Not only is there no necessity for those who make use of these diets to become stout, but they can easily be modified, so as to reduce the obesity of those who suffer from other diets.

Of course, if anyone begins on one of the above diets containing two or more pints of milk, and takes freely also of cream and butter, he may easily increase a good many pounds in weight even in a month or two.

And I mention this specially to point out that such increase in weight, if due to fat, is no proof of satisfactory nutrition, and does not show that the quantity of albumens daily consumed is sufficient; and under these circumstances the only proof that the supply of albumens is sufficient, is a more or less constant feeling of abundant strength, with ample powers of endurance, which, by the way, are almost never met with in those who are too stout.

Stout people have also in my experience very often decidedly high blood-pressure, and it is at least probable, as I have elsewhere suggested, that the cause of the high blood-pressure, namely collaemia and defective capillary circulation, is also the cause of the stoutness.

Defective or obstructed capillary circulation causes on the one hand high blood-pressure, and on the other deficient metabolism, or combustion in the tissues (see "Uric Acid," prev. ref., p. 776), one effect of which may, under certain circumstances, be an accumulation of uncombusted material, in the shape of fat. It may be thus no mere coincidence that stout people so often have high blood-pressure, or that stoutness has become connected in the popular mind with a tendency to apoplexy.

It follows also from my first principles, that those who have such defective circulation cannot have much power of endurance.

But if the weight tends to make a decided increase on any such diet, and it is not desired that the weight should increase further, reducing the butter and cream, and skimming, or, better still, separating the milk, is generally sufficient to bring it to a standstill.

But those who are already too stout and wish to reduce will have to further modify any of the above diets.

Thus, taking Table I., the milk will have to be reduced, and the cream separated from that taken, and cheese may be specially obtained which is poor in fat, or made from skim milk.

Bread must be reduced, or even entirely replaced by rice, which is poor in fat, together with protene and gluten, which are practically free from it. Thus:-

1 pint milk

3 per cent. of albumens

= 262 grs.

1 1/2 ozs. cheese ..

33 ,, ,,

= 211 „

1/2 oz. gluten ..

90

= 180 „

2 ozs. protene ..

85 „ „

= 631 „

4 ozs. rice

5 ,, ,,

= 86 „

1,370

A little acid fruit, say

30 grs.

1,400

In this way a sufficient supply of albumens is obtained with very little fat and a reduced quantum of starches, and the patient supplies what may be required in this direction from his own tissues, just as he would on the dangerous diet of meat and hot water that has been used for the same purpose.

But he escapes the great dangers of this latter diet, which are due to the xanthin, uric acid, and other effete nitrogen contained in the flesh, as these poisons are practically completely absent from the above diet table; and in this way he can reduce his weight with much greater safety and considerable ease. If necessary, gluten and protene may be increased, diminishing correspondingly the milk and the cheese which contain most of the fat. The object of allowing some acid fruits is to stimulate, as stimulation will tend to improve circulation, nutrition, and metabolism in general, and facilitate the breaking up and removal of the fat deposited, and in severe cases it may be necessary to give drugs, which have a more powerful effect in the same direction.

In this way weight can be safely and satisfactorily reduced without any failure of nutrition or strength, and without any danger from the deadly after-effects of the animal-tissue poisons in the pure meat diet.

A great deal has been said and written of late about the cure of tuberculosis by fresh air and overfeeding.

And no doubt such overfeeding, if it makes the human fire, so to speak, roar up the chimney, may help to cure a local tuberculosis, as I have suggested in "Uric Acid," p. 392; but I should like to point out that it is by no means necessary to abandon a uric acid-free diet to get such overfeeding, as the diet in the table just given is a very ample one for persons of ordinary weight, and as almost every item in it - milk, cheese, protene, and gluten - could be doubled, or even trebled, if necessary, there is no doubt that the required albumens can be obtained from these substances.

I would also point out that this stimulation of combustion is a temporary expedient for a temporary object, and that once the destruction of the microbe has been accomplished, the excess of food has almost of necessity to be considerably reduced, or disease would be produced in other directions by the accumulation of the waste products of such excessive combustion; and it follows from all my previous arguments that these waste products will be both less in quantity and less injurious in quality if the necessary albumens have been obtained from a uric acid-free source.