Recent History
February 2, 1852
Jean-Francois Dancel
Obesity, Carnivore, Keto
Obesity, or, Excessive corpulence : the various causes and the rational means of cure
Mons Desrenaudes "during the year 1852, he followed my system of treatment for two months, and obtained most satisfactory results" reported Dancel in his book on using the all meat diet to cure obesity.
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.
April 4, 1852
Jean-Francois Dancel
Obesity, Carnivore, Keto
Obesity, or, Excessive corpulence: the various causes and the rational means of cure
Dancel could do magic in just two weeks. "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."
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.
June 5, 1852
Jean-Francois Dancel
Obesity, Carnivore, Keto
Obesity, or, Excessive corpulence : the various causes and the rational means of cure
A 35 year old woman becomes enormously fat in just 8 years and becomes stuck in her bed with sores on her elbows, and then adopts the all meat diet and returns to perfect health. "The last two years she has enjoyed excellent health."
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!
June 6, 1852
Jean-Francois Dancel
Obesity, Carnivore, Keto
Obesity, or, Excessive corpulence : the various causes and the rational means of cure
Dancel's carnivore diet for obesity was used again for: "Lucian Eté followed my plan of treatment for two months." Lost 20 pounds in the first month and more the second - remained in perfect health thereafter.
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.
July 6, 1852
Jean-Francois Dancel
Obesity, Carnivore, Keto
Obesity, or, Excessive corpulence : the various causes and the rational means of cure
Madame d'Hervilly reviews the usage of the carnivore diet for herself and her husband: "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"
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.
Ancient History
Luxor, Luxor Governorate, Egypt
2475
B.C.E.
The Earliest Record of Sudden Death Possibly Due to Atherosclerotic Coronary Occlusion
WALTER L. BRUETSCH
The sudden death of an Egyptian noble man is portrayed in the relief of a tomb from the Sixth Dynasty (2625-2475 B.C.). Since there is indisputable evidence from the dissections of Egyptian mummies that atherosclerosis was prevalent in ancient Egypt, it was conjectured that the sudden death might have been due to atherosclerotic occlusion of the coronary arteries.
It may be presumptuous to assume that an Egyptian relief sculpture from the tomb of a noble of the Sixth Dynasty (2625-2475 B.C.) may suggest sudden death possibly due
to coronary atherosclerosis and occlusion. Much of the daily life of the ancient Egyptians has been disclosed to us through well-preserved tomb reliefs. In the same tomb that contains the scene of the dying noble, there is the more widely known relief "Netting Wildfowl in the Marshes." The latter sculpture reveals some of the devices used four thousand years ago for catching waterbirds alive. It gives a minute account of this occupation, which in ancient Egypt was both a sport and a means of livelihood for the professional hunter.
The relief (fig. 1), entitled "Sudden Death," by the Egyptologist von Bissing2 represents a nobleman collapsing in the presence of his servants. The revelant part of the explanatory text, as given by von Bissing, follows (translation by the author):
The interpretation of the details of the theme is left to the observer. We must attempt to comprehend the intentions of the ancient artist who sculptured this unusual scene. In the upper half (to the right) are two men with the customary brief apron, short hair covering the ears, busying themselves with a third man, who obviously has collapsed. One of them, bending over him, has grasped with both hands the left arm of the fallen man; the other servant, bent in his left knee, tries to uphold him by elevating the head and neck, using the knee as a support. Alas, all is in vain. The movement of the left hand of this figure, beat- ing against the forehead, seems to express the despair; and also in the tightly shut lips one can possibly recognize a distressed expression. The body of the fallen noble is limp. . . . Despite great restraint in the interpretation, the impression which the artist tried to convey is quite obvious. The grief and despair are also expressed by the figures to the left. The first has put his left hand to his forehead. (This gesture represents the Egyptian way of expressing sorrow.) At the same time he grasps with the other arm his companion who covers his face with both hands. The third, more impulsively, unites both hands over his head. ... The lord of the tomb, Sesi, whom we can identify here, has suddenly collapsed, causing consternation among his household.
In the section below (to the left) is shown the wife who, struck by terror, has fainted and sunk totheflor. Two women attendants are seen giving her first aid. To the right, one observes the wife, holding on to two distressed servants, leaving the scene. . . .
von Bissing mentions that the artist of the relief must have been a keen observer of real life. This ancient Egyptian scene is not unlike the tragedy that one encounters in present days, when someone drops dead of a "heart attack." The physician of today has almost no other choice than to certify the cause of such a death as due to coronary occlusion or thrombosis, unless the patient was known tohave been aflictedwith rheumatic heart disease or with any of the other more rare conditions which may result in sudden death.
Atherosclerosis among the Ancient Egyptians
The most frequent disease of the coronary arteries, causing sudden death, is atherosclerosis. What evidence is available that atherosclerosis was prevalent in ancient Egypt?
The first occasion to study his condition in peoples of ancient civilizations presented itself when the mummified body of Menephtah (approx.1280-1211B.C.), the reported "Pharaoh of the Hebrew Exodus" from Egypt was found. King Menephtah had severe atherosclerosis. The mummy was unwrapped by the archaeologist Dr. G. Elliot Smith, who sent a piece of the Pharaoh's aorta to Dr. S. G. Shattock of London (1908). Dr. Shattock was able to prepare satisfactory microscopic sections which revealed advanced aortic atherosclerosis with extensive depositions of calcium phosphate.
This marked the beginning of the important study of arteriosclerosis in Egyptian mummies by Sir Mare Armand Ruffer, of the Cairo Medical School(1910-11). His material included mummies ranging over a period of about 2,000 years (1580 B.C. - 525 A.D.).
The technic of embalming in the days of ancient Egypt consisted of the removal of all the viscera and of most of the muscles, destroying much of the arterial system. Often, however, a part or at times the whole aorta or one of the large peripheral arteries was left behind. The peroneal artery, owing to its deep situation, frequently escaped the em- balmer'sknife. Otherarteries,suchasthe femorals, brachials, and common carotids, had persisted.
In some mummies examined by Ruffer the abdominal aorta was calcified in its entirety, the extreme calcification extending into the iliae arteries. Calcified plaques were also found in some of the larger branches of the aorta. The common carotid arteries frequently revealed patches of atheroma, but the most marked atheroselerotic alterations were in the arteries of the lower extremities. The common iliae arteries were not infrequently studded with calcareous plaques and in some instances the femoral arteries were converted into rigid tubes. In other mummies, however, the same arteries were near normal.
What is known as Mdnekeberg's medial calcification was also observed in some of the mummified bodies. In a histologic section of a peronieal artery, the muscular coat had been changed almost wholly by calcification. In one of Ruffer's photographic plates, a part of a calcified ulnar artery is shown. The muscular fibers had been completely replaced by calcification.
In the aorta, as in present days, the atherosclerotic process had a predilection for the points of origin of the intercostal and other arteries. The characteristics and the localization of the arterial lesions observed in Egyptian mummies leaves litle doubt that atherosclerosis in ancient times was of the same nature and degree as seen in today's postmortem examinations.
As to the prevalence of the disease, Ruffer ventured to say that the Egyptians of ancient times suffered as much as modern man from arterial lesions, identical with those found in our times. Ruffer was well qualified to make this statement having performed many autopsies on modern Egyptians, Moslems, and other people of the Middle East. In going over his material and examining the accompanying photographic plates of arteries, one can have litle doubt that what Ruffer had observed in Egyptian mummies represented arteriosclerosis as it is known today.
Although the embalming left no opportunity to examine the coronary arteries inl mummified bodies, the condition of the aorta is a good index of the decree of atheroselerosis present elsewhere. In individuals with extensive atheroselerosis of the aorta, there is almost always a considerable degree of atherosclerosis in the coronary arteries. If Ruffer's statement is correct that the Egyptians of 3,000 years ago were afflicted with arteriosclerosis as much as we are nowadays, coronary occlusion must have been common among the elderly population of the pre-Christian civilizations.
Furthermore, gangrene of the lower extremities in the aged has been recognized since the earliest records of disease. Gangrene of the extremities for centuries did not undergo critical investigation until Cruveilhier (1791- 1873) showed that it was caused by atherosclerotic arteries, associated at times with a terminal thrombus.
SUMMARY
The record of a sudden death occurring in an Egyptian noble of the Sixth Dynasty (2625-2475 B.C.) is presented. Because of the prevalence of arteriosclerosis in ancient Egyptian mummies there is presumptive evidence that this incident might represent sudden death due to atheroselerotic occlusion of the coronary arteries.
Cairo, Cairo Governorate, Egypt
945
B.C.E.
Cardiology in Ancient Egypt by Eugene V. Boisaubin, MD
Egyptians describe coronary ischemia: "if thou examinest a man for illness in his cardia and he has pains in his arms, and in his breast and in one side of his cardio... it is death threatening him."
The classic pattern of cardiac pain--radiation to the left arm--was so well known that the ancient Egyptians and Copts even identified the left ring finger as the "heart" finger.
Altogether, ancient Egyptians were aware of a variety of abnormal cardiac conditions, particularly of angina pectoris and sudden death, arrhythmia, aneurysm, congestive heart failure, and venous insufficiency. Numerous remedies for afflicitions of the heart are found throughout the Ebers payrus.
There were a range of them using different foods, some even including carbohydrates like dates or honey and dough, but interesting, there is another combination of "fat flesh, incense, garlic, and writing fluid".
Extensive histologic analysis of mummies began, however; well before the development of the scanning electron microscope. In 1912, Shattock' made sections of the calcified aorta of Pharaoh Merneptah; and the work of Sir Marc Armand Rufer, published posthumously in 1921, is our most valuable early source of information about vascular disease in ancient Egyptians. Ruffer was able to study a relatively large number of tissue specimens from mummies, mainly from New Kingdom (1600-1100 BC) burials, but covering a wide period of time. In a mummy of the 28th to 30th Dynasty (404-343 BC), he observed atheromas in the common carotids and calcific atheromas in the left subclavian, common iliac, and more peripheral arteries. Ruffer concluded from the state of the costal cartilage that this mummy was not that of an old person. A mummy of a man of the Greek period (ca. 300 to 30 BC), who died at not over 50 years of age, showed atheromas of the aorta and brachial arteries. Since the discoveries of Rufer, numerous other mummies, whose ages at death ranged from the 4th to the 8th decade, have shown similar vascular changes (Fig.4).
In 1931, Long described a female mummy of the 21st Dynasty (1070-945 BC), found at Deir-el- Bahari-that of the lady Teye, who died at about 50 years of age. The heart showed calcification of one mitral cusp, and thickening and calcification of the coronary arteries. The myocardium is said to have had patchy fibrosis, and the aorta "nodular arteriosclerosis." The renal capsule was thickened, many of the glomeruli were fibrosed, and the medium-sized renal vessels were sclerotic. The condition appears to be that of hypertensive arteriosclerotic disease associated with atheromatous change. In the 1960s, Sandison examined and photographed mummy arteries using modern histologic methods (Fig.5). Arteries in the mummy tissues were described as tape-like, but could be dissected easily, whereupon arteriosclerosis, atheroma with lipid depositions, reduplication of the internal elastic lamina, and medial calcification were readily visible under microscopy.
Still more recently, one of the most extensively studied Egyptian mummies has been PUMIL from the Pennsylvania University Museum(hence its initials), now on loan to the National Museum of Natural History at the Smithsonian. It is believed to be from the later Ptolemaic period, circa 170BC. The heart and portions of an atherosclerotic aorta were found in the abdominal cavity. Histologically, large and small arterioles and arteries from other organs showed areas of intimal fibrous thickening typical of sclerosis. These findings are particularly striking since the estimated age of PUM I at time of death was between 35 and 40 years.
