and body. Disturbances of digestion and symptoms of a fatty heart. There

is less power to resist disease. Death may occur from fatty infiltration

of the heart, resulting in dilatation or rupture.






Treatment. Must be in regulating the diet. The person must avoid all

excess in food and drink, and avoid especially foods that contain starch

and sugar. There must be regular and systematic exercise, hot baths and

massages are helps. Medicines made from the poke berry are much used and

are successful in some cases.



Diet. The food of a fleshy person should be cut down gradually. Its bulk

can be great, but its nourishing properties should be small. The diet for

reduction of obesity should consist chiefly of bulky vegetables, but not

too much of any one article or set of articles. The following list is

recommended by Dr. Hare of Philadelphia:



For Breakfast. One or two cups of coffee or tea, without milk or sugar,

but sweetened with a fraction of a grain of saccharin. Three ounces of

toasted or ordinary white bread or six ounces of brown bread; enough

butter may be used to make the bread palatable, not more than one ounce.

Sliced raw tomatoes with vinegar, or cooked tomatoes without any sugar or

fats. This diet may be varied by the use of salted or fresh fish, either

at breakfast or dinner. This fish must not be rich like salmon or

sword-fish, but rather like perch or other small fish.



Noon Meal--Dinner. One soup plate of bouillon, consomme julienne, or

other thin soup, or Mosqueras beef-jelly, followed by one piece of the

white meat of any form of fowl or a small bird. Sometimes a small piece,

the size of one's hand, of rare beef, or mutton but no fat, may be

allowed, and this should be accompanied by string beans, celery (stewed or

raw), spinach, kale, cabbage, beans, asparagus, beets and young onions.

Following this, lettuce with vinegar and a little olive oil (to make a

French dressing), a cup of black coffee or one of tea, and a little acid

fruit, such as sour grapes, tamarinds and sour oranges, or lemons may be

taken, and followed by a cigar, if the patient has such a habit.



Supper. This should consist of one or two soft boiled eggs, which may be

poached, but not fried, a few ounces of brown bread, some salad and fruit

and perhaps a glass or two of light, dry (not sweet) wine, if the patient

is accustomed to its use.



Before Going to Bed. To avoid discomfort from a sensation of hunger

during the night, the patient may take a meal of panada, or he may soak

graham or bran crackers or biscuits in water and flavor the mess with salt

and pepper. The reduction of the diet is generally best accomplished

slowly and should be accompanied by measures devoted to the utilization of

the fat present for the support of the body. Thus, the patient should not

be too heavily clad, either day or night, should resort to exercise, daily

becoming more severe, and should not drink freely of water, unless

sweating is established sufficiently to prevent the accumulation of liquid

in vessels and tissues. Baths of the proper kind, cold or Turkish, should

be used, if the patient stands them well. The bowels should be kept active

by laxative fruit or purges. Salts are useful if drinks are thrown off

rapidly. If proper exercise is impossible the rest cure with massage,

electricity, passive exertion and absolute skimmed milk diet may be

resorted to, particularly in those persons known as "fat anemics," who

have not enough red corpuscles in their blood to carry sufficient oxygen

to the tissues to complete oxidation.