Part 9. Technique of Reduction Cures and Gout

Contents

The archive kept this book’s contents page but not its chapters. Each section is listed with the first lines it opened with.

1. Note By The American Editor For Technique Of Reduction Cures And GoutThe principles enunciated in the preceding volume of this series relative to the treatment of leanness apply with equal force to the treatment of obesity. In fattening cures the caloric intake should ...
2. Part I. Technique Of Reduction Cures. I. Genesis Of ObesityI will limit myself to a very brief discussion of the factors that lead to obesity. It is necessary, however, to indicate the main rules that should govern the treatment of obesity, for a careful unde...
3. a. Obesity from Overfeeding - Genesis Of ObesityThe Consumption of Energy Remains the Same, but the Food Intake Increases.-For one or the other reason, as I will illustrate later on by specific examples, more nourishment than is really necessary is...
4. b. Obesity from Lack of Exercise - Genesis Of ObesityThe Intake of Energy Remains the Same, but the Consumption of Energy Decreases.-As indicated above, the desire for food and the actual intake of food under altogether normal conditions correspond to t...
5. c. Constitutional Obesity - Genesis Of ObesityWe may consider it as established that in most obese people the amount of energy consumed pro kilo of protoplasm is altogether normal, and that there is no retardation of the metabolism. Overfeeding...
6. II. Indications For Reduction CuresI intend to discuss the indications for an obesity cure very briefly, because this subject has been thoroughly discussed in another monograph of this collection (Vol. 1, 1900). Must a reduction cure ...
7. III. Reduction CuresFrom all that has been said it is clear that obesity may be due to a great variety of causes. Before any plan of treatment is formulated the habits of life of the patient must be carefully and exactly...
8. I. Diet - Reduction CuresIn all cases of progressive obesity the intake of food is greater than the output of energy, and the problem to be solved is to arrange a proper proportion between the two. As soon as this is accompli...
9. a. The Three Degrees of Reduction Cures - Diet - Reduction CuresFor practical reasons I distinguish three degrees of reduction diet. I have utilized the above example to illustrate my meaning: Maintenance diet calculated as 2500 calories. I. Degree of reduction ...
10. b. Restriction of Fats or Carbohydrates - Diet - Reduction CuresThe diet calls for almost complete exclusion of fats; and the fat intake can be reduced without difficulty to 30 g. of fat a day. The fat ration cannot very well be reduced below this point, as otherw...
11. c. Proteid Ration - Diet - Reduction CuresThe diet moreover contains relatively abundant albuminous pabulum (meat, eggs, cheese). I consider it advisable to begin with about 120 g. of albumen a day and then gradually to increase the albumen i...
12. d. Water Intake - Diet - Reduction CuresSo far nothing has been said in regard to the water intake. This question has already been discussed at length in a previous volume of this collection (No. IV). I have for a long time been combating t...
13. e. Measuring Glass and Balance - Diet - Reduction CuresIn order to properly carry out a reduction cure of the III. degree, often even of the II. degree, measuring glass and balance must be employed. Without these aids errors will constantly creep in on th...
14. f. Warning Against Routine Methods - Diet - Reduction CuresI have emphasized above that in formulating regulations of a dietetic character intended to counteract obesity no definite schematic plan should be followed. Any one who has familiarized himself with ...
15. 2. Muscular Exercise - Reduction CuresAside from the arrangement of a suitable diet, the most important task in reduction cures is insistence upon a sufficient amount of muscular exercise. We possess no better, more certain, or more readi...
16. 3. Mineral Water Cures - Reduction CuresThere are many watering places in which fat people congregate every summer in order to undergo a reduction cure. In Europe Homburg, Carlsbad, Kissingen, Marienbad enjoy the greatest reputation. It is ...
17. 4. Hydrotherapy - Reduction CuresAmong hydrotherapeutic measures sweating, that is, for instance, the Turkish-Irish bath, and steam baths, are most popular as reducing means. Electric sweat baths are also very popular. As a matter of...
18. 5. Thyroid Therapy - Reduction CuresI mentioned in a previous chapter that there are cases of obesity due not to eating an extraordinarily abundant diet of a fattening character nor to performing an exceptionally small amount of muscula...
19. Part II. Gout, Nephrolithiasis Urica and Their TreatmentI. Definition Of Gout In the case of gout one is confronted with difficulties in attempting to formulate any exact definition of the disease. We know that in this disorder the fate of uric acid diffe...
20. II. On The Place Occupied By Uric Acid In The Metabolism Of GoutIn regard to the ultimate cause of gouty disease and the manner in which the fate of uric acid is determined thereby, we know essentially nothing. For the present we are limited in our studies of gout...
21. 2. Sources of Uric AcidOnly those substances that contain the purin nucleus discovered by E. Fischer can be considered sources of uric acid. From this purin nucleus are derived in addition to uric acid the bases adenin, hyp...
22. 3. Uric Acid Factors in GoutOur positive knowledge in regard to the metabolism of uric acid in gout is very scanty. I will not enter into a detailed discussion of this subject but will limit myself to a statement of the most imp...
23. a. The Diagnostic Significance of Uric Acid EliminationIn all those diseases that can be confounded with arthritis urica the elimination of endogenous uric acid is not so low as in chronic gout. There is one exception to this rule, namely, very old age. H...
24. b. The Therapeutic Significance of Tolerance DeterminationsThree years and a half ago I called attention to the therapeutic importance of tolerance determinations in gouty subjects in a little monograph that I published together with my former assistant, L. S...
25. III. The Dietetics Of Gout And Nephrolithiasis UricaJust as the physician who prescribes a diet for a diabetic should know the carbohydrate percentage of the different foods that he allows, so any one who undertakes to treat gout rationally should know...
26. 2. Purin-containing Foods - The Dietetics Of Gout And Nephrolithiasis UricaAside from the exceptions enumerated above, animal tissues alone need be considered as purin containing substances that lead to the production of exogenous uric acid. In the tissues the purin bodies a...
27. 3. Concerning Alcohol - The Dietetics Of Gout And Nephrolithiasis UricaI am no foe of alcohol, and I consider the use of moderate quantities of alcoholic beverages not only permitted, but often even useful. In patients, however, that have a tendency to uric acid retentio...
28. 4. Composition of the Diet - The Dietetics Of Gout And Nephrolithiasis UricaIn diabetes mellitus I proposed to divide the diet into two groups, and this plan has been almost universally adopted. 1. Main diet, carbohydrate free No restrictions in regard to the quantity; that...
29. Main DietA suitable arrangement of a Main Diet would be the following: Breakfast - Main Diet Milk, or coffee with milk, milk-cocoa or chocolate. Porridge made from oatmeal, Grape Nuts, or hominy, or green...
30. 2. Accessory DietA certain amount of meat or fish is permitted as an addition to the above diet, a great deal depending upon the individual peculiarities of each case. The unit, quantitatively, is 100 g. of roast beef...
31. 5. Mineral Waters and Drugs - The Dietetics Of Gout And Nephrolithiasis UricaWhereas, heretofore gout and nephrolithiasis could be discussed from a uniform standpoint, this cannot be done in discussing the use of mineral waters and drugs in these two disorders. For by means of...
32. b. - Nephrolithiasis UricaIn the case of uratic renal concretions conditions are altogether different. Here an endeavor must be made to reduce the production of uric acid to a minimum, as in arthritis urica, and in addition to...
33. 6. Remarks on Leanness and Obesity in Gout - The Dietetics Of Gout And Nephrolithiasis UricaGout occurs both in individuals with abundant and with scanty adipose tissue. In the latter group gout is decidedly less frequent; it is particularly that form of gout which is produced by chronic lea...