Hoffman's Diet consists of protein and fat, in four meals. Plasmon, nutrose, etc., can be added. Calorie value 2,000-2,500.

1. Milk, 200; cream, 50; meat, 100; 2 eggs, butter.

2. Meat, 200; peas and greens.

3. Milk, 200; cream, 50.

4. Ham and 4 eggs.

Analysis Of Special Diets. (Amounts Are Given In Grammes.)

Protein.

Fat.

Carbohydrate.

Calories.

Oertel (maximum)...

170

45

120

1,608

Hirschfeld (maximum) ....

139

65

167

1,400

Von Noorden.....

155

28

112

1,366

Ebstein.....

102

85

47

1,300

Oertal (minimum)

156

25

75

1,180

Banting.......

172

8

81

1,100

Hirschfeld (minimum) ....

100

41

50

1,000

The obvious objection to all these diets lies in the high proportion of protein. Average diets such as those of v. Ranke, Moleschott, and Pettenkofer and Voit contain from 100 to 137 grammes of protein, or 15.5 to 19.5 of nitrogen. Chittenden has shown that in professional men, soldiers and athletes, a diet containing about half the above amounts of protein and nitrogen, or even less, is sufficient to maintain nitrogenous equilibrium. It is, therefore, a most irrational proceeding to give the obese an excess of protein food to provide the calories of heat required. It is much more rational, besides being physiologically sound, to reduce all the different constituents of the diet to such an extent that the relative proportions are maintained, but the calorie value is brought down to 1,500-2,000, or even lower in suitable cases. In order to meet these requirements recourse must be had to a free supply of foods containing very little nutriment, such as the vegetables, and the calorie value of different foods must be studied. The Calorie Value of Common Foods per Ounce.

Meat, fish and cereals are cooked. Vegetables are boiled.

0-5.

5-10.

10-20.

20-30.

30-40.

40-50.

50-60

Vegetable marrow

Asparagus

Leeks

Potatoes

Baked beans

Dried peas

Sprats

Broccoli

Salsify

Salmon

Spinach

Artichoke

Green artichoke

Cherries

Lentils

Whole egg

Herring

Seakale

Broad beans

Prunes

Tunny

Onion

Petit pois

Figs

Macaroni

Mackerel

Turnip

Green peas

Haricot beans

Grapes

Scotch oatmeal

Brill

Chicken

(fricasseed)

Savoy cabbage

Brussel sprouts

Bananas

Lobster

(potted)

Beetroot

(uncooked]

Cauliflower

Crab

(tinned)

Haddock

Crab

(potted)

Parsnip

Gurnet

Beetroot

Strawberry

Lobster

(tinned)

Trout

Carrot

Water melon

Pine-apple

Roach

Scarlet runner

(Uncooked)

Lemon

Smelts

Red mullet

Cranberry

Dory

Halibut

Orange

Sole

Celery

Raspberry

Whiting

Cucumber

Blackberry

Plaice

Lettuce

Apricot

Turbot

Tomato

Apple

Cod

Radish

Pear

Lemon sole

Nectarine

Buttermilk

Whey

Benger's food (cooked)

Most farinaceous foods

Tea

Coffee

Jam

Jam

Milk

Koumiss

Egg-white

Hake

60-70.

70-80.

80-90.

90-100.

100-125.

Over 125.

Breads -

Arrowroot

Sardines

Boast pork

Egg yolk

Bacon (ribs)

Daren

Breads -

Boast turkey

Polony

Manhu

White

Mutton(leg8 roast or boiled)

Brie cheese

Roastmutton

Stilton cheese

Cytos

Bermaline

Parmesan cheese

Uncooked cereals

Hovis

Graham

Neuchatel „

Brown

Ham

Pork sausage

Currants

(dried)

Milk

Pea-nuts

Salt herrings

German „

Cheese -

Sweet almonds

Eels

Dutch

Figs

(dried)

Cream cheese

Boast lamb

Camembert

Gorgonzola,,

Boast beef

Filberts

Cheddar „

Cocoas

Veal cutlets

Chestnuts

Guyere „

Chocolate

Boast veal

Cheshire „

Toffee

Treacle

Maple sugar

Gloucester ,,

Butter

American „

Roquefort ,,

Raisins

Dates

Walnuts

Cocoa-nut

Cane sugar

Beet sugar

Honey

In urgent cases and in fat anaemic women complete rest in bed, milk and massage should be tried. At first skimmed milk is added to the ordinary diet and then finally substituted entirely for it. The quantity is reduced until the patient loses about half a pound daily. The pulse, temperature and weight must be carefully watched and the diet increased, if necessary. The milk cure, really a starvation method, may be adopted (vide p. 175).

Reference to the preceding table enables one to draw up a diet suitable for the obese in quantity and variety and yet not containing an undue proportion of nutritive material. The following dietary may be adopted as a basis, being modified according to the bulk and age of the patient, the mode of life, and the progress of the case.