August 20, 1849
"In the month of August, 1849, M. Guénaud, a master baker, still residing in the Rue St. Martin, Paris, presented the following appearance:—Age, twenty-eight years; height, four feet eleven inches. His obesity was such that he was scarcely able to walk, and whenever he attempted to do so, suffered from difficulty of breathing." Cured after 3 months of the following diet. "A beefsteak or a couple of cutlets, with a very small allowance of vegetables, together with half a cup of coffee, constituted his breakfast. Dinner consisted of meat and a very small quantity of vegetables."
Obesity, or, Excessive corpulence : the various causes and the rational means of cure
CASES OF REDUCTION OF CORPULENCE.
In the month of August, 1849, M. Guénaud, a master baker, still residing in the Rue St. Martin, Paris, presented the following appearance:—Age, twenty-eight years; height, four feet eleven inches. His obesity was such that he was scarcely able to walk, and whenever he attempted to do so, suffered from difficulty of breathing. When standing for a short time, he experienced great pain in the region of the kidneys. He was incapable of superintending the workshop and attending the flour market, duties which devolved upon him as manager of an extensive bakery. An unconquerable drowsiness overcame him the moment he sat down, and rendered him unable to attend to his numerous accounts. When in bed he was obliged to be propped up by a number of pillows, in a semi-recumbent position; for if his head happened to be too low, he suffered from vertigo, dizziness, &c. His countenance was suffused, and the veins of the head, especially the temporal, were more than usually distended. The slightest exercise was attended with excessive perspiration. The cerebral circulation was so much impeded, that he could not bear even the pressure of a hat; and asserted that he would not dare to stoop, even were it to insure him a fortune. In this distressing condition he sought the advice of a physician, under whose directions he was repeatedly bled, and freely purged. He was recommended to live upon the smallest quantity of food that nature would permit, and to diet chiefly upon watery vegetables, such as cabbage, turnips, salad, spinach, sorrel, &c., and only occasionally to partake of a very small quantity of meat. He was also directed to use active exercise, to work in the bake-house, and to take long walks. But he found it impossible to follow the latter part of this advice, on account of a feeling of impending suffocation, and severe pains in the region of the kidneys. He was therefore recommended to take exercise on horseback; but this even could not be borne, and in spite of every effort his obesity was constantly on the increase. At last he could not walk a quarter of a mile, and was obliged to confine himself to the house, passing his time in a listless, somnolent condition, entirely deprived of all mental and bodily energy. His mother, who lived in the neighbourhood of Paris, having seen the advertisement of my book upon Obesity, and thinking of the melancholy condition of her son, procured a copy and read it. She thereupon brought her son in a carriage to my office. Guénaud was quite out of breath from having to ascend one pair of stairs; he seated himself upon a sofa in my room, and soon fell asleep. Occasionally he would wake up, and take some part in the conversation. The mother and her son went home, and on the following day Guénaud began to carry out the directions he had received from me; and at the end of thirteen days he was able to walk from the Porte St. Martin to La Chapelle, where his mother resided, delighted at having recovered the use of his legs. What astonished him most was that he had been able to perform the journey on foot, without once taking his hat off. The latter remark may appear trivial; it shows, however, the great inconvenience he had been wont to suffer from the violent perspiration hitherto induced by the slightest exercise. By the end of the month Guénaud had reduced his weight from one hundred and ninety to one hundred and seventy-four pounds, and his circumference round the belly from fifty to forty-three inches. He was recovering his activity, both of mind and body, and his respiration was already considerably improved. The treatment was continued two months longer, and at the end of the three months his circumference was reduced fourteen inches, having lost forty pounds of fat. His muscular powers were now much increased. Guénaud had a very short neck; the two masses of fat, which made his cheeks appear continuous with his chest, have disappeared. The line of the lower jaw is now perfectly distinct, and without the slightest wrinkle. Instead of his former aged appearance, induced by obesity, his figure is now youthful, his countenance intelligent and sparkling. Before commencing my system of treatment, the patient was in continual danger from threatening head symptoms. It was generally said, even by the medical men under whose care he had placed himself, that he suffered from excess of blood; yet he has not lost a single drop during the whole course of treatment, and is now free from somnolency, giddiness and headache. The veins of the head are no longer turgid, nor does he suffer from excessive perspiration of the head.
I am satisfied that this man, at the present time, has more blood in his system than he had when labouring under obesity; but the circulation being now free, all inconvenience has disappeared.
It is unnecessary to add that, owing to the lungs being no longer oppressed on all sides by a superabundance of fat, their movement is unimpeded, air finds easy access, and the difficulty of breathing, with sense of impending suffocation, no longer exist. Guénaud can now sleep in the ordinary recumbent position. Men of great corpulence, when walking, experience severe pain in the kidneys, and this arises from the enormous mass of fat which surrounds these organs, inducing by its weight a dragging sensation. Guénaud, having lost his big belly, is no longer troubled with this uneasiness when walking.
With respect to this patient, and in all the other cases which have come under my care, it may be well to remark that the muscular system has recovered its tone, and that the muscles are harder than they were before treatment; and I can safely say, without fear of contradiction, that every person who has been submitted to my system for the cure of obesity, is convinced that his flesh, his muscle, has increased both in firmness and in size.
I have had men under my care weighing two hundred and fifty pounds. Upon the occasion of their first visit, having felt their limbs, I have said, "I can diminish your weight by fifty pounds; but these enormous muscles will be increased rather than diminished in size. You must not expect a reduction of more than fifty pounds; but fifty pounds less of fat, distributed among organs overloaded with it, will be highly beneficial to health."
Guénaud is far from being thin, but he is strong and muscular, and has the physical and moral energy of a robust young man. His enormous size had rendered him conspicuous in that part of the city where he carried on his business as a baker; but when he had become reduced to the normal size of other men, the change produced considerable sensation, and excited curiosity as to the cause. He has done justice to the treatment which has made him once more a man. I will also do him the justice to say that he has honestly carried out my instructions. A beefsteak or a couple of cutlets, with a very small allowance of vegetables, together with half a cup of coffee, constituted his breakfast. Dinner consisted of meat and a very small quantity of vegetables. From being a great water-drinker, he had come down to an allowance of a bottle or a bottle and a half of liquid in a day. When thirsty he drank but little at a time; and between meals, used to gargle his mouth with fresh cold water.