l quantities, and then
preferably in the form of toast. Cheese likewise contains too much fat;
and mushrooms are so rich in hydrocarbons that they should be rejected.
Condiments, water, vegetable acids (vinegars excepted) may be permitted;
especially pernicious is vinegar where there is any tendency to gout or
gravel. All fatty beverages--_bouillon_, unskimmed milk, chocolate, or
cacao--and all alcoholics, are hurtful; breakfast tea is undoubtedly the
best beverage, but, after a little, is advantageously replaced by light
white wine diluted with water.

Kisch believes in a free and abundant use of water by the obese,
especially where there is a tendency to plethora, since this fluid
facilitates oxidation as the result of absorption; thus he advocates the
inhibition of large quantities of cold water by all, save those
presenting evidence of cardiac insufficiency. In short, his regimen is
based upon the administration of a large quantity of albumen, like that
of Harvey-Banting.

E. Munk recommends an almost identical dietary, save that he prefers
great moderation in fluids employed as beverage.

M. Robin has sought to harmonize the opposing views regarding fluids,
and therefore declares obesity arises from two distinct sources: 1.
Augmentation of assimilation. 2. Reduced disassimilation. In the former,
he insists water must be interdicted, while in the latter it may be
allowed _ad libitum_.

Again, in order to recognize the exact variety of obesity, he divides
his patients into three classes, each recognizable by the volume of urea
excreted. In the first there is an increase above normal; in the second
the volume of urea is stationary; in the third decreased, increased, or
stationary.

When the urea is stationary, which is most frequently the case, it is
necessary to calculate the coefficient of oxidation; that is, the
relation existing between the solid matters of the urine and the urea.
The elevation of the coefficient is _prima facie_ evidence the obesity
is due to excess of assimilation, while depression of the coefficient
indicates default of assimilation. In the first case, water and liquids
must be denied as far as possible, the same as if there was no
augmentation of urea; in the second, the same as if there was diminution
of urea, the patients may be permitted to imbibe fluids at pleasure.

For the obese from default of disassimilation, Robin recommends a
regimen of green vegetables and bread chiefly--the