By Dr. Paul Cheron.

In order to properly regulate the regimen of the obese, it is first necessary to determine the source of the superfluous adipose of the organism, since either the albuminoids or the hydrocarbons may furnish fat.

Alimentary fat becomes fixed in the tissues, as has been proved by Lebede, who fed dogs, emaciated by long fast, with meat wholly deprived of fat, and substituted for the latter linseed oil, when he was able to recover the oil in each instance from the animal; parallel experiments with mutton fat, in lieu of oil, afforded like results.

Hoffman also deprived dogs of fat for a month, causing them to lose as high as twenty-two pounds weight, then began nourishing with bacon fat with but little lean; the quantity of fat formed in five days, in the dog that lost twenty-two pounds, was more than three pounds, which could have been derived only from the bacon fat.

It has been stated, however, that alimentary fat seems to preserve from destruction the fat of the organism which arises from other sources. Be this as it may, it is a fact that the pre-existence of fat furthers the accumulation of more adipose; or in other words, fat induces fattening!

That adipose may be formed through the transformation of albuminous matters (meat) is an extremely important corollary, one established beyond cavil by Pettinkofer and Voit, in an indirect way, by first estimating the nitrogen and carbon ingested, and second the amount eliminated. Giving a dog meat that was wholly deprived of fat, they found it impossible to recover more than a portion of the contained carbon; hence some must necessarily have been utilized in the organism, and this would be possible only by the transformation of the carbon into fat! It goes without saying, however, that the amount of adipose thus deposited is meager.

Other facts also plead in favor of the transformation of a portion of albumen into fat within the economy, notably the changing of a portion of dead organism into what is known as "cadaveric fat," and the very rapid fatty degeneration of organs that supervenes upon certain forms of poisoning, as by phosphorus.

The carbohydrates, or more properly speaking hydrocarbons, are regarded by all physiologists as specially capable of producing fat, and numerous alimentary experiments have been undertaken to prove this point. Chaniewski, Meissl, and Munk obtained results that evidenced, apparently, sugar and starch provide more fat than do the albuminoids. Voit, however, disapproves this, maintaining the greater part of the hydrocarbons is burned (furnishes fuel for the immediate evolution of force), and that fat cannot be stored up unless a due proportion of albuminoids is also administered. He believes the hydrocarbons exert a direct influence only; being more oxidizable than fats, they guard the latter from oxidation. This protective role of the hydrocarbons applies also to the albuminoids.

We may believe, then, that the three great classes of aliment yield fat, in some degree; that alimentary fat may be fixed in the tissues; and that hydrocarbons favor the deposition of adipose either directly or indirectly.

It is well understood that fat may disappear with great rapidity under certain conditions; many maladies are accompanied by speedy emaciation; therefore, as fat never passes into the secretions, at least not in appreciable quantities, it probably undergoes transformation, perhaps by oxidation or a form of fermentation, the final results of which are, directly or indirectly, water and cadaveric acid. It is certain the process of oxidation favors the destruction of adipose, and that everything which inhibits such destruction tends to fat accumulation.

Since the earliest period of history, there seems to have been an anxiety to secure some regimen of general application that would reduce or combat obesity. Thus Hippocrates says:

Fat people, and all those who would become lean, should perform laborious tasks while fasting, and eat while still breathless from fatigue, without rest, and after having drunk diluted wine not very cold. Their meats should be prepared with sesamum, with sweets, and other similar substances, and these dishes should be free from fat.

In this manner one will be satiated through eating less.

But, besides, one should take only one meal; take no bath; sleep on a hard bed; and walk as much as may be.

How much has medical science gained in this direction during the interval of more than two thousand years? Let us see:

First among moderns to seek to establish on a scientific basis a regimen for the obese, was Dancel, who forbade fats, starchy foods, etc., prescribed soups and aqueous aliment, and reduced the quantity of beverage to the lowest possible limit; at the same time he employed frequent and profuse purgation.

This regimen, which permits, at most, but seven to twelve ounces of fluid at each repast, is somewhat difficult to follow, though it may be obtained, gradually, with ease. Dr. Constantine Paul records a case in which this regimen, gradually induced, and followed for ten years, rewarded the patient with "moderate flesh and most excellent health."

In Great Britain, a mode of treatment instituted in one Banting, by Dr. Harvey, whereby the former was decreased in weight forty pounds, has obtained somewhat wide celebrity; and what is more remarkable, it is known as "Bantingism," taking its name from the patient instead of the physician who originated it. The dietary is as follows:

Breakfast

Five to six ounces of lean meat, broiled fish, or smoked bacon--veal and pork interdicted; a cup of tea or coffee without milk or sugar; one ounce of toast or dry biscuit (crackers).

Dinner

Five or six ounces of lean meat or fish--excluding eel, salmon, and herring; a small quantity of vegetables, but no potatoes, parsnips, carrots, beets, peas, or beans; one ounce of toast, fruit, or fowl; two glasses of red wine--beer, champagne, and port forbidden.