ent painful attacks of gout.

OBESITY

~Causes.~--Heredity, overeating, unbalanced diet, chronic alcoholism,
and disturbed metabolism, as manifested in gout and other pathological
conditions.

~Cures~ are more or less of a risk, except when undertaken upon the
advice and under the care of a competent physician. As a rule they are
too strenuous to be carried out alone and are of no good unless
persisted in. Among the best known obesity cures may be mentioned
those formulated by Banting, Oertel and Ebstein.

Most physicians have their own methods of treating obesity, but all
are based primarily on diet and exercise.

~Food~ is the chief cause of obesity and since some foods are more
readily converted into adipose tissue than others, it is necessary to
understand the behavior and functions of the various food combinations
in the body before it is possible to say which are the offending
articles of diet.

~Water~ has no fattening properties of its own. This is proved by a
glance at its chemical composition, but as it acts as a distributor
and carrier of food to the various parts of the body and since the
bulk of all the secretions is composed of water and every tissue in
the body stores this fluid, thus adding to the weight, a consideration
of the intake of water for obesity patients is most essential.

~Appetite~ requires attention. The majority of obese patients eat more
than their energy output calls for, consequently it is necessary to
curb the appetite and increase the energy output in order to utilize
the material on hand in the form of adipose tissue.

~Exercise~ is absolutely essential in order to force the body to burn
up its surplus fat as fuel. The best form of exercise is that which is
taken out of doors. The well-worked muscle is heavier than one which
is unaccustomed to exercise. The latter is infiltrated with fat and
weighs less than muscular tissue, but a muscular body can endure more
than one which is covered with adipose tissue.

~The Heart~ of obese patients becomes more or less affected as obesity
advances and it becomes absolutely necessary in many cases to get rid
of some of the surplus fat in order that the patient may live. This is
best accomplished by dietetic treatment.

~Circulatory Changes~ likewise occur as the heart becomes affected,
making it necessary to institute some dietary measures at once.

~Glycosuria~ in obese patients suffering from gout is not at all
unusual and to re