All History

Among the foremost activists opposing the drug therapists and offering another option was New York City's own Russell Trall, M.D., who was also a leading advocate of vegetarianism. Most who denounced medical mayhem and instead employed holistic, drugless, natural medicine were convinced that flesh foods had no place on the menu. (Anyone for bringing back the term "flesh foods"?)

In 1852, Trall founded the New York Hygieo-Therapeutic College, the first medical school to admit women on equal terms with men. Trall was influenced by Sylvester Graham and Isaac Jennings, M.D., who taught that the body is governed by natural laws originating from God and verified by observation.

Trall contended that when these laws were broken, sickness and death could result. A frugivorous diet--as mandated in Genesis and verified as natural for human beings by 19th-century studies of human anatomy--was one of the laws. When illness developed, rather than suppressing symptoms the drugless doctors sought to remove the causes. Once the causes were removed, the body tended to heal itself. Trall maintained that drugs harmed the body; they did not act upon the body but the body acted upon the drugs. For example, a laxative drug seemed to work only because the body rejected it. The drug itself did not cause the bowels to work.

Trained as an allopath, Trall had observed patients who had become well without drug intervention and those who had been made sicker by drugs. He noticed how the body was helped when patients were prescribed rest, "vegetable diets," treatments such as massage and hydrotherapy (the "water cure"), and direction to fill the mind with higher thoughts.

Trall was a sought-after doctor who even lectured at the Smithsonian Institution during the Civil War on behalf of soldiers. The doctor published more than a dozen books, which found an audience hungry to help themselves and to avoid the horrors and the sometimes fatal results of the regular doctors' medicine.

Hygieo-therapeutic Dr. Trall told his students that his practice was not lucrative, and the only reason they should become physicians was that they wanted to help the sick and teach them how to avoid sickness in the future.

Trall's views about medicine led to his vegetarianism and a vice presidency of the American Vegetarian Society. Like other vegetarians of his time, he abhorred cruelty to animals. In the 20th century, Herbert Shelton studied and then expanded Trall's work, which is today known as natural hygiene. Yet more than 100 years after Trall's death, and after billions of tax-payer dollars have been spent on health care, the nation has yet to examine the drugless doctor's ideas seriously.

He was an influential promoter of vegetarianism and was Vice-President of the American Vegetarian Society.[10] Trall's The Hygeian Home Cook-Book published in 1874 is the first known vegan cookbook in America.[11] The book contains recipes "without the employment of milk, sugar, salt, yeast, acids, alkalies, grease, or condiments of any kind."[11] Trall opposed the consumption of alcohol, coffee, meat, tea and the use of salt, sugar, pepper and vinegar.[7] He believed that spices were dangerous to health.[7]

In 1910, physician David Allyn Gorton noted that Trall's diet was "most simple and abstemious, consisting chiefly of Graham bread, hard Graham crackers, fruits, and nuts—two meals a day, without salt."[12]

https://catalog.hathitrust.org/Record/010747022

Fruits and farinacea the proper food of man :
being an attempt to prove, from history, anatomy, physiology, and chemistry, that the original, natural, and best diet of man is derived from the vegetable kingdom /
by John Smith, with notes and illustrations by R.T. Trall, M.D

Mons. Desrenaudes, living in the Rue du Faubourg St. Honoré, became very corpulent in a comparatively short time. This was a source of great inconvenience to him, from the fact, that being much devoted to the pleasures of the turf, his increased weight unfitted him for the saddle. During the year 1852, he followed my system of treatment for two months, and obtained most satisfactory results, and, as in every other case, without necessitating the slightest interference with his daily avocations.

M. Albert C. was an officer in the 4th Hussar regiment. He became so corpulent that he wished to exchange into the gendarmery. In 1852, he was appointed lieutenant in this branch of the service. His new position, however, still required him to be much on horseback; and when required to travel any distance, and to trot for a short time, he suffered much from difficulty of breathing, and complained of a sense of oppression in the region of the heart. It seemed as though the heart had not sufficient space for the execution of its movements. Feeling naturally anxious about his health, he wrote to me desiring to place himself under my care. Impressed with the idea that his trouble was consequent upon his excessive corpulence, I gave him advice, which he followed for several weeks; but in consequence of a severe wound in the leg, which obliged him to keep his bed, and undergo a surgical operation, he left off my plan of treatment. Some time afterwards, he fell sick; he was bled, leeched, &c., and partially recovered his health; but the heart affection became exceedingly troublesome, especially when on horseback. His physician advised him to return to Paris. 

On his arrival, he resumed my system of treatment, and after a fortnight experienced great relief; his appetite had improved, he slept well, and the pain which he had suffered in the region of the heart disappeared. When he came to Paris, he was scarcely able to walk, but at the end of fifteen days he could walk all over the city. His health became thoroughly re-established on the loss of his obesity, and he was enabled to resume his military duties.

On the recommendation of this patient, Madame de M., in the month of June, 1852, requested me to call upon her. She was between thirty and thirty-five years of age, and during the last eight years she had become enormously fat. She was ailing, and had been under treatment for almost every variety of disease. Most of the medical men whom she had consulted, owing to the pain she complained of, ascribed her trouble either to organic pulmonary lesion, to bronchial affection, or to disease of the heart. She had tried every means of cure. Had been under the care of many of the principal physicians to the hospitals of Paris, and also of professors of the faculty. Deriving no advantage from these, she had consulted homœopathic practitioners, and had been treated by them unavailingly. In her despair, she had sought the advice of a female clairvoyant; and in order that she might obtain every possible benefit from the treatment, had taken her into her own house—but her sad condition was in no wise ameliorated.

Possessed of a naturally active and energetic temperament, she was nevertheless compelled to remain seated in an arm-chair, yet could not lean back in it, owing to a sense of suffocation which such a position was sure to induce. When weary of this erect position, the only relief she could obtain was by leaning upon her left elbow, resting on the knee of the same side. If she attempted to recline upon the right side, she was subject to fits of coughing and suffocation. Her days were passed in this position: at night she was obliged to sit upright, without any support to her back; and when overcome with weariness, would fall forward upon the left elbow, the only support she could endure. Finally, however, in consequence of the great and continued pressure of the weight of the body, the elbow became inflamed, an extensive sore formed upon it, and a pad for the elbow became necessary. She had scarcely any appetite, and had long since given up the use of meat. She could walk a little about her apartment, and although her sister had lived for the last six years in the house on the opposite side of the street, she had not been able to visit her. Madame de M. although by no means tall, weighed between one hundred and eighty and one hundred and ninety pounds. Under percussion the chest proved resonant throughout, and air entered freely the whole extent of the lungs. By the aid of the stethoscope a râle was heard in both lungs. Beneath both clavicles there existed scars, the result of blisters and cauteries. And the whole surface of the chest and the pit of the stomach were covered with the marks of leech bites. There were no febrile symptoms. Complexion blonde, with a remarkably fair skin and large blue eyes, which seemed never to have known pain. Under such circumstances no organic lesion either of the lungs, the bronchi, or of the heart could be suspected: and I was satisfied that the great disturbance of health in the case of this lady arose from excessive obesity. Having placed herself under my treatment, she experienced relief the first week, and, at the end of a fortnight, Madame de M. had perceptibly grown thinner. One morning, when calling to see her, I was told that she had gone for a ride to the Bois de Boulogne, and that she had been out also the day before, and was able to get in and out of the carriage without assistance. She continued to lose her embonpoint and her health became thoroughly re-established. She was able to lie down in bed, and upon either side. At the end of the month she visited friends whom she had not called upon for the last six or eight years, and six weeks or two months after commencing my treatment, she danced repeatedly at a ball given by her sister upon the occasion of her recovery. Until then she had not worn corsets for the last six years.

It was not until the month of October following, that I again had occasion to see Madame de M. Not feeling well, she sent for me. She had caught cold the day before, when returning late in the evening from the country, and was slightly feverish. She was, however, quite well again in a day or two. The last two years she has enjoyed excellent health, although, like most other ladies, she is occasionally subject to trifling nervous attacks. In the enjoyment of health and riches, she leads the fashionable life of a gay young lady. How forcibly does her present condition contrast with the previous eight long years, passed in weariness and suffering!

In the month of June, 1852, Mr. Lucian Eté, chief operator in the chemical works of Mr. Christofle, silverer and gilder, Rue de Bondy, sought my advice in reference to his corpulence, which gave him much anxiety, as he feared that he would be obliged to give up work. The sole support of a numerous family, it required his utmost efforts to go through the duties of the day. Obliged to be constantly in motion, and frequently to go up and down stairs, he suffered great pain in the kidneys, and was often so much out of breath that it was almost impossible for him to speak when giving his orders or explanations. His head was constantly bathed in perspiration; and if he attempted to sit down for a moment, he was immediately seized with an irresistible drowsiness. He had been repeatedly bled and purged, but without any salutary effect.

Lucian Eté followed my plan of treatment for two months. During the first month he lost from fifteen to twenty pounds of fat. I do not recollect how much he lost in the second month, but at the end of this time he was so far reduced that further treatment was unnecessary. Let it be observed, that during the two months he was under treatment, he was not absent a single day from his duties in the factory.

I heard from Lucien d'Eté last year. He was then in the enjoyment of perfect health, and his corpulence had not returned.

Madame d'Hervilly, residing in garrison at Elbœuf, with her husband, a captain in the 2nd regiment of the line, having met with my treatise on Obesity, came to Paris in order to consult me. After her return to Elbœuf, she adopted my system of treatment, and a fortnight afterwards wrote as follows:

"6th July.—Your predictions have been verified. I am now in excellent health, and no longer suffer from the great oppression to which I was formerly subject during hot weather. Your medicine, according to my experience, is everything that can be desired; but I have been a sufferer for the last thirty years, and it will take some time to effect a perfect cure. I have not perceptibly diminished in size, but am sensible of a peculiar freedom of motion of the internal organs. My husband also intends shortly to put your system in practice."

On the 11th August, this lady wrote again, to say that she was still pursuing the treatment; that she had not weighed herself, but was then several inches less in circumference than before.

The treatment was continued, and she became thin. Her husband subsequently adopted the system for a month, and derived great advantage from it. I cannot say how much his weight was diminished; but his great desire was to get rid of an unsightly cushion of fat, situated upon the back of his neck. I learn from Madame d'Hervilly that this unmilitary-like appendage has disappeared.

An English lady wrote to me from Dieppe, on the 15th of July, 1852. The following is an extract from her letter:—"Arrived here only a short time ago. I at once made trial of your plan for the cure of obesity, and have already experienced considerable improvement. I have not yet had an opportunity of being weighed, and therefore cannot assert positively that my actual weight is less than it was, but I certainly feel lighter, and my hands are neither so red nor so fat as formerly."

On the 7th August, 1852, M. Alcide Desbouillons wrote to me from Brest, to the effect that his corpulence was a source of great inconvenience; that his duties required him to be much on horseback, and consequently in hot weather he suffered greatly from fatigue. He weighed two hundred pounds, and measured forty-nine inches in circumference. On the 2nd September, after twenty days' trial of my system, and, as he says, perhaps not as rigorously carried out as it should have been, he weighed himself again, and obtained the following result: Weight, one hundred and eighty-nine pounds: circumference, forty-five inches. Twenty days after this he weighed one hundred and eighty-seven pounds, and measured forty-three inches in circumference. This was but a slight difference; yet M. Desbouillons, after the first few days of treatment, could walk with less difficulty, was more active, and was no longer bathed in perspiration. In his last letter he says, "I am continuing your plan of treatment, and expect to find a notable amelioration both in size and weight. The effects produced by your medicine have been in perfect accord with what you had led me to expect. The experiment appears so far conclusive, and I trust that my case will prove thoroughly demonstrative."

The First Case of Diabetic Retinopathy 

(Eduard von Jaeger, Vienna 1853) by FRANZ FISCHER 

We have before us the plates and documentation of a case of retinitis (retinopathy) in diabetes mellitus, the first of its kind. It derives from the Beitrage zur Pathologie des Auges by Eduard von Jaeger for the year 1855. That it was the first such case we have the best guarantor, Theodor Leber. In 1875, he collected the cases from the literature - there were 19 in all, of which Jaeger's case was the first - and coined the term retinitis diabetica. So characterized, Jaeger's case wanders through the literature. After Leber he found no-one more appreciative. We thought it stimulating as well as conducive to the continuity of research to exhibit this case. 

It is no accident that the observation was made in Vienna, and made by Eduard von Jaeger. In the second half of the 18th century and subsequently, Vienna was very fruitful medical soil, a place where the new seed of ophthalmology could flourish. We see Joseph Barth, the gifted individualist, Georg Joseph Beer (first professor, 1818), the first teacher and founder of scientific ophthalmology, Friedrich Jaeger, Ritter von Jaxtthal (Eduard's father), Professor at the military medical Joseph's Academy (Josephinum), the most sought-out eye-surgeon in Europe. In the so-called II Vienna Medical School, Eduard von Jaeger with Ferdinand von Arlt and K. Stellwag von Carion was an outstanding champion of the specialty. As the son of Friedrich von Jaeger and grandson of the great Joseph Beer, Eduard von Jaeger had glittering prospects. 

Nevertheless, and with all his personal accomplishment, he was denied what he felt to be his heart's desire: only at the age of 65 did he become Professor at the II Ophthalmic Clinic, Vienna, not long before his death (5 July, 1884). His main creative work lay in ophthalmoscopy. The best witnesses on his account are two competent ophthalmologists: Ludwig Mauthner (in the obituary): "Eduard von Jaeger's career is inextricably bound up with the history of the ophthalmoscope. He was one of the first who turned Helmholtz's discovery to practical use. He also produced an improved form of Helmholtz's instrument very soon for everyday practice. Eduard von Jaeger was the greatest ophthalmologist the world had yet seen." Then Maximilian Salzmann (in the preface to the reworked Atlas of 1890): "The time has its expectations, which Eduard von Jaeger, linked with the appearance of his Atlas has satisfied in full measure. His work is recognized as the most important in the field of ophthalmoscopy and has become a foundation on the basis of which numerous young doctors have been introduced into this important oculists' discipline." So much for the environment and personality of our author. 

And now for the case. The description begins as follows: "The gardener Wilhelm W., then 22 years old, of slender physique and medium height, had always been healthy and strong in childhood and adolescence. However, 4 years previously, through catching cold, he developed a disorder which repeatedly kept him in bed with slight fever and swelling of the right foot, loss of strength and appearance. As this continued, the phenomenon of a diabetes emerged, coupled with marked anorexia, dry throat, frequent vomiting after eating and feelings of great decline and weakness. For a short time the patient had also complained of frequent cough with much sputum and feelings of oppression and pressure in the chest. " 

We now shorten this account. 5 weeks before he had experienced a disturbance of vision: transient seeing of flashes and "slight clouding of the outer half of the visual field in the left eye". The clouding had spread to the other eye and was increasing. The sight in the left eye had temporarily improved. The disorder had steadily increased. It is stated: "The patient presently appears very ill and low, is thin and has a sallow complexion." Then a "disturbance of the visual field in the middle" with reduction of visual acuity is described. Passing to the ophthalmoscopic findings: The media had appeared quite transparent and normal. The peripheral parts of the fundus were free from lesions. 

On the other hand, the site and vicinity of the transverse section of the optic nerve (in the extent of the extravasate illustrated in the picture) is dull in color, less translucent, more blood-red, and the optic nerve cross-section is so completely covered by the aforesaid color change as to be no longer perceived and can only be recognized by the union of the retinal vessels. 

"Anomalous redness of the optic fundus" and "radiate spreading of the optic fibers in the vicinity of the optic nerve" were reported. Then it states: "In the region of this anomalous coloring of the optic fundus there are to be perceived a considerable number of apparently uniformly distributed blood-red flecks, some punctate, some striate or otherwise shaped, of the most various size, which seem to lie in the plane of the retinal vessels, i.e., deep to the retina, are predominantly elongated, and whose arrangement and orientation correspond partly to the optic expansion and partly to the paths of the retinal vessels, particularly the veins. Between the flecks, at some distance from the optic disc, there also appear numerous irregular, rounded, light-yellow spots whose brightness makes them very obvious." 

It then states that the retinal vessels in the region of the optic disc were hazy. The arteries showed an especially brilliant media. The diameters of the arteries and veins were significantly increased above normal. The description ends as follows: "The left eye exhibits objectively and subjectively exactly the same appearances, though to a lesser degree and the patient is still capable with its aid of getting about in the street and even doing some work as a gardener." 

We note that plate and text are quite consistent. The text, based on the author's principle, is descriptive, not explanatory. The illustration is quite true to life and free from any exaggeration. The lithography and color printing, carried out by the Imperial and Royal Court and State Press in Vienna is an amazing technical achievement for a hundred years ago. 

What was Eduard von Jaeger describing? At the fundus: an edema of the optic disc and adjacent retina, streaked and radially arranged hemorrhages at some distance from the disc, light-yellow spots, to be explained later, as essential features. The question whether this complied with the concept of diabetic retinitis (retinopathy), then and now, may be answered as follows. Th. Leber (1875) remarked of Jaeger's case that it resembled the retinitis occurring in albuminuria. Later, the edema (with the star figure in the macula) were counted as characteristics of albuminuric (nephritic, angiospastic) retinitis as against diabetic retinitis. What can we say today? Diabetic retinopathy embraces a whole range of retinal lesions: "blood-spots (anatomically: capillary aneurysms) at the outset, hemorrhages and white degenerative foci subsequently, and finally vascular and connective tissue proliferation, vitreous hemorrhage, retinal shrinkage, etc. (retinitis proliferans), though these stages are not always observed. As always with retinopathy, the edema is not part of the fundus picture. It is the view of not a few workers today that, when an edema appears, the case is one of nephritic and not diabetic retinopathy. We believe, however, that diabetic retinopathy can, exceptionally, imitate nephritic retinopathy. Edema formation is shown especially by young diabetics, as confirmed by R. Thiels and our own observations. Frankly, we cannot share Thiels' view (1956) that this depends on the special nephropathic forms of diabetes, the KimmelstielWilson glomeruloscleroses. The fact that most Kimmelstiel-Wilson cases are heralded by retinopathy without edema formation is an argument against. Therefore nothing prevents us from acknowledging Jaeger's case as one of true diabetic retinopathy, despite any similarity with albuminuric retinitis. Jaeger's case admits of another interpretation. The indistinct disc, the numerous radially arranged hemorrhages, the markedly reduced visual acuity - all are very suggestive of a thrombosis of the central vein of the retina. This is not at all an uncommon event in older diabetics (with advanced arteriosclerosis), in any case commoner than in non-diabetics; in young diabetics it was unknown. Now, J. Dietzel and P. White have recently observed a central vein thrombosis in a young diabetic, followed by a retinitis proliferans in the other eye. This demonstrates that the angiopathy specific to diabetes (and not just the usual arteriosclerosis) is capable of producing such a picture. Jaeger's case in a 22-year-old diabetic could be interpreted in this sense; but, frankly, the fundus picture is not at all consistent and the appearance in both eyes arouses doubts. The possibility exists. Now for the "rounded light-yellow spots" in our fundus picture. That this referred to the usual retinal degenerative foci we believe can be dismissed without more ado. K. vom Hofe was the first (1938) to point out the frequency of such a finding in diabetic retinopathy, and we confirm this from our own experience. It only surprises us how little awareness of this there was until now. Vom Hofe interpreted the picture as lipid infiltration of the deep retinal layers or choroid and proved correct. For the picture certainly is not related to "choroiditis in diabetic retinopathy" as we have recently described it. How accurate, then, were Jaeger's observations!

 If we leave the fundus picture: the patient's age of 22 years leads to the following remarks. Until some 10 years ago, diabetic retinopathy below 40 years of age was an absolute rarity. Thus we find in a world-famous textbook of ophthalmology of 1935 that only a single case is quoted from the literature. A marked change has occurred here. The number of young diabetics is large and steadily increasing, due to insulin and other modern treatment. The young diabetic is becoming older and now experiences its vascular complications, notably nephropathy and retinopathYi at the age of 30 or 40, he is confronted with a gloomy fate. For us, this is the main problem of diabetes mellitus today. On the other hand, the practicality of oral treatment of diabetes is fading. 

And now back to Jaeger's case. At that time, and for one of his age, he was certainly a rarity. And it should be considered that in the pre-insulin era young diabetics died off very quickly without exception from comai young diabetics did not live to experience vascular complications. As for the duration of the diabetes - in our case barely longer than 5 years - the following may be noted. As far back as 1858, Albrecht von Graefe was struck by the fact that the ocular disorders in diabetes mellitus belonged to "an advanced stage of the general disease". It required intensive research up to our own time to reveal the role of the duration of the diabetes in the development of retinopathy. 

Today, many workers, notably Dolger (USA) adopt the standpoint that every diabetic will experience the "vascular complications" of nephropathy, retinopathy, etc., if he lives long enough, for 20 years or more. On the other hand, Joslin's school in the USA advances the view that the vascular complications can be prevented or at least postponed by precise management of the diabetes from the outset without interruption, with proper treatment and surveillance. The advocates of the "free diet" (which actually is not a free diet) for diabetic children and adolescents rather incline to Dolger's view. We ourselves acknowledged Joslin's requirements in various articles though, like other authors, we were well aware that in by no means a few cases, and despite the best monitoring of the diabetes, a retinopathy (and nephropathy) develops after quite a short duration of the diabetes, while others remain unaffected despite continuously poor monitoring and overlong duration of the disease (30 or more years). We sought to explain the "bad" cases by a special penetrating power of the diabetes on an unherited basis. 

We are further of the opinion that, not only the diabetes as such, but also the associated vascular constition are inherited, and in a decisive manner. On this, the findings have yet to be made known. Jaeger's case, with its relatively short duration of diabetes, therefore also falls outside the rule in this respect and requires a special explanation, as given above. What does the case tell us otherwise? We may pass over the classical diabetes symptoms. Nothing is said relating to albuminuria or nephritis. Th. Leber felt this as a defect in the completion of his task. Thanks to the exact illustration, we can say with fair certainty that a nephropathy did exist, indeed in the uremic end-stage. This is not surprising, since we know how much alike are diabetic retinopathy and nephropathy, both clinically and pathologically; and it is just in young diabetics that nephropathy, as Kimmelstiel-Wilson's glomerulosclerosis, runs a deleterious course. 

That the report contains nothing about the blood-pressure only evokes the late development of blood-pressure measurement. A hypertension would not be surprising; according to our findings, it is associated just like the nephropathy with the retinopathy of young diabetics. The disease was ushered in by an infection, as we know well today. We amplify: the course of the diabetes was also unfavorably influenced by infection. Unfortunately, the eradication of focal sepsis has been pushed into the background in modern diabetes treatment. The description even suggests pulmonary tuberculosis. Over and again, this disease plays a noteworthy yet too little noted role in juvenile diabetes, being the second cause of death after uremia. 

We may conclude: The case reported by Eduard von Jaeger in 1855 is unusual as regards age, duration of diabetes and fundus findings. It withstands any check by current standards. We are right to see in it the first observation of diabetic retinopathy. The strictly scientific approach of the author has saved the case from oblivion. Yet it is quite remarkable that our acquaintance with diabetic retinopathy should have begun in such an unusual way. And what is even stranger is that in Jaeger's case we encounter the problem case of diabetes mellitus today. Eduard von Jaeger published this case in his Beitriigen zur Pathologie des Auges (1855-1856). 

Just listen, in conclusion, to what our historian, J. Hirschberg, writes on this: "No sacrifice for science was too heavy for him. For his wonderful Contributions to the Pathology of the Eye he plunged into a debt of 20,000 gulden, which he gradually paid off from his earnings." Such was Eduard von Jaeger. May he be a model to all young ophthalmologists!

 Summary 

The priority of the case is certified by Th. Leber (1875). That the observation was made in Vienna and by Eduard von Jaeger (1855) is not a matter of chance. Though this case of diabetic retinopathy is unusual in many respects, the diagnosis is beyond doubt and satisfies any check. The author's comprehensive and very factual approach gives us cause, even today, for valuable inferences and reflections, and not only as regars the fundus appearances. The spirit of a true natural scientist reveals itself. 

References 

F. Fischer: Probleme der diabetischen Retinopathie. Klin. Mbl. f. Augenheilkunde 125 (1954): 666 - Einst und jetzt. Die historische Entwicklung der Retinopathia diabetica. Miinchner med. Wschr. 44 (1954)1287. - Die Retinopathie des jungen Diabetikers (unter 40 Jahren). Graefes Arch. 1957. - J. Hirschberg: Geschichte der Augenheilkunde. In Handbuch Graefe-Saemisch, Bd. XV, 1916. - Eduard von Jaeger: Beitrage zur Pathologie des Auges. 2. Lieferung, S. 33, Tafel XII. K. K. Hof- und Staatsdruckerei, Wien 1855. - Th. Leber: Uber die Erkrankungen des Auges bei Diabetes mellitus. Arch. f. Ophthalm. 21, 3 Abtlg. (1875): 206 - Die Krankheiten der Netzhaut. In Handbuch Graefe-Saemisch, Bd. VII12 (1914): 969. -1. Mauthner: Eduard von Jaeger. Wiener Med. Wschr. 28 (1884): 878 - Th. Puschmann: Die Medizin in Wien wahrend der letzten 100 Jahre. M. Pedes, 1884. - M. Salzmann: Ophthalmoskopischer Handatlas von Eduard von Jaeger, neubearbeitet und vergr6Bert. F. Deutike, Leipzig und Wien 1890. - L. Schonbauer: Das Medizinische Wien. Geschichte, Werden, Wiirdigung. Urban & Schwarzenberg Berlin und Wien 1944. in: Wiener Medizinische Wochenschrift 107 (1957) 969-972.

If free from prejudice, and willing to acknowledge the truth of that which is manifest, the cases we have just cited ought to satisfy any candid enquirer that obesity may be entirely overcome without prejudicially affecting the general health. At first sight, this would appear undeniable; yet medical writers, who have hitherto insisted that a meat diet is conducive to the development of fat, and that vegetables have an opposite tendency, will not frankly acknowledge their error.

Physicians who have derived their knowledge from books, and from the lectures of their teachers, must find it difficult to change their opinions in reference to obesity. With the public, when any one is told that the imbibition of large quantities of water is productive of fat, and that feeding upon animal food induces leanness, a similar degree of doubt is excited as when Galileo asserted that the sun did not revolve around the earth. On the publication of the first edition of my treatise upon Obesity, I experienced a degree of impatience, and even irritation, in view of the systematic opposition which a self-evident truth received at the hands of the medical profession. At the present time, however, I calmly recognize that the same happened in the case of every attempted innovation. I call to mind how Galileo endangered his very existence. Vesalius, the founder of anatomy, was saved from the stake only by the interference of his sovereign. Harvey, the discoverer of the circulation, was compelled to seek royal protection from the attacks of the medical men of his day. Peysonnel, a physician of Marseilles, and a great naturalist, devoted himself to the study of corals and madrepores. In 1727, he laid before the Academy of Science a monogram, proving to demonstration that corals and madrepores are structures due to animal life; that what Dioscorides, Pliny, Linnæus, Lamarck, Tournefort, &c. &c. had thought to be flowers, are in truth animals; and that these living creatures constructed and augmented their abodes; the Academy, like most learned bodies, admitted as truth only that which it taught, and consequently paid no attention to this memoir, which, nevertheless, was destined to produce an entire change in a large department of natural history. When, long afterwards, Trembley published his discoveries on fresh-water polypes, the studies of Dr. Peysonnel in this direction were remembered, and naturalists were forced to admit that the physician of Marseilles was right in maintaining that what had been taken for flowers are in reality animals. His claim as the discoverer of a fact which was destined to effect an important revolution in an extensive department of natural history, has since then not been disputed, nor could it be. All men, and men of science especially, require time before yielding to evidence, when that evidence is in opposition to preconceived views, and interferes with personal interest.

The system I have introduced progresses, and, as some might say, works wonders, and effects cures in France, in England, in Belgium, in Austria, in Russia, in Turkey, in Africa; and in almost every instance, my patients are persons occupying prominent positions—magistrates, state authorities, general officers, or men of wealth, who have enjoyed the advantages of a good education, and are able to judge of and appreciate the merits of my mode of treatment. The judgment of such a tribunal should convince the incredulous. This is no matter of faith. I lay claim to the possession of no revelation, which is not to be explained, or which is to rest solely upon my assertion. I do not say that my discovery is a mystery, and that it is your part to believe in it. Under such circumstances, disbelief would not astonish me, notwithstanding all the cases of cure brought forward; but when the nutrition of the body is explained in accordance with the laws of nature, when it is shewn to be in conformity with the well understood laws of chemistry, and that facts are cited, in reference both to man and the lower animals, in support of these phenomena, I confess that opposition to this system excites my astonishment. Physicians cannot by any possibility advance sufficient reasons against a system which, when once explained, must appear self-evident to every one.

Another fact in support of this system must be submitted to my readers. What would a medical man say if I should venture the following piece of advice: You have a horse you wish to dispose of. He is a good beast, and travels well, but he is thin. If he were fatter, he would look better, and you could sell him to greater advantage. Make him fat; and if, in order to do this, I advised him to give his horse a double allowance of oats, he would only laugh at me. He would say; why, everybody knows that if you wish to fatten a horse, the best way is to give him, in addition to an abundance of hay, bran, mixed with plenty of water, or in other words, bran mashes; or the horse may be sent to pasture, to live upon grass, which is composed principally of water and a small proportion of ligneous matter. Under such circumstances, the horse will make fat, and his form will become more round and plump; but if, when he was thin, he was able to travel thirty miles without sweating and without fatigue, now that he is fat he will scarcely be able to go five without being covered with sweat, and without shewing manifest signs of fatigue. When thin, he was a good horse; but being fat, he has lost his best qualities, which can be restored only by feeding him again upon less bulky food, with a due allowance of oats, and a small proportion of water.

I have been informed that the gentleman in charge of the stud of King Charles X. availed himself of the knowledge of this fact, and allowed only half the usual quantity of water to the horses under his charge, and that this plan was attended with the most satisfactory results, the horses being thereby able to endure a greater amount of fatigue than under a full allowance of water.