The Meat And Hot-Water Treatment

This method is a treatment for obesity and chronic gastric catarrh, which consists in the restriction of the diet exclusively for several weeks to large quantities of rare beefsteak, and salt codfish and hot water for the first fortnight, three pounds of rump steak, one pound of codfish, with six and one third pints of hot water, are subsequently given for two or three weeks. The water is gradually reduced to four pints, and lean beef and fresh fish may be eaten with dry toast or zwieback, and a very little green vegetable food. After five or six weeks the hot water is still further reduced to a quart a day, and dry crackers and dry toast and stale bread crusts, poultry, and game are added to the diet, and the patient may be allowed to drink hock diluted with carbonic or Seltzer water. The hot water, if desired, may be flavoured with fresh lemon juice, and five or ten grains of bicarbonate of soda are given twice a day. This treatment is found impracticable by many persons, who rebel against the extreme monotony of it, and are unable to eat so large an amount of meat either with or without other food; it is principally adapted to persons who are habituated to overeating, and is not to be recommended for the majority of cases.

The Bouchard System

According to Bouchard's method, the frequent observation of the urine should form the basis of the treatment of obesity. When the nitrogenous waste is increased in the urine he reduces the allowance of animal food; but he also believes, in opposition to many other theories of treatment of obesity, that the total quantity of farinaceous and fatty food allowed should be five times greater than the quantity of animal food, and asserts that giving vegetable acids with the carbohydrates favours the oxidation of the latter. He therefore prescribes such fruits and fresh vegetables as are rich in the potassium salts of the organic acids. He forbids the use of vinegar and other acids, which he claims diminish the alkalinity of the blood and thereby increase the formation of fat.

The patient's exercise is also governed by the elimination of urea and phosphates. When these salts are present in excess, he argues that the oxidation of the tissues is being unduly stimulated; but if they are not present in too large quantity, exercise before meals is recommended. A review of the principles involved in this theory does not strengthen the belief in their value.

The oxidation processes in the body are still too obscure to enable one to take the urine as an absolute criterion of the conditions of metabolism, especially in those cases where a large reduction in the body weight is being obtained by the consumption of previously stored-up material. It is true that superfluous fat, when fully oxidised, leaves the body in the form of carbonic acid and water from the lungs, and in the form of water and carbonates in the urine; but it is not definitely known to what extent this combustion spares the proteid materials of the body from disintegration and allows the animal food products to pass directly into the urine as urea or other nitrogenous waste matter.' While the urine should be carefully studied in these cases, a much better guide for the treatment of obesity is found in the observation of other symptoms and in the disappearance of previously existing abnormal conditions.