Vacuity

“ Sir,—Having read your book on the treatment of obesity, I wish to ask if you will undertake my case, although living at a distance of three hundred miles from Paris. I am fifty years of age, and possessed of a vigorous constitution. Since I have retired from business, now ten years ago, I have steadily increased in corpulence; my present weight being one hundred and eighty-nine pounds. I am troubled with an affection of the heart, shortness of breath, and my legs swell, especially when not taking much exercise on foot. I am not fond of walking, since it induces great fatigue. ”

“ When I first read Science and Health I weighed one hundred and four pounds; I now weigh over one hundred and sixty. This physical health is not to be compared to my happiness, — my harmony that nothing can take away, — because it is the gift of God. Nothing has shown me the perversity of the human mind more than in its conclusions in regard to my healing. ”

“ Where a loss of weight occurs, it usually indicates a failure to assimilate a sufficient amount of food, rather than a failure to eat sufficient. A good circulation, particularly through the vital organs, deep full breathing of fresh air, and regular and complete rest periods, should be observed. ”

“ All medical writers agree that want of sufficient exercise—as by lying too much in bed, riding in a carriage, &c.—is favourable to the development of obesity. The explanation is simple. We are all cognizant of the fact, that the body is sustained chiefly by means of food; but we also know that the atmosphere by which we are surrounded, plays an important part in the nourishment of the body. ”

“ I shall now confine myself chiefly to its use in the various forms of weakness which exist with thin blood and wasting, with or without distinct lesions of the stomach, womb, or other organs.
Whether we shall ask a patient to walk or to take rest is a question which turns up for answer almost every day in practice. Most often we incline to insist on exercise, and are led to do so from a belief that many people walk too little, and that to move about a good deal every day is well for everybody. ”

“ It has been said not to constitute a disease: that it is a normal condition: that it is a condition intermediate between health and disease: that a fat person is predisposed to disease.
For my part I cannot comprehend a condition between health and disease, with corpulence; and if such do exist it is attended with those infirmities and serious inconveniences already mentioned. Predisposition to disease and morbid tendency are, in the case of persons labouring under obesity, the precursors of serous or sanguineous apoplexy, obstructions, &c. ”

“ From twenty-five to thirty-five pounds may be considered an average estimate in a healthy adult of medium size. The time in which the blood courses through the body and returns to the heart, is different in different individuals. Many writers on physiology unconditionally limit the period to three minutes. It is undeniable that the size and health of a person, the condition of the heart, lungs, and brain, the quantity of the circulating fluid, the amount and character of the inspired air, and the amount of muscular action, exert a modifying influence. ”

“ Limiting the Fluids in Obesity.—Thus it is seen that when the intake of fluids is limited, the body will call upon that surplus which is stored in every nerve, tissue, and fluid throughout the entire organism to assist in the necessary work of the organs, thus reducing the body weight just that much.
Exercise.—The athlete who is overweight, due to adipose tissue, increases his exercise at times, even adding to the weight of his clothing, causing an increased energy output, profuse perspiration, etc., all of which causes the body to use its surplus fuel in the form of the stored fat. ”

“ How many people after age 35 have a conformation of body that is in accord with proper ideals of health and symmetry? The average individual, as age progresses, gains weight until he reaches old age, when the weight usually decreases.
This movement of weight is so universal that it has been accepted as normal, or physiological, whereas it is not normal, and is the result of disease-producing and life-shortening influences. ”

“ Among female patients who consult me in reference to their obesity, many complain of a general sense of uneasiness, with frequent pains in the stomach, kidneys, headache, &c., asserting that their excess of fat came on after a confinement and when they had not suckled the infant, and thence infer that their obesity is owing to a decomposition of milk within the system. ”

“ As the months and years went on, it so happened that all my fatalities were of a character as not to involve in the least suggestions of starvation, while the recoveries were a series of demonstrations as clear as anything in mathematics, of evolving strength of all the muscles, of all the senses and faculties, as the disease declined. No physician whose practice has been extensive has failed to have had cases in which the same changes occurred, and in which the amount{32} of food taken did not explain this general increase of strength. ”

“ For the Adult.—Muscular activity, Age and Size, are most important factors influencing the food requirements. The physical condition and environment of the individual also exert a certain amount of influence upon the intake of food.
Work.—Muscular activity, as already stated, increases the body expenditures; consequently the more active the work the greater amount of energy food needed per unit of weight.
Age.—As the individual grows older, the rate of metabolism decreases until, in old age, it is not more than a third to a fifth of what it was in earlier life. ”

“ Again he revives from his sickness and he begins to recruit by partaking of various kinds of nourishment, and by and bye he weighs perhaps two hundred pounds. Another fit of sickness overtakes him and he loses fifty or sixty pounds in weight again, and thus in the course of a long life, by intervals of sickness and health, perhaps some twelve or fifteen hundred pounds of matter have departed from his body, and been renewed again through the food that he has eaten. ”

“ The vital powers, and their exciting causes, are continually varying, and thus occasion a constant instability in the functions of the organs, for a thousand causes may at every moment double or triple the activity of the circulation, and respiration, increase or diminish the quantity of bile, urine, or saliva, and suspend or augment the nutrition of the parts. Hunger, food, sleep, motion, rest, and the passions may all of them impress upon these functions so great a mobility, as every day to make them run through a hundred degrees of strength or weakness. ”

“ Many authors, both ancient and modern, and many physicians also, recommend, in order to reduce obesity, that the patient should eat a less amount by weight than the body loses. By such means a wasting of all the organs of the body would be simultaneously effected; not only fat, but muscle, nerve, tissue, blood—all must suffer. ”

“ I know no exact Way of determining the Quantities of our Food, and of the Changes inducible upon the Body, by the Quantities only, (before Pain and Sickness teach the Exceeding, when perhaps it may be past Remedy) but the Balance, and yet a Man would run the Hazard of being turned into Ridicule, that should gravely talk to People of weighing their Food or their Bodies, at certain Times. ”

“ Looking back over the whole subject, it will be well for the physician to remember that increase of fat, to be a wholesome condition, should be accompanied by gain in quantity and quality of blood, and that while increase of flesh after illness is desirable, and a good test of successful recovery, it should always go along with improvement in color. Obesity with thin blood is one of the most unmanageable conditions I know of. ”

“ It is the especial prerogative of children to be fat, but when too great an accumulation comes, with advancing years, it brings discomforts, disadvantages, and oftentimes fatal diseases, among which are Apoplexy, Fatty Liver, Diabetes, Bright's Disease and Fatty Heart. The sanguine or entonic variety is distinguished by florid skin, full strong pulse, turgid veins, with firm and vigorous muscular fibres, and the serous or atonic, is denoted by a full, but frequent and feeble pulse, smooth and soft skin, plump but inexpressive figure, and general languor or debility of the vital functions. ”

“ The greater weight is a burden to carry. The muscular tissues have in part changed to fat, and are therefore less able to do their work. The action of the lungs and the heart is interfered with by the pressure of the fat, and the individual quickly becomes exhausted and short of breath. There is the greater demand, therefore, on the part of those who incline to obesity, to exercise with determined persistency and regularity, in order to reduce their weight. ”

“ The intense bodily activity of childhood is attended with a large consumption of material and a great amount of waste. The food is converted into blood, which circulates through the arteries of the body, carrying the nutritive particles to the remotest parts, and returns through the veins, conveying the waste and worn out matter to be expelled from the system.
Quantity of Food.—Placing the average weight of an adult man at one hundred and forty-four pounds, the average daily amount of food and drink needed would be six pounds, or about one-twenty-fourth the weight of his body. ”

“ IV. It must be admitted that, under ordinary and normal conditions of diet and muscular exercise, the weight of the body being uniform, the ingress and egress of matter necessarily balance each other. If this balance be disturbed by diminishing the supply of food below the requirements of the system for its nutrition and for muscular work, the body necessarily loses weight, a certain portion of its constituent parts being consumed and not repaired. ”

“ Whether fat people possess greater power of resistance as against the fatal wasting of certain maladies or not, does not seem to be known, and I fancy that the popular medical belief is rather opposed to a belief in the vital endurance of those who are unusually fat.
That I am not pushing too far this idea of the indicative value of gain of weight may be further seen in persons who suffer from some incurable chronic malady, but who are in other respects well. The relief from their disease, even if temporary, is apt to be signalled by abrupt gain in weight. ”

“ If the increase of weight in a small compass of time, rise to above a certain quantity, it will cause disorders.
“I can bear an increase of above a pound and a half in one day, and an increase of three or four pounds in six or seven days, without being disordered; but think I should suffer from an increase of five or six pounds in that time.
“An increase of weight may be carried off by lessening the Food,—or by increasing the Discharges.—The discharges may be increased either by exercise, or by evacuations procured by art. ”

“ Later on, in a chapter on fasting, I shall prove to you that you carry around with you in your body sufficient reserve of food to keep you alive for eighty or ninety days; and if you draw on a small quantity of this you do not do yourself the slightest harm. Cut down the amount of your food; eat the bulky foods, which contain less calory value, and weigh yourself every day, and you will be surprised to discover how much less you need to eat than you have been accustomed to. ”

“ The loss or gain in body-weight has always been taken as indicating the nature of body condition, a loss usually indicating that there is a loss of body substance and a gain the reverse. In experiments in which a delicate balance between the income and outgo is maintained, as in these experiments, it is of special interest to compare the losses in weight as determined by the balance with the calculated metabolism of material and thus obtain a check on the computation of the whole process of metabolism. ”

“ In many persons there exists a constitutional tendency to the excessive formation of blood, occasioning a plethoric condition, and thereby rendering the individual liable to a great many diseases; others again suffer from an exalted or diminished sensibility of the nervous system, [2] inducing some of the greatest woes to which humanity is liable.
Many different elements are combined in the structure of the various organs of the body, and among these fat, in suitable proportion, must be recognized as necessary for the due and equable performance of the several organic functions. ”

“ I purpose it to put the system in vigorous health, to vitalize weakened organs and strengthen the heart by perfectly reducing every pound of superfluous flesh on all parts of the body, double chins, large stomachs, fat hips, etc. ”

“ The body of a man weighing one hundred and fifty pounds contains less than fifty pounds of solid matter. The blood, brain, and nerves are about eighty per cent water; the muscles, nearly eighty per cent; and even the bones and the teeth contain a large percentage of water. Man may be deprived of solid food for a day or more without suffering, and, in some instances, persons have subsisted for several weeks on water alone, but to be deprived of water for ten or twelve hours causes much suffering. ”

“ I have heard a physician telling his patient—whose complaint was merely gluttony and want of exercise—that ‘the earliest symptom of hyper-nutrition is a deposition of adipose tissue,’ and no doubt the fine long words greatly consoled the poor man under his increasing load of fat. ”

“ Those who believe as I do, that an excessive development of fat may induce and sustain a generally diseased condition of body, will readily admit that the diminution of excessive obesity is the only rational means of cure in such a case. ”

“ The two little kidneys with the caul that is upon them which is by the flanks, and the fat of the liver with the little kidneys.
3:16. And the priest shall burn them upon the altar, for the food of the fire, and of a most sweet savour. All the fat shall be the Lord's.
3:17. By a perpetual law for your generations, and in all your habitations: neither blood nor fat shall you eat at all.
Fat... It is meant of the fat, which by the prescription of the law was to be offered on God's altar; not of the fat of meat, such as we commonly eat. ”