Recent History
September 23, 1849
Jean-Francois Dancel
Obesity, Carnivore, Keto
Obesity, or, Excessive corpulence: the various causes and the rational means of cure
A 26 year old lady suffering obesity uses Dr Dancel's advice of an exclusive meat diet to lose at least 15 pounds.
A lady, residing in the town of Montereau, wrote to me in the early part of September, 1849. She was twenty-six years of age, and weighed one hundred and seventy pounds. Her corpulence was increasing to such an extent that she would soon be unable to attend to her household duties. She wished to know if my system of treatment would interfere with her general health, and whether it would prevent her pursuing her usual and indispensable daily avocations. On receiving the necessary explanations, she immediately placed herself under my care, and upon the 23rd of the same month, she informed me that her weight was already considerably less, but that her size remained about the same. A letter of the 12th October following states that she has lost fifteen pounds weight, and that her size is materially diminished. The treatment was continued for some time longer, and never caused the least interference with the discharge of her domestic affairs.
March 3, 1850
Jean-Francois Dancel
Obesity, Carnivore, Keto
Obesity, or, Excessive corpulence : the various causes and the rational means of cure
Dr Dancel explains his third case of obesity cured through meat diet. She wrote after seventeen days trial of the system:—"My corpulence is perceptibly diminished, and I am no longer afflicted with drowsiness after meals. I follow rigidly the instructions you have given me, and each day feel more deeply indebted to you."
In the course of the following year I received a communication from Widow Rollin, of Versailles, stating that she is the only support of a large family, which necessitates great exertions on her part: that a daily increasing corpulence with most troublesome abdominal enlargement gives rise to the most serious anxiety as to the future. Provided no interruption in her daily duties be required she would cheerfully submit to my treatment. She wrote after seventeen days trial of the system:—"My corpulence is perceptibly diminished, and I am no longer afflicted with drowsiness after meals. I follow rigidly the instructions you have given me, and each day feel more deeply indebted to you. At the end of the month I shall do myself the honour of calling upon you, as it is my wish to continue under treatment until entirely freed from my encumbrance. I can now walk with ease, which was for a long time an impossibility. The pain in the loins has likewise disappeared."
November 11, 1850
Jean-Francois Dancel
Obesity, Carnivore, Keto
Obesity, or, Excessive corpulence : the various causes and the rational means of cure
Towards the latter end of 1850, the wife of Dr. Pecquet, of Paris, purchased my work on Obesity. Having read it, she spoke to her husband about it, who said that, like most medical men, he was persuaded that the only way to reduce corpulency, is to eat less than the system demands. "Eighteen years of suffering and misery, in spite of every medical aid which has been bestowed upon me!" She then lost 100 pounds by eating more meat and less vegetables.
Towards the latter end of 1850, the wife of Dr. Pecquet, of Paris, purchased my work on Obesity. Having read it, she spoke to her husband about it, who said that, like most medical men, he was persuaded that the only way to reduce corpulency, is to eat less than the system demands.
Madame Pecquet, then about sixty years of age, had long been troubled with excessive corpulency, and weighed two hundred and fifty pounds. She had, in consequence of this affliction, passed the greater part of the last eighteen years either in her arm-chair or in bed. According to some of the most celebrated physicians of Paris, and also of her husband, her disease at one time was said to be pulmonary catarrh—at another time, disease of the heart—and again, something else; till at length Madame Pecquet had no rest, day or night.
If she attempted to go to sleep in the horizontal position, she was immediately troubled with a rush of blood to the head, accompanied with the most distressing hallucinations, which utterly prevented her from sleeping. She was unable to take exercise on foot, even when her ailments allowed her any respite, owing to the excessive pain she experienced in the region of the kidneys, and the abundant perspiration of the head, which a walk of even a few steps was sure to induce. It was consequently impossible for her to go out, unless in a carriage. Those only who are unable to enjoy this pleasure, know how great a privation it is not to be able to take a walk on a fine day, and how wearisome it is to be compelled to make use of a carriage in order to enjoy the advantages of fresh air, or to move from place to place.
Madame Pecquet was so situated, and many a time she has said,—"Eighteen long years have I been in this condition! Eighteen years of suffering and misery, in spite of every medical aid which has been bestowed upon me!" Under these circumstances, we can readily understand how anxiously she must have sought a means of cure. One day, without the knowledge of her husband, she took a carriage, and called to consult me.
Those who believe as I do, that an excessive development of fat may induce and sustain a generally diseased condition of body, will readily admit that the diminution of excessive obesity is the only rational means of cure in such a case.
Impressed with this idea, Madame Pecquet called upon me, and placed herself under my care. I prescribed some medicine, which she took without the knowledge of her husband, who, although eating at the same table, did not perceive that she partook of less vegetables and ate a larger quantity of meat than usual. Having continued the treatment four months, Madame Pecquet said to her husband,—"I have been following the anti-obesic treatment, and weigh at the present time one hundred pounds less than I did before commencing it. Formerly I was confined to my arm-chair, in consequence of catarrh or something else. I could not walk fifty yards without stopping to take breath; and now I can go out every day if I please, when the weather is fine. Night, formerly so wearisome, is now a season of delightful and refreshing repose; and, in fine, I have recovered my health, after eighteen years of continued suffering."
I again met this lady last year, and found her in the enjoyment of perfect health. She had not regained her embonpoint, but was in all respects perfectly happy, and gratefully ascribed her recovery to my system of treatment.
November 24, 1850
Jean-Francois Dancel
Obesity, Carnivore, Keto
Obesity, or, Excessive corpulence : the various causes and the rational means of cure
Dancel cures obesity over and over again in Madame K. "On the other hand I recommended her food should consist of meat principally." Dancel notices that early weight loss benefits the patient substantially and would use the "full meat diet" to achieve results quickly.
The following letter has been also received:
"Saint Dié, 24th Nov., 1850.
"Sir,—Having read your book on the treatment of obesity, I wish to ask if you will undertake my case, although living at a distance of three hundred miles from Paris. I am fifty years of age, and possessed of a vigorous constitution. Since I have retired from business, now ten years ago, I have steadily increased in corpulence; my present weight being one hundred and eighty-nine pounds. I am troubled with an affection of the heart, shortness of breath, and my legs swell, especially when not taking much exercise on foot. I am not fond of walking, since it induces great fatigue. My belly has become much enlarged, and I am greatly troubled with drowsiness. For breakfast I use coffee with milk, although I am not fond of it, but I find that it prevents headache, to which I am otherwise subject, &c. You will oblige me by sending the necessary instructions, if you can take charge of my case, by the bearer of this letter, together with such medicines as you may direct.
"Yours, &c. K."
In answer to Madame K., I sent her the medicine, together with the necessary information. On the 25th of February I received a letter, from which the following extracts are made:—
"Your directions have been scrupulously observed for the past fifteen days. I take a daily walk in the mountains, and to-day was weighed. I have lost but four pounds: too small a reduction I fear; but perhaps due partly to my temperament. The medicine requires to be taken in larger doses, I think. Nevertheless I am well satisfied with the result thus far, being now free from those troublesome palpitations of the heart to which I have been hitherto subject."
The 9th of April following this lady wrote: "My legs do not swell as they used to do, and the palpitations have ceased. I am delighted with this good result of your method of treatment."
Nothing more was heard of Madame K. until the month of August in the following year. She then writes that in accordance with the advice of the medical men of Saint Dié, she, together with her family, went to take the waters of Plombières. That on her return her legs were again swollen, and that she suffered from palpitation of the heart, which gave rise to a choking sensation. She was desirous of again undergoing the anti-obesic treatment. On the 30th of September following she wrote that she had followed my instructions during the last three weeks, and had lost only four pounds in weight; but added, I have obtained a much more valuable result, and that is, the almost total release from my troublesome heart palpitation. I have not since heard from this lady, but I have no doubt that she has been once more cured of her palpitation, and that she is no longer troubled with swellings of the feet and legs. The loss of fat in this case has been attended with freedom from palpitation of the heart, from shortness of breath, and from swelling of the lower extremities. What explanation can be given as to the cause of these results? As to her ailments, did they arise from an excess of blood in the system, or was she suffering from cardiac disease? Physicians thought so and bled her, administered sedatives and alteratives, and restricted the diet of the patient. Still they did not cure her. On the other hand I recommended her food should consist of meat principally; that she should be allowed strong coffee and wine; which, together with the employment of alkaline remedies, reduced her fat and effected a cure. The following season she goes, together with her family, to the springs, and returns thence afflicted in the same way as before, and again my mode of treatment produces the same result.
It is manifest that this heart affection, this shortness of breath, depended upon obstruction to the heart's action, and not upon any excess of blood in the system, since I abstracted no blood, but on the contrary, administered stimulants, together with the use of full meat diet. The swollen limbs arose no doubt from a partial portal obstruction, and ceased when the reduction of fat was effected. It may be urged that the patient was better, or even cured, of heart palpitation, before she had lost much in weight. She had lost, however, four pounds; and four pounds of fat occupy a large space. The fat in a living body is fluid and very light. A pound, therefore, is a large quantity. When a person begins to lose his corpulency, the reduction takes place first in the interior of the body, and consequently there is a great improvement during the first six or eight days in the general health of obese patients, when treated in accordance with the principles now advocated.
April 12, 1851
Jean-Francois Dancel
Obesity, Carnivore, Keto
Obesity, or, Excessive corpulence : the various causes and the rational means of cure
Mr. Roberts uses Dancel's Carnivore Diet: "I weighed two hundred and six pounds, and now weigh only one hundred and ninety-two. I am delighted with the success which has attended your system of treatment, and am happy to be able to inform you of it. Accept my sincere thanks."
On the 12th of April, 1851, I received a letter from Mr. Roberts, of Tours, in which he says:—"I am twenty-seven years of age, and weigh two hundred and six pounds. I fear that my great corpulence, which is constantly on the increase, may prove exceedingly troublesome. Having read your book, I am resolved to give your method of treatment a fair trial. You will oblige by giving me an explicit and detailed statement as to what is necessary to be done, and by sending from Paris such medicines as may be necessary."
On the 22nd of the same month Mr. Roberts wrote as follows:—"I weighed two hundred and six pounds, and now weigh only one hundred and ninety-two. I measured forty-three inches in circumference, and now only thirty-one inches. I am delighted with the success which has attended your system of treatment, and am happy to be able to inform you of it. Accept my sincere thanks, for I am indebted to you for a condition which I despaired of ever again attaining. Yours truly,
"Roberts."
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.
