action on the vascular system, and because they strongly excite diuresis
through their low temperature and contained carbonic acid; Carlsbad
deserves preference only when obesity is combined with uric acid
calculi, or with diabetes. For very anaemic persons, however, the weak
alkaline and saline waters should be selected; or they should confine
themselves to chalybeate waters containing an excess of sulphate of
soda. Water containing sulphate of soda is also indicated as a beverage
where there are troubles of the circulatory apparatus; it is
contraindicated only in accentuated arterio-sclerosis.

As a matter of fact, I find the suggestion of M. Dujardin-Beaumetz,
that the obese should be divided into two groups, a most practical one,
for some are strong and vigorous--great eaters, perhaps even
gluttons--while others, on the contrary, are feeble and debilitated,
with flesh soft and flaccid; and upon the former may be imposed all the
rigors of the reducing system, while the latter must be dealt with more
carefully.

In general, it must be noted, the regimen prescribed for the obese is
insufficient, as the following table prepared by M.C. Paul abundantly
proves:

-------------------------+----------+----------+---------------
Author. |Albuminous| Fatty |
| Matters. | Matters. | Hydrocarbons.
-------------------------+----------+----------+---------------
Voit. | 118 | 40 | 150
Harvey-Banting. | 170 | 10 | 80
Ebstein. | 100 | 85 | 50
Oertel. | 155-179 | 25-41 | 70-110
Kisch (plethoric). | 160 | 10 | 80
" (anaemic). | 200 | 12 | 100
Normal ration. | 124 | 55 | 455
-------------------------+----------+----------+---------------

There is, therefore, as Dujardin-Beaumetz asserts, autophagia in the
obese, and all these varieties of treatment have but one end, viz.:
Reduction of the daily ration. But the quantity of nourishment should
not be too greatly curtailed, for, manifestly, if the fat disappears the
more surely, the muscles (rich in albumen) undergo too rapid
modification. It is progressive action that should always be sought.

The quantity of aliment may be reduced either by imposing an always
uniform regimen, which soon begets anorexia