked with great difficulty — suffered much pain in the kidneys — my legs were swollen. I had a constant cough, and 108 CASE OF JULES WIMY. was mucli troubled with drowsiness. Imme- diately after ado2:>ting your system, my fat began to disappear, my appetite improved, and, after a few months, my weight was re- duced to one hundred and sixty pounds, and my circumference to thirty-two inches. My health is now excellent. Being landlord of the Golden Lion Hotel, at Marie, where the stages put up, my recovery is known to a great many; and travellers who stopped at my house two years ago, when I was labour- ing under obesity, on seeing me at present, and noticing the wonderful change which has taken place, invariably ask by what means it has been effected. " It always affords me great pleasure to ac- knowledge that my cure is due to your system of treatment. " I have the honour to be, &c., " Jules Wimy. " Golden Lion Hotel, " Marie, Aisne." A person who visited Marie about four months ago, and who had not seen M. Wimy since the great change had been effected in his appearance, was much astonished, and made inquiries respecting the cure. Some time af- terwards, this person met, at Orleans, a wealthy iifii THE POSTMASTER AT ORLEANS. 109 gentleman, about forty years of age, suffering from obesity, and told liim what he had wit- nessed at Marie ; recommending him at the same time to visit Paris, in order that he might have the advice of the doctor who had freed Wimy from his excessive fat. This gentleman WTote to Marie, before coming to Paris, and received a satisfactory answer. He called to consult with me, saying that he wished to place himself under my care, provided that it would not interfere Avith his business or with his usual habits. He is post- master at Orleans, and, previous to the build- ino- of the raib'oad, had a cjreat deal of business to attend to. Having many more horses than necessary for his business at Orleans, he has opened a livery stable in Paris. He is conse- quently obliged to attend all the fairs and markets, in order to purchase horses and pro- vender for his two establishments, — the one at Paris and the other at Orleans, and is almost constantly travelling between these two cities, and therefore leads a life of great activity. He weighs two hundred and twenty-tw^o pounds, and Welshes to lose fifty pounds of fat, but he cannot afford to lose a day from his business. My reply to Mr. M. w^as, that so far from mv treatment demanding any cessation from liO CONSTANCY OF KESULT. work, it would ratlier give liim strength to carry it on. He began tlie treatment ten weeks since, and has already lost between twenty-eight and thirty pounds of fat ; and, as I had promised, without causing him the loss of a single day. It is said, that in order to be understood and believed, it is necessary to repeat the same thing over and over again. But all things must have an end ; and all the cases which I might yet report, would still end in diminu- tion of obesity. It may be said, Iiowever, that, like most medical writers, I report only favourable cases, and conceal those which are unfavourable. My answer is, that I have never treated a single case in which a favour- able result has not been obtained, provided the patient has observed my directions for even eight days ; and I am satisfied that if any one could be found to say that he has not been benefited, that it would be because he has not been willing to carry out the treatment for even eight days. It has no doubt frequently happened that a patient has consulted me, and has then followed my directions for two, three, or even four days, and tlicn, for some cause, has given them up : under tliese circumstances it might be said that no benefit has been de- rived. ilt:80LtTlON lIliCliSSAllY. Ill V Many such cases have occurred. In one in- stance, a wealthy man, a gokl-beater by trade, living in Paris, sought my advice. He fol- lowed my system for several weeks, without success. One day I said to him, " I can only explain your want of success hy attributing it to excessive drinking. You live upon meat principally, it is true; but how much liquid do you imbibe daily?" His answer was, — " I cannot abstain from drinking wlien thirsty, find my thirst is frequent. I spend the whole day in the factory, among fifteen or twenty Workmen, and the heat is necessarily great, as the nature of our manufacture demands it, and I am therefore obliged to drink a great deaL" I consequenly recommended him to ab- stain from further trial of a system which, under these circumstances, could not possibly be of any benefit. We meet with people who make, or seem to make, a resolution to live according to a cer- tain plan, for eight or ten days, and who, like spoiled children, forget the very next day the resolution they had made. I have met with many such cases. One wouhl scarcely believe that a lady, reduced to despair on account of her obesity, and threatening to commit suicide unless relieved of her eiiibon^oint^ could pro- mise that she would obey my instructions to 112 EESOLUTION NECESSAKY. h ! ' r live eliie% upon a meat diet, and to abstain from inordinate quantities of fluid, yet the very next day would resume her customary mode of living; — breakfasting upon eggi^, pre- serves, and ' two or three cups of sweetened tea; and dine upon ric^li pastry and sweet- meats, accompanied with a full allowance of champagne. I could not liave believed it possible had I not witnessed it myself Men generally carry out my directions more faithfully tlian women, being firmer and more persevering in their resolves. I am almost angry at times with this want of perseverance in persons wlio boast that they have carried out my treatment without suc- cess. It w^ould be an easy matter to shew that the want of success in such cases is en- tirely their own fault. A young lady of one of the most illustrious families of France, and married to a wealtliy foreign nobleman, consulted me in the month of May, 1853, in reference to her corpulence. She told me that her cousin, the Duchess of X., had derived great benefit from my treatment ; and from what she had witnessed in her case' she was induced to place herself under my care. Slie promised to connnence my system on the following day. A few days afterwards I saw her. She told I'llE FAT PROPE8SOH. 113 1110 she liad f(n'gottcn to take lier iiiedicine the day before. In subsequent visits, she con- fessed tliat she had not taken any medicine, either because she had l)een up very hite the previous evening and had hiid in bed hite that morning, or that she had been spending a day or two in the country ; or that, having been out for an early ride, she had forgotten all about it. On the occasion of my last visit, she told me that she was going for some time to her country-seat, and from thence intended to visit a watering-place. The Baroness did not follow my treatment for three days con- secutively, and consequently lost nothing of her emhonjpoint. Under such circumstances, want of success ought surely not to be attri- buted to inefficacy of the treatment. A very corpulent professor adopted my system for eight days, and lost three pounds and a half in weight. Being relieved at the same time from a sense of oppression which had continually troubled him, he was de- lighted, and spoke of the happy results to many of his acquaintances. Unfortunately at this time he received from the country a present of a large basket ot grapes, and being very partial to them, neglected my instruc- tions, and partook of them inordinately as long as they lasted. The consequence is, that the E 2 I 114 CASKS OF SKIN" DISEASE. professor is as fat as ever, althono;!! lie liarl followed my plan of treatment for eio:lit days. Now whose fault is this? Nevertheless, ids acquaintances, to whom he had spoken of being under my care, will attribute the failure to me. I shall see him again, no doubt, some of these days, when in danger of suffocation. The reader who has perused the preceding cases of cure, may say that I have omitted to speak of obesity accompanied with skin dis- ease, and in my introduction mention has been made of its frequency. In truth, many such cases have been met with ; but skin disease, in my opinion, is of such a nature that it is better not to give a liint even of the parties in whom it has been met with and cured at the same time with co-existing corpulence. My method of reducing obesity being thus frankly explained, is perhaps likely to lose its value in the eyes of many, owing to its ex- treme simplicity. M. Desbouillons, of Brest, a patient whom I successfully treated, wrote to me on the 15th August, 1853 :~" On read- ing your treatise a second time, I cannot but express my astonishm-.nt that the medical faculty should so long have failed to discover the means which you now so successfully em- ploy for the cure of obesity." Having accomplished the object I had in rREJTJDTCES OVERCOME. 115 view, it matters not whether it be the result of little study or of long and deep enquiry into the secrets of animated nature ; my batisfac- .tion consists in having destroyed those false and prejudicial doctrines which had existed for ages in the writings and teachings of philo- sophers, and in having demonstrated a truth destined to render important services to our common humanity. m 116 ALIMENTARY SUBSTANCES. wmid'y d I CHAPTEH YII. ON THE SELECTION OE ALEVIENTAKY SUBSTANCES FAVOURABLE TO THE REDUCTION OF CORPULENCE* It is to be borne in mind, that in dividinc^ alimentary matter into two kinds— on n fitted to develop fat, ^nd the other having an oppo- site tendency— my object is merely to suit the indispensable requirements of my plan of treat- ment. Nor is the conclusion to be drawn, that in order to diminish corpulence, an exclusive meat diet is absolutely necessary. Man is om- nivorous ; tliat is to say, he partakes of every- tiling entering into the composition of ordinary alimentation ; but, for the purposes of my system, azotized substances should constitute, though not exclusively, his principal food. Large quantities both of animal and vegeta- ble substances compose the ordinary diet of man. According to some philosophers, man should live on flesh only ; while others main- tain that man is by nature a vegetable feeder. Most naturalists, however are agreed that the human species is omnivorous ; that is to say, ! =J MAI^ OMNIVOROUS* 117 can live botli upon vegetable and animal mat- ter. A certain proof, in my opinion, that such is the case, is to be found in the fact that man is provided with the two kinds of teeth, the one appertaining especially to carnivorous, and the other to herbivorous animals. It is remarkable that man, in his present state of civilization, does not instinctively recognize the kind of food Which is beneficial or prejndicial to his well-being. Experience alone teaches him what is good or bad. With the lower animals it is otherwise ; they have the power to discern that which is suitable for food. The colt and the kid know how to select, among the varied herbage, the particular grasses which are suitable to their organiza- tion. Domesticated animals, having but an insufficiency of food, do sometimes partake of noxious plants. It may be that man, in conse- quence of his civilization, has lost that instinct possessed by the lower animals, and in blind confidence partakes of everything which is served to him in the shape of food; and this view derives support from the fact, that sav- ages, and people but partially civilized, refuse to eat anything they are unacquainted with, no matter how temptingly it may be prepared. The uneducated peasantry of France, at this day, will not taste food to which they ai'e un- 118 POWER OF SELECTION. accustomed, or if they do, it is only with great mistrust. It is matter of daily experience, that man can simultaneously fed upon both vegetable and animal matter, and can also live when restricted to one of these alone ; such restric- tion, however, being better borne mider the varied conditions of age, season and climate. From these considerations it follows that, for the accomplishment of a given purpose, man has the privilege of selecting certain alimen- tary substances, and of refusing many others ; the health of the individual, who may thus submit to the diet of his choice, being ia no wise affected thereby. Bearing in mind the well established princi- ples of phy-^iology and chemistry, together with the precepts set forth in the preceding pages, we may be safely guided in the selection of such alimentary substances as will conduce to the fixity of a certain condition of emhonpoint^ although having a tendency to redundancy; or which, on the other hand, will insure a diminution of obesity. Such results can be obtained by paying attention to the following remarks : That kind of meat known ..^ :^ime is very nutritious, occupies but small rj v;'>, and con- sequently only moderately diste r»s the alinieu- ^ ^ OF MEATS. 110 ^ ^ tary canal. It contains but a small amount of carbon, relatively to the other compounds and therefore should be used as much as pos- sible : such as venison, hare, the warren rabbit, woodcock, snipe, partridge, quail, plover, wild duck, &G. The fluid portion of all ragouts should be avoided by those who dread corpulence, and game should therefore be roasted rather than stewed. The same may be said of butcher's meat, such as surloin of beef, beefsteak, veal cutlet, mutton chop, fresh pork, leg of mutton, &c. Gelatinous dishes, such as calves' feet and tripe, should be avoided. Poultry, w^hen roasted, is not contra-indicated. It is a matter of observation, that those races which live chiefly upon fish are gross and dull, pale and lymphatic, and less courageous than biich as live upon flesh. A flsh diet is consequently favourable to the development of fat, and the usual accompaniment of butter sauce is also productive of a like result. The anti-obesic treatment, therefore, requires that fish should be partaken of sparingly; still it has been remarked that patients, while undergoing treatment, who eat principally of meat, with a very small amount of fish, do nevertheless succeed in the accomplishment of the object they have in view. The most nutri- I 120 OP FiSIt* tious fisli are tiirbot, trout, sole, salmon, percli, pike, tench and carp. On the other hand, shell fish, such as oysters, lobsters, crabs and shrimps, have a tendency to impede the formation of fat. Yegetables, such as lettuce, chicory, sorel, artichokes, spinach, green pease, beans, cab- bage, celery, and '•ill such as are used by way of salad, are not very nutritive, but contain much watery and mucilaginous matter, favour- able to the development of corpulency: the same may be said of carrots, turnips, potatoes, rice, beet-root, maccaroni and vermicelli bread ; all kinds of cakes, pastry and biscuits, which are made of wheaten flour, are decidedly con- tra-indicated, as are also eggs, cream, cheese and butter. . In reference to chocolate, much difference of opinion has hitherto existed as to its nutritious properties ; but we know by experience that it is easy of digestion, and eminently suited to such as are subject to great mental exertion. Some dietists have held that chocolate has a tendency to prevent any augmentation of cor- pulency. When made with water, it is deci- dedly preferable to coffee made with milk, the latter being productive of fat. Milk, by virtue of its composition, combines all the elements which are fitted for the development and nutri- tion of the body ; casein containing nitrogen, -* % • OF MILK. 121 a fiitty matter (l)iitter), and a saccharine sub- stance (sugar of milk). Chemistry reveals the remarkable fact, that the composition of casein or the cheesy portion of milk, is identical with that of the fibrin and albumen of the blood. Under this aspect, therefore, milk is very nutritious. The sugar and butter which exist in milk, have no analogy with flesh ; according to ana- lysis, they are composed of carbor. and the ele- ments of water. When, therefore, we partake of milk, we obtain in one and the same sub- stance all the elements which are necessary for the growth and nutrition of the body, and such is the case in infant life. Since, however, both carbon and hydrogen, in very large proportion, enter into the composition of milk, it is advi- sable, whenever there is a manifest tendency to corpulence, that the use of it as an article of diet should be avoided. Infants are usually fat, owing to the elements of adipose matter forming so large a proportion of their food, whether that consist of milk alone, or in com- bination with starchy or farinaceous and sac- charine substances. F 122 BEVERAGE. CHAPTEE yill. "Witli few exceptions, the corpulent, both male and female, drink a great deal with their meals; and I am more and more convinced, by daily experience, that the large amount of fluid thus imbibed has powerfully contributed fo produce their present condition. .It may be said that it is constitutional with them to require so much drink. I grant that many persons are in the habit of drinking a great deal more than others, and even that they are constitutionally so inclined ; but I cannot allow that they are compelled to drink as much as they do. Habit exercises a powerful influence over all our actions ; and I have no doubt that, notwithstanding the existence of a natural pre- disposition to drink a great deal at meal time, the inclination might be held in check, by not yielding too easily to the desire. Many people, without thinking, ircrease and stimulate their thirst by making use of highly seasoned dishes ; it would be'well that they should exercise cau- tion in this respect. Even when using a mode- rate amount of beverage, a selection as to kind is necessary. Beer and cider being especially BiJIZJSffi BEER AND CIDER, 123 S > rich in aqueous and mucilaginous matter, are by virtue of tliese elements particularly prone to tlie production of corpulence. All kinds of drink, when taken in excess, act rather as dej)ressants than stimulants of the nervous centres, and a want of physical and mental activity, alike predisposes to obesity. Alcoholic drinks of every kind tend to the development of fat, owing to the large amount of the carbonaceous element they contain. Men Avho use brandy in excess are frequently so puffy and soft that you can scarcely dis- cover the presence of muscular tissue beneath the skin. "When blood is abstracted from such persons, it is found to be thin, and to contain a less amount of the most important of tlie sanguineous elements. We must not deceive ourselves; fat is not to be taken al- ways as an evidence of strength, but, on the contrary, sliould be regarded as indicative of want of tone and of vital power, as in the case of the aged, who are frequently corpu- lent though infirm ; young chlorotic females ; persons deprived of a due supply of fresh air ; and such as make use of an excessive amount of alcoholic drink. With respect to the last, it may be said, perhaps, that some are to be met with who^ far from being corpulent, are excessively thin, in consequence of drinking 124 ALCOHOLIC DKTIS'KS. large quantities of brandy ; and such is indeed sometimes the case, but it is due to the fact that some essential organ of the body is suffering under the pernicious influence. And although the person may have been, at a former period, fat and lusty, the body finally becomes wearied with this continued excess, the stomach is dis- eased, nutrition is impeded or wholly suspend- ed, and a complete destruction of the. vital organism results. It wdll scarcely be believed, yet it is never- theless true, that females can bear these ex- cesses for a longer period than men, and that when they do unfortunately yield to them, they indulge to even a greater extent. Observation and experience fully corrobo- rate the assertion. Among a great number of cases that could be cited, one must sufiice. A young lady, a Creole, living in Paris, was in the habit of taking daily a pint of brandy, without its producing any disturbance of her faculties, and, it might be almost said, without committing any excess. When she took a larger quantity,— which indeed was often the case, — she became loquacious and troublesome to her attendants: complained of headache and hallucinations, whil^h deprived her of sleep, and said that she dreaded an attack of apoplexy. During four or five years of pro- <, ^ WINE AND WATER. 125 t •> . fessional attendance upon lier, I have been witness to several of these fits of excess. She rarely or ever walked, but made use of her carriage, rose late, and seldom partook of meat unless strongly seasoned w^ith red pepper. She became excessively obese under this system of living, and when I lost sight of her she was an utter deformity. Her complexion, how- ever, was still good, and I could attribute her obesity only to her extreme intemperance. Water is the natural beverage of man ; but being no longer in a state of nature, that which was at first destined to assuage his thirst, is not found to be in accordance with his changed habit, — his altered mode of life consequent upon civilization. To the water a small quantity of wine may be advantageously added, producing a tonic and slightly stimula- ting drink, suitable to such stomachs as may stand in need of it as an adjunct to digestion. Pure wine is not suitable for ordinary be- verage, but will rather excite thirst than allay it, and at the same time may induce irritation, or even inflammation of the stomach. Those only w^ho use a great deal of exercise in the open air can tolerate pure wine with impunity. Many of the white wines produce a diuretic effect, and are less apt to induce corpulence than the red wines. 126 OF TEA AND COFFEE. Id Champagne is certainlj most agreeable to the palate, and on account of its stimulating effect, even when taken in small quantity, is much in vogue; yet it is not suited to such as have a tendency to make tat. A young lady under my care, who was enormously fat, ac- knowledged that she lived exclusively on pastry and sweetmeats, and drank nothing but champagne. A change both of food and be- verage effected a speedy cure. In some cases this wine gives rise to indigestion, owing to the large amount of free carbonic acid gas which it contains, acting injuriously upon the nerves which are distributed to the stomach. A strong infusion of tea is one of those beverages having a tendency to oppose the formation of fat ; it is nevertheless nutritious, inasmuch as it prevents the disintegration of tissue. Moreover, its action on the nervous system is exhilarating. On account of these properties it is much used in England by all classes. A weak infusion of tea, with a su. perabundance of milk and sugar, is, on the other hand, highly conducive to the formation of fat, and therefore should be avoided. The beneficial effects of tea and coffee are due to substances heretofore named '' theine^'' and "caffeine,'' according to the source whence the J were obtained. These substances are t I 4 STRONG COFFEE. 127 f A now known to be identical, altliougli derived from plants of entirely different families. An infusion of coffee produces effects similar to those induced by tea. If weak, it is favour- able to the development of corpulence ; but if strong, it acts as a powerful stimulant upon the nervous system, and assists digestion. A very strong infusion of coffee, more particu- larly w4ien taken upon an emj)ty stomach, is powerfully anti-obesic in its effects. It has been alleged that coffee must be nu- tritious, because labourers are enabled to sup- port life upon a small amount of solid food when supplied with an abundance of coffee. Now the fact is, that coffee has all the proper- ties of tea, and, like it, prevents waste of tissue, thereby economizing food to the ut- most, and enabling the labourer to do a large amount of bodily work w^ith a comparatively slight expenditure . of the organized tissues of the living body. W. C. CHEWETT .is CO., PRINTERS, KING STREET EAST, TORONTO.