"A fat person, at whatever period of life, has not a sound tissue in his body: not only is the entire muscular system degenerated with the fatty particles, but the vital organs--heart, lungs, brain, kidneys, liver, etc.,--are likewise mottled throughout, like rust spots in a steel watch spring, liable to fail at any moment. The gifted Gambetta, whom M. Rochefort styled the fatted satrap died--far under his prime--because of his depraved condition; a slight gunshot wound from which a clean man would have speedily recovered ended this obese diabetic's life. Events sufficiently convincing are constantly occuring on both sides of the Atlantic; every hour men are rolling into ditches of death because they do not learn how to live. These ditches have fictitious names--grief, fright, apoplexy, kidney troubles, heart disease, etc.,--but the true name is chronic self abuse."

Fortunately there is a considerably greater apprehension in the public mind now than a few years ago as to the evils of growing fat. The writings of Mr. Banting, an enthusiastic layman who was greatly helped by a reduction of obesity, and whose interest in his fellow men prompted him to make as widely known as possible some thirty years ago his method of cure, has done much to dispel dense ignorance concerning this topic; and in more recent years the illness of Bismarck, and his restoration through the reduction of his obesity, was also a great help to spread knowledge on this most important subject. 

The exciting cause of obesity is the ingestion of more food that the system requires, together with the weakening of the excretory organs, which results in the failure of the system to adequately throw off its waste matter. But the profound and primal cause of obesity will one day be recognized to be the use of cereal and starch foods. An obese person weighing two, four or six stone, twenty-five, fifty, or eighty pounds, or even a still larger amount, more than is natural, may be given a diet of flesh with water with or without the addition of starchless vegetables, as lettuce, watercress, tomatoes, spinach, and the like, excluding bread, pulses and potatoes, and the patient will be gradually but surely reduced to his normal weight. As soon, however, as the patient returns to his usual diet of bread and potatoes he straightway begins to increase in weight; and while an obese patient can easily be reduced eight pounds per month when placed upon a flesh diet, he will gain fully this much or more upon returning to a free use of bread and starch vegetables. If this patient who has been reduced, and who has again developed obesity, is persuaded to again adopt the exclusive flesh diet, again the reduction is sure to take place; and in the course of our practice this process has been repeated among many patients, and in a few a reduction and return to flesh has been repeated three times. It is plain from such demonstrations that without starch foods corpulency would not exist. Chemically starch foods are chiefly carbon; adipose tissue is also carbon, and it would naturally be expected that a diet of oil and the fat of animal flesh would contribute quite as much to obesity as bread and starch foods. But experience proves that such is not the case. The reason for this is not, in the present state of science, understood; it will likely be found in the fact that starch foods undergo a complicated process of digestion, whereas oils require only emulsion to render them assimilable by the system. 

The courage and strength of conviction possessed by the average family doctor is curious to behold. It will be found to be inversely to the ratio of his knowledge. The less conversant he is with this malady the greater confidence he seems to have in his opinions. During the years that we were in practice some hundreds of patients came to us for assistance in this trouble, a large number of whom were under the control of their family physician. Many of these patients came in defiance of the express orders of their physicians; and while they had assumed courage enough to disobey their orders and come to us, they needed much encouragement to enable them to proceed with any confidence. They were usually told by their medical advisers that in them it was natural to be stout, that they had "better leave well enough alone," and the direst results were prophesied in the event that they had the temerity to proceed. In point of fact these patients quite invariably experienced nothing but the happiest results. many of them came out of an interest in their personal appearance; finding their figures destroyed and their beauty going, they desired restoration to their youthful form and feature. Others, again, were annoyed at clumsiness in getting about, shortness of breath in climbing stairs, and the general awkwardness and inconvenience that result from this "too, too solid flesh." Only a small proportion of these patients came from a knowledge that obesity is a disease, that it encourages other states of inflammation and other diseases, and that its reduction is a great aid in the return of health. But while thees patients as a rule did not come to us with this expectation, it was common for them to testify to geat benefits that had resulted from their treatment. These benefits were quite frequently greater than the patient would readily admit or remember. It was our custom, with all patients beginning treatment, to take the name, age, height, weight, and a list of the infirmities, if any, from which they were suffering. These details were elicited by a series of questions, and the answers duly recorded. Out of sight out of mind is the old adage; and human beings are fortunately so conditioned that when their aches and pains have taken flight they forget not infrequently that they were ever present. many of these patients would have stoutly denied the benefit rendered but for the diagnosis taken at the beginning of treatment, and a reference to wich only would convince them of the coniditon they had been in.