The Chambers System

Day's Regimen For A Three Weeks' Course

Rise at 7. Rub the body well with horsehair gloves, have a cold bath, take a short turn in the open air. Breakfast at 8 or 8.30, on the lean of beef or mutton, cutting off the fat and skin, with dry toast, biscuit, or oatcake, a tumbler of claret and water or tea without milk or sugar, or made in the Russian way with a slice of lemon. Luncheon at 1 on bread or biscuit, Dutch cheese, salad, water cresses, or roasted apples (without sugar or cream), hung beef, or anchovies, or red herring or olives, and such like relishes. Drink, after eating, claret and water, unsweetened lemonade, or plain water, in moderation. Dinner at any convenient hour. Take no soup, fish, or pastry, but plain meat of any kind except pork, rejecting the fat and skin. Spinach, French beans, or any other green vegetable may be taken, but no potatoes, made dishes, or pastry. A jelly or a lemon water ice, or a roast apple must suffice for sweets and dessert. Claret and water at dinner, and one glass of sherry or Madeira afterwards.

"Between meals exercise, as a rule, in the open air, to the extent of inducing perspiration, must be taken. Running, when practicable, is the best form in which to take it".

Chambers also advised giving liquor potassae with the proteid diet, or the remedy of Dancel, consisting of one half or a teaspoon-ful of sodium bicarbonate added to five or ten grains of tartaric acid in a small tumblerful of water, and drunk while effervescing. He restricted sleep to seven hours a day, for it is weakening for the obese to remain too long in bed in a close room. Turkish baths were also recommended. Chambers's further directions to be observed by the patient to prevent a possible return to corpulency were as follows: Continue to avoid fat meats, rich milk, butter, malt liquors, sweet wines, starches, especially pastry and puddings, and sweet vegetables, such as parsnips and beets.

The patient may have lean beef or mutton, venison, game, poultry, boiled fish, poor new cheese, green vegetables and fresh fruits, oranges, lemons, almonds, roast apples, salads, olives, buttermilk, claret, hock. Bread should be aerated or toasted. Captain's biscuits may be eaten. Among the green vegetables which may be eaten are tomatoes, celery, stuffed red and green peppers, radishes, asparagus, artichokes, oyster plant, squash, and spinach.

Of the various systems above described, that of Oertel is, on the whole, the best adapted for the greater number of cases. The Eb-stein treatment diminishes the appetite and is useful for robust patients, but if there is enfeebled digestion and weakness, this diet is not to be recommended on account of the large proportion of fat 43 and the relatively small amount of proteid foods. The essential value of all methods of dietetic treatment of obesity is based upon two objects to be attained: First, to enable the patient to fully oxidise and eliminate the fat which is already accumulated in various parts of the body, and, secondly, to make it impossible for it to be reformed.

From what has been said of the cause and nature of obesity, it follows that no one system of treatment is applicable in every instance. The effect of any treatment should be observed from day to day, care being taken that the patient while losing flesh does not at the same time lose in strength to a degree which may become dangerous - i. e., more than two or three pounds per week. Frequent examinations should be made of the heart action, the circulation, and the urine.

The thyroid-gland extract has a remarkable effect in reducing obesity in some cases, even without accessory treatment. The cat-abolism of the process is not understood, but the C02 elimination is increased, and in addition to increased consumption of fat tissues there is increased nitrogenous waste. The effect is not permanent, and the lost weight is soon regained if the patient fails to persist in dietetic treatment with exercise. The powdered gland is given in tablet form, in doses not exceeding five grains three times a day. It is best not to give more than five grains at first in twenty-four hours, for the remedy sometimes produces serious cardiac weakness and digestive disturbance. I have usually found that after a reduction in weight of about thirty pounds the use of the extract had to be discontinued.

Debove's theory of obesity is that the nervous system is at fault through failure to regulate metabolism. His treatment comprises (1) a period of reduced feeding, (2) a period of voluntary regulation. His sample diet is as follows:

For breakfast, a cup of tea or milk; mid-day meal, one or two slices of meat, a few vegetables or a little salad, a hundred to a hundred and fifty grams of bread, a little cheese, fruits as desired, and a cup of black coffee without sugar. For supper, a glass of hot milk, sweetened, 30 to 50 grams of bread, and fruits as desired.