Obesity

Important as the hot water treatment is, the meat diet is far more so. The Salisbury treatment may be said to consist of two factors : first, the practice of taking a large amount of hot water on an empty stomach ; and second, confining the patient to lean flesh, preferably beef, minced or scraped to thoroughly break down and as far as possible remove the connective tissue. The leg or ham of beef — that portion usually sold as round or buttock steak — is the part preferred. It is recommended in the case of very delicate stomachs that the fat, gristle, and like parts be removed, and that the lean flesh be run through a meat-chopper two or three times to insure a thorough breaking down of the connective tissue. This minced meat should be loosely made up into round balls from half an inch to an inch or more in thickness, and three or four inches in diameter. Let a frying-pan be made very hot, and the meat balls placed in it, shaking the frying-pan to keep the meat from burning; when the surface has been browned, turn the ball over, cover- ing the frying-pan to keep in the steam, and set it back where the meat will cook gently but continuously. It should be cooked until all the red color has disappeared. A small portion of salt, and when desired a very little pepper, may be added. All persons taking this treatment who are not too stout are advised to add fresh butter to the meat ; and when the butter is salted no further addition of salt is necessary. When preferred, the meat cakes can be placed on a common grill or broiler, turning the grill often until the red has disappeared from the center of the balls. 

Mrs. Stuart prefers a preparation of stewed meat, as follows : In preparing beef for a Salisbury steak, a considerable portion of valuable meat must be discarded. This is utilized by slow and long boiling until the value of the meat is extracted in soup. Then to one and a half pounds of the minced meat add about a pint of the meat soup, which has first been allowed to cool and the fat removed. Add a little salt and pepper, and stew over a gentle fire until the redness of the meat has disappeared. It will be found that it is not necessary to boil the meat; boiling dissipates some of the valuable elements, and distinctly damages it, but it can be thoroughly cooked without boiling. Many people prefer this method of cooking to the broiled cakes, and it affords a variety to those who care for it. 

Most persons reading these directions for the first time will think at once that such a diet would be very repulsive and cloying to the appetite. Surprising as it may seem, a majority of those who confine themselves to this food come to relish it greatly, and not particularly to miss the lack of bread or other usual foods. It has long been known that hunger is the best sauce ; and when an adequate food is furnished to a hungry man, the food is relished, digested, assimilated, and passed off, leaving the system with a good appetite when the time comes for more food. 

It will be found by all persons who try this diet that it is not difficult if they resolutely abstain from the use of all other foods. If, however, they indulge themselves at the outset by tasting, in what may seem to be trifling quantities, other and accustomed kinds of food, the appetite for the beef is very likely to vanish, and the patient will find considerable difficulty in sticking to it. Fortunately, for all those not obese and who are not taking this diet largely for effecting a reduction of their weight, it is not necessary to be wholly confined, as Dr. Salisbury recommends, to the minced beef. We have found that all the conditions that may be obtained from a strict adherence to the beef and hot water regime are obtained by the addition of some food-fruits to this diet. These fruits may be dates, stewed figs, prunes, raisins, sultanas, and — when thoroughly ripe and of good quality before drying — peaches or apricots. If too much of this fruit be eaten it will cause acidity and flatulence ; on the other hand, if those persons confining themselves to the Salisbury diet will gradually add such food-fruits, they will find a distinctly better relish with the meals, the removal of more or less longing that is inevitable with those who are eating only the meat, and a greatly improved tendency toward the removal of constipation. 

At the same time, it must be borne in mind that to some patients there appears to be nothing so easily digested, that at the same time gives anything like so much nourishment and vitality, as the pulp of lean meat; and if the addition of fruits even when made cautiously produces flatulence, heartburn, or other evidences that there is fermentation instead of digestion, to such very weak stomachs it is best to rely for the time upon beef alone, and until the stomach is so far restored that such fruits may be safely added. 

The rationale of the beef and hot water treatment is easily understood; that of the hot water is already given. Health depends upon nourishment; a food may be rich in all the elements of nutrition, and yet be valueless to a person either because it is of itself unfitted to human digestion, or because the digestion of such person has been weakened by wrong habits, or by heredity, or by both, and is thus rendered unable to get nourishment from such ill-adapted food. All persons out of health, and all whose digestion is weak, and whose nervous system has been overstrained — and this classification includes vast numbers, a great majority in civilization — are in need of a food which will give greatest nourishment for the least expenditure of vital force. The lean meat of our domestic animals, and of some kinds of game, and especially that of beef, answers this demand in a remarkable degree. A good quality of beef or mutton, roasted or broiled, to the average stomach will be found quite easy of digestion, and is more conveniently obtained than the minced meat, though flesh that has been well chopped or minced has its connective tissue largely destroyed, and this connective tissue offers the chief obstacle in the way of digestion. This can also be broken down by continuous cooking for hours in succession. A simple method of accomplishing this is to put the meat into a covered tin or copper vessel, and place this in a large stewing vessel. Insert a piece of brick, coal or like substance between the bottom of the vessel containing the meat and the bottom of the stewpan or boiler; fill with water that will surround the inside vessel but not enter it; cover also the larger vessel, bring it to a boil, and keep it gently boiling for about five hours. No water is to be placed in the vessel containing the meat; and it will be found after long cooking that the connective tissue is substantially destroyed, the meat is exceedingly tender, its juices are all retained, and many of the advantages secured that result from mincing the beef. A good way of cooking such meat, also, is to boil in an ordinary boiler with but little water until thoroughly done — from four to six hours. In whatever way meat is cooked, skin, gristle, and indigestible lumps must not be eaten; these substances are very difficult to digest, and must be avoided. 

If this food be taken only in such quantities as the needs of the system demand, it will be found to be less liable to fermentation than most foods, and persons troubled with flatulence or any other evidence of a weakened state of the stomach and bowels will find this food especially favourable to the recovery of strength and vigorous digestive power. 

All persons who are at all corpulent, having more adipose tissue or fat than is natural, will find this diet of special value; and all such will do well to exclude, until they are reduced to a normal weight, the fat portions of the meat, and refrain from the use of butter or sweet fruits. A continuous exclusive diet of lean beef in quantities barely sufficient for the needs of the systern, with the addition of stewed tomatoes or spinach and a moderate amount of lettuce and like salads, is sure to reduce almost any obese person to their normal weight. When such weight is reached, butter and oil may be gradually added to the dietary, and also the food fruits. One great advantage of a diet composed of a moderate amount of animal flesh, as beef and mutton, and a considerable portion of the food-fruits — dates, figs, prunes, sultanas, apples, etc. — is that these fruits are distinctly aperient, and overcome the tendency to constipation which is quite sure to be induced by an exclusive meat diet. When for any reason these fruits are excluded from the dietary, recourse must be had to a mild aperient. A leading symptom by which to differentiate between health and illness is the color and appearance of the skin. Persons accustomed to a free use of cereals and starchy vegetables, when out of health are quite apt to have a pale or anaemic color, and a rough and blotchy skin. All such persons who will adopt the diet herein recommended will be gratified to see in a few weeks' time improvement in their complexion. A pink, healthy hue takes the place of the pale color, and the skin becomes soft and pliable. Many persons in middle life have more or less accumulations of dandruff in the head and hair, which is sometimes so plentiful as to need brush- ing from the clothes several times a day. This condition is frequently changed by the adoption of this diet, and sometimes entirely overcome.

In connection with this interesting and important discussion, the following observations by Tsclierwinsky arc referred to in Landois' "Textbook of Human Physiology." He fed two similar pigs from the same litter. 

No. 1 weighed 7,300 grammes ; 

No. 2 7,290 grammes. No. 1 was killed, and its fat and proteids estimated. No. 2 was fed for four months on grain, and then killed. The grain and excreta and the undigested fat and proteins were analysed, so that the amount of fat and proteins absorbed in four months was estimated. The pig then weighed 24 kilos. ; 11 was killed, and its fat and proteins were estimated : — 

No. II. contained 2.50 kilos. of albumen and 9.25 kilos. of fat 

No. I.                        0.94 „                                        „ 0.69 „ 

Assimilated            1.56 „                                        „ 8.56 „ 

Taken in in Food   7-49 „                                      „ 0.66 „

Difference            — 5.93                                      " +7.90"     

There were therefore 7.90 kilos, of fat in the body which could not be accounted for in the fat of the food. The 5.93 kilos. of albumen of the food which were not assimilated as albumen could yield only a small part of the 7.90 kilos, of fat, so that at least 5 kilos. of fat must have been formed from carbohydrates. Lawes and Gilbert calculated that 40 per cent of the fat in pigs was derived from carbohydrates. How the carbohydrates changed into fat in the body is entirely unknown." 

As has already been stated, the weight of evidence appears to be distinctly in favour of the conclusion that, in some way or other, the carbohydrates are capable of being converted into fat in the system ; but, in any case, the same result occurs, and they promote, either directly or indirectly, the deposition of fat within the body. 

The probability that lactic and other acids of the same class are formed in the body, chiefly or solely from carbohydrates, is drawn attention to by Parkes. "The formation of these acids is certainly most important in nutrition, for the various reactions of the fluids, which offer so striking a contrast (the alkalinity of the blood, the acidity of most mucous secretions, of the sweat, urine, etc.), must be chiefly owing to the action, of lactic acid on the phosphates or the chlorides, and to the ease with which it is oxidised and removed." We may conclude, then, that the carbohydrates by their capacity for rapid metabolism contribute largely to the production of heat and mechanical work, find also that their use greatly favours an increase in the constituents of the body, and especially of the albumen and fat. If we desire to increase the albumen without adding greatly to the store of fat, we should (according to Bauer) give a liberal allowance of albuminates with relatively small quantities of carbohydrates. But if we desire a substantial addition to the fat, the food should contain less albumen and more carbohydrates, with a fair proportion of fats.

The class of carbohydrates have much in common with the fats. They serve the same purpose of checking albuminous waste ; like them, they are resolved by combustion within the body, ultimately, into carbonic acid and water, and so, like the fats, are capable of yielding heat and mechanical work. Unlike the fats and the albuminates, however, they do not appear to enter into the structure of the tissues, although they are found in some of the fluids and organs of the body. 

All the carbohydrates are converted into glucose, or grape sugar (or maltose), before they are absorbed, and in this form they are much more readily metabolised than the fats or albuminates. 

It is believed by many, and the weight of evidence, as will be seen, is in favour of the conclusion, that carbohydrates can be converted into fat within the organism. Bauer,* however, is indisposed to accept this view. Basing his opinions on the experiments of Pettenkofer and Voit, who showed that carbohydrates, even when administered in great excess, are almost completely destroyed within the body, he maintains that although the carbohydrates, when given together with albumen and fat, favour an increase of the constituents of the body, and especially of fat, yet it is not because they are themselves converted into fat, but because, owing to the facility with which they are metabolised, they protect the other food-stuffs from destruction. 

"When fat and carbohydrates co-exist in the food, the latter are always the first to be consumed; and when they are present in sufficient amount, the consumption of fat in the body may be completely suspended." And he explains in a similar manner the fact that a deposit of fat may be observed to take place when the diet consists of albuminates and carbohydrates alone, without any fat; for in that case, he says, the fat, which "originates as a product of the splitting-up of albumen, is withdrawn from further metabolism in favour of the carbohydrates, and contributes to the gain." He also rejects the view that the ready decomposition of the carbohydrates in the body depends on their great affinity for oxygen; he considers it lies rather in the properties of the animal tissues, and he points out that the assumed equivalents of starch and fat, as 240 of the former to 100 of the latter, calculated on the quantity of oxygen required for their combustion, are incorrect; and that in the living organisms "175 parts of starch are in the material actions approximately equivalent to 100 of fat." 

Germain Sée begins by supporting the view taken by Bauer, and asserts that the principal function of the carbohydrates is the immediate development of heat and mechanical work ; that they are not annexed in any way directly or indirectly to the organisms ; and that the fat that is deposited in consequence of their use is derived from the splitting-up of albuminates. He urges the experiments of Boussingault, who found that when he fed ducks on a pure carbohydrate like rice, they grew thin; but on adding a small quantity of butter, they grew fat. The same experimenter also asserted that milch-cows only gave out the quantity of fat in their milk that was contained in their food. Sée also points out that the particular kinds of grain selected for fattening animals are always such as contain, like maize, a considerable quantity of fat. But, notwithstanding all this, he appears in the end to yield to the weight of evidence that fat may be, under certain circumstances, formed from carbohydrates. 

Dujardin-Beaumetz believes in the possibility of the transformation of glucose, the product of the digestion of carbohydrates, into fat. He sees a great analogy between the formula for glucose, C6H12O6, and that of glycerine, C3H8O3, and thinks that the latter may result from the splitting up of the former with the addition of hydrogen. He also shares, to a certain extent, Pavy's views, and considers that a portion of the glucose derived from the digestion of carbohydrates is deposited as " hepatic glycogen" in the liver, and thus furnishes the glucose necessary to the organism when the food does not contain any carbohydrates, Pavy maintains, as is well known, that saccharine matter, when absorbed, "on reaching the liver is transformed by that organ into amyloid sub- stance [glycogen], which is stored up in its cells for subsequent further change preliminary to being appropriated to the purposes of life." The occurrence of this "amyloid substance" in the liver, even when a purely animal diet has been taken, he accounts for by the supposition that the liver is the organ in which the splitting-up of the albuminates into urea and a non-nitrogenous substance occurs, and that the latter is metamorphosed by the liver into "glycogen." Pavy believes that carbohydrates are first converted into this "amyloid substance," and that this is afterwards converted into fat. But he points out what is doubtless a most important condition in the conversion of carbohydrates into fat, namely, "the co-operation of nitrogenous in conjunction with saline matter," for it is probably by the changes occurring during the metabolism of the albuminates that this transformation is excited. The presence of a small amount of fat with the carbohydrates would seem also to favour this conversion, for the rapid deposition of fat which sometimes occurs when animals are fed on such a mixture appears to be more than can be accounted for by the small quantities of fat ingested. Pavy dops not admit that any of the carbohydrates undergo direct oxidation in the system, or contribute strictly to force production.

Simple Rules for a Successful

Reduction Cure.

IT ALL DEPENDS ON THE DIET

Food Containing Sugar and Starch Must Be put aside - The Quantity of Food Eaten Is Not of Importance if the material is of the proper kind— Ice cream, potatoes, and bread must be abolished--  No water or Liquors at meals.

"This is the season of the year in which people who want to reduce their flesh would do best to begin," said a doctor who has made himself more famous in this particular field than any other American physician. "For one reason, there are fewer privations which the patient is compelled to endure now. Very few of the things that are delicacies at this time of the year are prohibited by a course of diet intended to reduce one's flesh. As a matter of fact, the forbidden articles are very few indeed, so surprisingly few that I always wondered why people look upon a course of banting as a hardship. Practically the only spring vegetables which should not be eaten are potatoes, beets, and peas, and no fruits are on the proscribed list.

"Patients who come to me receive one invariable prescriptlon. All fat comes from the same natural cause, and can be made to disappear in the same way.

I never can give any medicine beyond what is needed to put the patient in a state of good natural health. After I have accomplished that the reduction begins by following a method so publicly known that there is no reason why I should hesitate to reveal its use in my own case. It is wrong to say that only by a regimen of eating can a person's flesh be reduced. What is drunk has quite as much to do with the result. 

"I begin by refusing to allow my patients to eat anything containing either starch or sugar. Bread must first of all be given up. There is enough fat-making material in one breakfast roll to counteract the effects of mineral water treatment taken for months. Bread must absolutely be kept off the bill of fare of any one who wants to get thin. Sometimes very dry toast may be eaten in very small quantities, but nowadays there are excellent substitutes for bread provided, and th ese are quite as toothsome if a person can only break himself for a while of the feeling that he must accompany every meal abundantly with rolls or crackers, as the case may be. The new breads made without any starch are, of course, admissible, because if they are what they pretend to be there can be no fattening substance in them.

"The bread out of the way, one great step has been accomplished. Sugar must follow, and the substitutes for that are so nearly the same in effect that nobody should mind taking saccarine in coffee, instead of several lumps of sugar. It is in puddings, pies, and other similar combinations of flour and sugar that these two substances are most missed, but all pastry, puddings, and desserts of any kind in which sugar is employed are forbidden. Sugar and starch must be left alone. And this includes all corn bread and similar bread foods made of flour, cornmeal, and similar substances.

All Liquors are Fattening.

"With practically no other foods forbidden, it is possible for a person to lose as much as five pounds a week by following the rules outlined. I have known thirty pounds to be lost in six weeks on this sort of a regimen. All meats, all kinds of fish, except salmon, and all vegetables, except beets, peas, lima beans, and potatoes, can be enjoyed. Liquor must in nearly every form be left entirely alone. Beer is, of course, so fattening hat no one with any idea of reducing his weight would ever touch it, and some other alcoholic drinks are very nearly as bad. Whisky is very fattening, and so is champagne. Such concoctions as cocktails, all kinds of punches, and other mixed drinks put on more fat that years of diet could take off. There is no hope in a reduction diet for the person who continues to take alcohol. Candles, of course, and sweets should never be touched, while ice cream and similar edibles are just as high up on the forbidden list.

"This practically completes the entire cure. One need only observe carefully these rules of diet to lose flesh certainly and quickly. More than that, such a selection of food would improve the patient's general health. Abstinence from starch and sugar is known to cure many bad cases of indigestion, and I don't believe there ever was a person following such a course that did not feel better for it. Wine in small quantities and usually white in color, and rather dry in quality, may be taken with a meal, but water."

How to Reduce Flesh

A man or woman who feels that flesh accumulating too rapidly may lose it by drinking sassafras tea, either cold or hot, with or without sugar, as the taste demands. There might be conditions of the system when it might be injurious, however, and it would be better to consult a doctor before using it. A strong infusion may be made of one ounce of sassafras to a quart of water. Boil half an hour very slowly, let it cool, and keep from the air.

A perfectly safe way to get thin is to eat chopped meat without any potatoes. Drink as little as possible of any fluid. Exercise a great deal without drinking and if possible eat no bread, butter, or sweets. Lemonade, acid drinks of any kind, a little strong tea and saline mineral waters will assist you, but of thees take only as little as possible. Start the morning by drinking a glass of clear water.

How to Increase Flesh

Thin people who wish to get stout should eat oatmeal, hominy, or any of the preparations of wheat now sold. Wheat rolls, corn mush, cream, chocolate, milk, sugar, omelets, jams, eggs, potatoes, bacon, and all other fattening foods.