iminate phosphate in excess, when an
oxidating treatment will not only fail, but prove positively injurious.

The bile throws out fat, therefore, to accelerate nutritive oxidations,
the liver and nervous system must be acted upon, _i.e._, stimulated.
Everything that tends to diminish the activity of the former, or depress
the latter, must be avoided. Hence intellectual labor should be
encouraged, or in lieu thereof, travel advised. Exercise should be taken
chiefly while fasting; the limits of sleep confined to strict necessity,
and _siestas_ after meals and during the day strictly forbidden; the
skin stimulated by hydro-therapeutic measures, including massage under
cold affusions, during warm salt baths, etc.

To increase the activity of the liver, salicylate of soda may often be
advantageously administered for its cholagogue effect; or resort may be
had to saline purgatives such as are afforded by the springs of
Marienbad, Kissengen, Homburg, Carlsbad, Brides, Hunyadi, or
Chatel-Guyon; and it is somewhat remarkable that while undergoing a
course of these waters, there is often no appreciable change in weight
or obesity, though the decrease becomes most marked almost immediately
upon cessation of treatment.

Everything tending to increased or fuller respiration is to be
encouraged, for the fats are thus supplied with oxygen, hastening their
disintegration and consumption.

Direct medicinal treatment presents no very wide scope. Bouchard
imagines lime water may be useful by accelerating nutrition, but this is
problematical, since fat in emulsion or in droplets does not burn.
Nevertheless, alkalies in general, alkaline carbonates, liquor potassa,
soaps, etc., aid in rendering fat more soluble, and consequently more
susceptible to attack. The alkaline waters, however, are much less
active in obesity than the saline mineral waters, unless, as sometimes
happens, there is a complication of diabetes and obesity.

Purgatives are always more or less useful, and often required to be
renewed with all the regularity of habit. Then too, the iodides,
especially iodide of sodium or potassium, as recommended by M. Germain
See, frequently prove of excellent service by aiding elimination and
facilitating the mutations.

According to Kisch, the cold mineral waters containing an abundance of
sulphate of soda, like Hunyadi and Marienbad, are to be preferred to the
hot mineral waters, such as Carlsbad, because of their lesser irritant