even enormously
stout, are seen with us than formerly, and fewer of the
"inordinately fat middle-aged people" in England than used to be
encountered. With us the over-fat are chiefly to be found among the
women of the well-to-do classes of the cities, and from thirty
years old onward. They persecute the medical men to reduce their
weight, and the vast number of advertisements of quack and
proprietary remedies against obesity indicate how wide-spread the
tendency must be.

Among women somewhat younger, as indeed among men, the American
observer whose recollection takes him back twenty-five years must
note a more hopeful change, a very decided average increase of
stature, not merely in height but in general development. This
change is to be seen throughout the whole country, and must be
taken first as a sign of improved conditions of food and manner of
life, and next, if not more largely, of the new interest and
partnership of girls in the wholesome activities of field and wood.

CHAPTER III.

ON THE SELECTION OF CASES FOR TREATMENT.

The remarks of the last chapter have, of course, wide and general
application in disease, and naturally lead up to what I have to say as
to the employment of the systematic treatment to describe which is my
chief desire. Its use, as a whole, is limited to certain groups of
cases. In some of the worst of them nothing else has succeeded hitherto,
or at least as frequently. In others the need for its application must
depend on convenience and the fact that all other and readier means have
failed. It is, of course, difficult to state now all the groups of
diseases in which it may be of value, for already physicians have begun
to find it serviceable in some to which I had not thought of applying
it,[11] and its sphere of usefulness is therefore likely to extend
beyond the limits originally set by me. It will be well here, however,
to state the various disorders in which it has seemed to me applicable.
As regards some of them, I shall try briefly to indicate why their
peculiarities point it out as needful.

There are, of course, numerous cases in which it becomes desirable to
fatten and to make blood. In many of them these are easy tasks, and in
some altogether hopeless. Persons who are recovering healthfully from
fevers, pneumonias, and other temporary maladies gather flesh and make
blood readily, and w