INCHES

AND
00152
VIALE
APOUNDS
BY
SALVATOR
NEW
A.T.W.
-APPROACH
MURA
ROME
MUNDI
SIMEONS
GIANICOLENSI,
TO M.
INTERNATIONAL
OBESITY
D. 77 HOSPITAL
FOREWORD
This book discusses a new interpretation of the nature of obesity, and while it
does not
fancy slimming
advocate dietyetitanother
does describe a method of treatment which has grown out o
f theoretical
based
What Ionhave
clinical
toconsiderations
sayobservation.
is an essence of views distilled out of forty years of grappl
ing with of
problems theobesity,
fundamentalits causes, its symptoms, its very nature. In these many ye
ars of specialized
thousands of cases have
work passed through my hands and were carefully studied. Ever
y new theory,
method, every promising
every new lead was considered, experimentally screened and critica
lly evaluated
became known. Butas soon
invariably
as it the results were disappointing and lacking in unifo
I felt that we were merely nibbling at the fringe of a great problem, as, indeed
rmity.
, do most serious
overweight. We havestudents
grown pretty
of sure that the tendency to accumulate abnormal f
at is a very
metabolic disorder,
definitemuch as is, for instance, diabetes. Yet the localization and
remained
the nature a mystery.
of this Every
disorder new approach seemed to lead into a blind alley, and th
ough are
they patients
fat because
were told theythat eat too much, we believed that this is neither the who
le truth to
Refusing
matter. norbetheside-tracked
last word inbythe an all too facile interpretation of obesity, I ha
ve always
the resultheldof thethatdisorder,
overeating notisits cause, and that we can make little headway u
ntil sort
some we canofbuild
theoretical
for ourselves
structure with which to explain the condition. Whether
such aisstructure
truth not important
represents
at this themoment. What it must do is to give us an intellec
tuallyissatisfying
what happening in interpretation
the obese body. of It must also be able to withstand the onsla
ught of all
clinical factshitherto
and furnish
known a hard background against which the results of treatm
entmecanthis
To be requirement
accurately assessed.
seems basic, and it has always been the center of my inte
rest. In it
patients dealing
becamewith
a habit
obeseto register and order every clinical experience as if
jig-saw
it werepuzzle.
an odd Andlooking
then,pieceas inofaajig saw puzzle, little clusters of fragments b
eganfittoinform,
to nowhere.
thoughAstheythe years
seemedpassed these clusters grew bigger and started to
years
amalgamate
ago, auntil,
completeaboutpicture
sixteen
became dimly discernible. This picture was and sti
Illcannot
is dotted
findwith
the pieces,
gaps forbut which
I do now feel that a theoretical structure is visi
ble asmounting
With a whole.experience more and more facts seemed to fit snugly into the new f
ramework, based
treatment and whenon such
then speculations
a showed consistently satisfactory results, I
advance
was surehadthat beensome
made,practical
regardless of whether the theoretical interpretation of t
heseclinical
The results results
is correct of theor not.
new treatment have been published in scientific jour
nal and these
generally wellreports
receivedhave by the
beenprofession, but the very nature of a scientific a
rticle does not
presentation of new
permittheoretical
the full concepts nor is there room to discuss the finer
points the
reasons
During offortechnique
16observing
years that
andthem.
the
have elapsed since 1 first published my findings, I hav
e had manyfrom
enquiries hundreds
research
of institutes, doctors and patients. Hitherto I could only
refer thosepapers,
scientific interested
thoughto Imyrealized that these did not contain sufficient infor
mation
the newtotreatment
enable doctors
satisfactorily.
to conductThose who tried were obliged to gain their own
trials
Doctors
experience
and
fromerrors
through
all over
which
thetheImany
have long
world havesince
come to
overcome.
Italy to study tire method at first
Mutidi
hand inInternational
my clinic inHospital
the Salvatorin Rome. For some of them the time they could spat
e hasgrasp
full been of tootheshort
technique,
to get aand in any case the number of those whom I have bee
n ablecompared
small to meet withpersonally
the many is requests for further detailed information which kee
p coming in. I have tried to
keep up with these demands by correspondence, but the volume of this work has be
comedealing
that
In unmanageable
is onewith
excusea disorder
and
for writingin which
this the
book.patient must take an active part in the
treatment,
that he or she
it is,
haveI an
believe,
understanding
essentialof what is being done and why. Only then ca
n there be intelligent
cooperation between physician and patient. In order to avoid writing two books,
one for for
another the the
physician
patient-a
and prospect which would probably have resulted in no book
requirements
at all-1 haveoftriedboth in
to ameet
single
the book. This is a rather difficult enterprise in
whichexpert
The I maywill
not grumble
have succeeded.
about longwinded while the Jay reader may occasionally h
avemake
word
To toinlook
the text
up anmore
glossaryunfamiliar
provided
readablefor I shall
him. be unashamedly authoritative and avoid al
l thewhich
with hedging
it is
andcustomarily
tentativeness to express new scientific concepts grown out of cli
nical experience
Confirmed by clear-cut
and notlaboratory
as yet experiments Thus when I make what reads like a
professional
factual statement,
reader may
the have to translate into: clinical experience seems to sug
gest that such
observation might
andhesuch
tentatively
an explained by such and such a working hypothesis
, requiring
further research
a vastbefore
amounttheofhypothesis can be considered a valid theory. If we c
an afrom
as mutually
the outset
accepted
establish
convention,
this I hope to avoid being accused of speculative
THEaNATURE
exuberance.
Obesity
As basis
a Disorder
OF OBESITY
for our discussion we postulate that obesity in all its many forms is
some
due part
to anofabnormal
the body'
functioning
and that every
of ounce of abnormally accumulated fat is alw
ays the result
disorder of certain
of theregulatory
same chanisms. Persons suffering from this particular
disorderthey
whether willcat
getexcessively,
fat regardless normally
of or less than normal. A person who is free
fat,
Those
of theeven
indisorder
whom
if hethefrequently
will
disorder
neverisovereats.
getsevere will accumulate fat very rapidly, those in
whom it isincrease
gradually moderateinwillweight and those in whom it is mild may be able to keep th
eir excess-weight
long periods, in all stationary
these cases
for a loss of weight brought about by dieting, trea
tments with
reducing drugs,
thyroid,
laxatives,
appetite-
violent exercise, massage, baths is only temporary an
d willasbetherapidly
soon reducingregained
regimenasis relaxed. The reason is simply that none of these
While
disorder.
measures
therecorrects
are greatthevariations
basic in the severity of obesity, we shall consider a
ll the
and at all
different
ages asforms
always
in being
both sexes
due to the same disorder. Variations in form wou
ld then partly
degree, be partly
an inherited
a matter ofbodily constitution and partly the result of a secon
dary involvement
glands such as theofpituitary,
endocrine the thyroid, the adrenals or the sex glands. On th
e other hand,
deficiency of any
we postulate
of these glands
that nocan ever directly produce the common disorder
known
If thisasreasoning
obesity. is correct, it follows that a treatment aimed at curing the di
sordersexes,
both must at
be all
equally
ageseffective
and in alliiiforms of obesity. Unless this is so, we are e
ntitled atogiven
whether harbortreatment
grave doubts
corrects
as tothe underlying disorder. Moreover, any claim
that the disorder
corrected must be substantiated
has been by the ability of the patient to eat normally of
regaining
any food abnormal
he pleasesfatwithout
after treatment. Only if these conditions are fulfilled c
an weproblem
obesity
Our legitimately
rather
thusthan
presents
speak
of reducing
ofitself
curing
weight.
as an enquiry into the localization and the nat
ure of theThedisorder
obesity. historywhich
of thisleads
enquiry
to is a long series of high hopes and bitter d
isappointments.
ThereHistory
The was a time,
of Obesity
not so long ago, when obesity was considered a sign of health
and prosperity
beauty, amorousness
in manandandfecundity
of in women. This attitude probably dates back to
years
Neolithic
ago, when
times,forabout
the first
8000 time in the history of culture man began to own pr
operty,houses,
land, domestic pottery
animals,
and metal
arabletools. Before that, with the possible exception
of some racesobesity
Hottentots, such aswasthealmost non-existent, as it still is in all wild animals
and most
Today obesity
primitive
is extremely
races. common among all civilized races, because a dispositi
on to the disorder
inherited. Wherevercan abnormal
be fat was regarded as an asset, sexual selection tend
ed toinpropagate
only very recentthe times
trait.that
It ismanifest obesity has lost some of its allure, tho
ughthe
always
The
In theearly
Significance
acult
signNeolithic
ofofthe
latent
of outsize
Regular
times
obesity-shows
bust-
Meals
another change
that the
tooktrend
placestill
whichlingers
may well
on.account fo
r the factdispositions
inherited that today nearlysoonerallor later develop into manifest obesity. This chang
e was the
meals. In pre-Neolithic
institution oftimes regular
man ate only when he was hungry and on1y as much a
s he required
pangs of hunger. to Moreover,
still the much of his I food was raw and all of it was unrefine
d, lie
did notroasted
boil it,hisasmeat,
he hadbutnolie
pots, and what little be may have grubbed Iron' th
e earth
be
The ate
whole
asandstructure
hepicked
went along.
from
of man's
the trees
omnivorous digestive tract is, like that of an ape,
continual
rat or pig, nibbling
adjusted of tidbits.
to the It is not suited to occasional gorging as is, for
carnivorous
instance, the catintestine
family. Thus of the
the institution of regular meals, particularly of f
ood rendered
placed a greatrapidly
burdenassirni1,
on modern man's ability to cope with large quantities of f
ood institution
system
The suddenly
from the pouring
intestinal
of regular
into his
tract.meant that man had to eat more than his body re
meals
quired
so as toattide
the him
moment
overofuntil
eatingthe next meal. Food rendered easily digestible sudd
enly floodedofhiswhich
nourishment bodyhewithwas in no need at the moment. Somehow, somewhere this su
rplus
Three
In theKinds
had
humantoofbody
beFat
stored.
we can distinguish three kinds of fat. The first is the struct
ural fatvarious
between which fills
organs, theagaps
sort of packing material. Structural fat also performs
bedding
such important
the kidneysfunctions
in softaselastic tissue, protecting the coronary arteries and
itkeeping
also provides
the skinthe smooth
springy
and cushion
taut, of hard fat under the bones of the feet, wi
thout
to
The walk.
second
whichtype
we would
of fatbeisunable
a normal reserve of fuel upon which the body can freel
y draw from
income when the intestinal
nutritionaltract is insufficient to meet the demand. Such normal
the
reserves
body. Fatare islocalized
a substance
all over
which packs the highest caloric value into the smal
lestfuel
of spaceforsomuscular
that normal
activity
reserves
and the maintenance of body temperature can be mos
t economically
form. Both thesestoredtypesinofthis
fat, structural and reserve, are normal, and even if t
he body
this
But there
canstocks
never
is a third
themcalled
be totype
capacity
obesity.
of fat which is entirely abnormal. It is the accumulat
ion offrom
only, suchwhich
fat, theand overweight
of such fatpatient suffers. This abnormal fat is also a pot
ential
the normal
reserve
reserves
of fuel,
it isbutnotunlike
available to the body in a nutritional emergency.
It is,andeposit
fixed
When soobese
to speak,
and islocked
patient not
tries
kept
away
toinreduce
ina current
a by starving
account,himself,
as are he
thewill
normal
first
reserves.
lose hi
s normal
are exhausted
fat reserves.
he beginsWhen to burn
theseup structural fat, and only as a last resort wil
l the body yield its abnormal
reserves, though by that time the patient usually feels so weak and hungry that
the this
for diet reason
is abandoned.
that obese
It ispatients
just complain that when they diet they lose the w
rong fat.
tired and their
They feel
facefamished
becomes drawn
and and haggard, but their belly, hips, thighs an
d upper arms The
improvement. showfat
little
they have come to detest stays on and the fat they need to
cover Their
less. their skin
boneswrinkles
gets lessandandthey look old and miserable. And that is one of th
e mostthen
experiences
Injustice
When frustrating
toathe
obese human
patients
Obese
and
being
depressing
are
canaccused
have. of cheating, gluttony, lack of will power,
greed and
strong become
sexualindignant
complexes,
and decide
the that modern medicine is a fraud and its repre
sentatives
weak just give
fools,
up the
whilestruggle
the in despair. In either case the result is the same
resignation
a further gain to aninabominable
weight, fate and the resolution at least to live tolerably
the doctors
for
Obeseshort
patients
span
andonly
allotted
insurance
feeltophysically
companies.
them-a figwell as long as they are stationary or gaini
ng weight.
owing to theTheylethargy
may feelandguilty,
indolence always associated with obesity. They may fee
l ashamed
been led toofbelieve
what they
is ahave
lack of control. They may feel horrified by the appeara
nce of their
tightness of their
nude body
clothes.
and the
But they have a primitive feeling of animal content
which turnsastosoon
suffering misery
as they
and make a resolute attempt to reduce. For this there are
sound
In thereasons.
first place, more caloric energy is required to keep a large body at a ce
rtain body
small temperature
Secondlythan
thetomuscular
heat a effort of moving a heavy body is greater than i
n the caseeffort
muscular of a consumes
light body.Calories
The which must be provided by food. Thus, all othe
r factors
person requires
being more
equal,food
a fat
than a lean one. One might therefore reason that if a
fat person food
additional eats his
onlybody
the requires he should be able to keep his weight stationar
y. Yet every
studied obesephysician
patients under
who hasrigorously controlled conditions knows that this is
actually
not true.gain Manyweight
obeseonpatients
a diet which is calorically deficient for their basic ne
eds.oneThere
mechanism
Glandular
At timeTheories
atmust
itwork.
was
thusthought
be somethat
other
this mechanism might be concerned with the sex g
lands. Suchbyathe
suggested connection
fact thatwasmany juvenile obese patients show an under- developme
nt of the sex
middle-age spread
organs.
in men
Theand the tendency of many women to put on weight in the
menopauseaseemed
indicate causaltoconnection between diminishing sex function and overweight. Ye
t when highly
hormones becameactive
available,
sex it was found that their administration had no affecte
d whatsoever
sex
The
When glands
Thyroid
it wascould
Gland
discovered
on obesity.
therefore
that
Thenot
tilebethyroid
the seatgland
of the
controls
disorder.
the rate at which body-f
uel isbyconsumed,
that administering
it wasthyroid
thoughtgland to obese patients their abnormal fat deposit
s could beThis
rapidly. burned
too proved
up moreto be entirely disappointing, because as we now know, t
hese in
part abnormal
the body's
deposits
energy-turnover
take no - they are inaccessibly locked away. Thyroid
medication
body to consume
merelyitsforces
normalthefat reserves, which are already depleted in obese pat
ients, and then
structurally essential
to breakfatdown
without touching the abnormal deposits. In this way a
brink
patientof starvation
may be brought in spite
to theof having a hundred pounds of fat to spare. Thus an
y weight-medication
thyroid loss broughtis always
about at
by the expense of fat of which the body is in dire
While the majority of obese patients have a perfectly normal thyroid gland and s
need.
ome even one
thyroid, havealsoan overactive
occasionally sees a case with a real thyroid deficiency. In su
ch cases,
brings about
treatment
a smallwith
lossthyroid
of weight, but this is not due to the loss of any abno
rmal fat. It is entirely the result of
the elimination of a mucoid substance, called myxedema, which the body accumulat
es when thyroid
primary there isdeficiency.
a marked Moreover, patients suffering only from a severe lack
become
of thyroid
obesehormone
in the true
neversense. Possibly also the observation that normal person
s - though
weight rapidlynot when
the obese
their-thyroid
lose becomes overactive may have contributed to the
deficiency
false notion andthat
obesity
thyroid
are connected. Much misunderstanding about the supposed r
ole of the
obesity is still
thyroidmetglandwith,inand it is now really high time that thyroid preparati
ons beofonce
list remedies
and forforallobesity.
struckThis
off is
theparticularly so because gibing thyroid gla
nd to anisobese
thyroid eitherpatient
normalwhose
or overactive, besides being useless, is decidedly dang
erous.
The Pituitary
next glandGlandto be falsely incriminated was the anterior lobe of the pituitary
important
or hypothesis.
gland lies
This well
most protected in a bony capsule at the base of the skull.
It the
in has body,
a vastamong numberwhich
of functions
is the regulation of all the other important endocrine
glands.ofThe
signs anterior
fact thatpituitary
variousdeficiency are often associated with obesity raised
the hope might
disorder that the be inseatthis
of gland.
the But although a large number of pituitary hormon
es have been
extracts of the isolated
gland prepared,
and many not a single one or any combination of such fact
ors treatment
the proved to of be obesity.
of any valueQuiteinrecently, however, a fat-mobilizing factor has b
eenisfound
it stillintoo pituitary
early toglands
say whether
but this factor is destined to play a role in t
he treatment
The
Recently,
Adrenalsa long
of obesity.
series of brilliant discoveries concerning the working of the a
drenal which
bodies or suprarenal
sit atopglands,
the kidneys,
small have created tremendous interest. This intere
st also when
obesity turnedittowasthediscovered
problem ofthat a condition which in some respects resembles
soa called
severe Cushing's
case of obesity-the
Syndrome-was caused by a glandular new-growth of the adrenal
s or by theirwith
stimulation excessive
ACTH, which is the pituitary hormone governing the activity of
the outer
When
adrenals.
we learned
rind orthat cortex
an abnormal
of the stimulation of the adrenal cortex could produce
obesity,
signs that
thisresemble
knowledge truefurnished no practical means of treating obesity by decr
easing the
adrenal cortex.
activity
Thereofistheno evidence to suggest that in obesity there is any exc
ess ofall
fact, adrenocortical
the evidenceactivity;
points tointhe contrary. There seems to be rather a lack o
f adrenocortical
decrease
So here again
in theoursecretion
function
search forandthe
of ACTH
a mechanism
from the which
anterior
produces
pituitary
obesity
lobe.led us into a
blind alley.
students of obesity
Recently, havemany
reverted to the nihilistic attitude that obesity is cau
sed those
can
The
For simplybeofbycured
only
Diencephalon usovereating
who
orbyrefused
Hypothalamus
underandeating.
tothat
be discouraged
it there remained one slight hope. Bu
ried deep
human braindown there
in istheamassive
part which we have in common with all vertebrate animals
theaso-called
is very primitivediencephalon.
part of theIt brain and has in man been almost smothered by th
e hugewhich
with masses we think,
of nervousreason
tissue
and voluntarily move our body. The diencephalon is t
he part nervous
central from which system
the controls all the automatic animal functions of the body,
such as breathing,
digestion, sleep, sex, the the
hearturinary
beat, system, the autonomous or vegetative nervous
system
whole
It wasinterplay
and via the
therefore ofnotthe
pituitary
unreasonable
endocrinethe glands.
to suppose that the complex operation of stori
ng andalso
might issuingbe controlled
fuel to thebybody the diencephalon. It has long been known that the co
ntent ofthe
fuel-in sugar-another
blood depends formonofa certain nervous center in the diencephalon. When
this centeranimals
laboratory is destroyed
they develop
in a condition rather similar to human stable diabe
tes. It has also long been known
that the destruction of another diencephalic center produces a voracious appetit
e andFat-
animals
The
Assuminga which
rapid
bank in
that gainmaninget
never such
weight
fata center
spontaneously.
in controlling the movement of fat does exist, i
ts function
much like that would
of ahavebank.
to When
be the body assimilates from the intestinal tract mo
re fuel this
moment, than surplus
it needsisatdeposited
the in what may be compared with a current account
. Out ofbethis
always withdrawn
accountasitrequired.
can All normal fat reserves are in such a current a
ccount,
diencephalic
When now,andforitcenter
reasons
is probable
manages
whichthatthe deposits
will abe discussed
and withdrawals.
later, the deposits grow rapidly w
hile small
become morewithdrawals
frequent a point may be reached which goes beyond the diencephalon's
banker
bankingmight
capacity.
suggestJust to aaswealthy
a client that instead of accumulating a large an
d unmanageable
he should investcurrenthis surplus
accountcapital, the body appears to establish a fixed depo
sit from
but into which they all surplus
can no longer
funds gobe withdrawn by the procedure used in a curren
t account. In "this
diericephalic fat-bank
way the" frees itself from all work which goes beyond its norm
al obesity
of banking dates
capacity.fromThe theonset
moment the diencephalon adopts this labor-saving ruse.
established
Once a fixedthedeposit
normalhas fatbeen
reserves are held at a minimum, while every available
fixed
Three
(1)
Assuming
surplus
TheBasic
deposit
Inherited
is Causes
that locked
and Factor
thereisof
away
istherefore
Obesity
ainlimit
the totaken
theout
diencephalon's
of normal circulation.
fat banking capacity., it f
ollowsinthat
ways whichthere
obesity
are canthreebecome
basicmanifest. The first is that the fat-banking cap
acity isSuch
birth. abnormally
a congenitally
low fromlow diencephalic capacity would then represent the in
herited
this abnormal
factortrait
in obesity.
is markedly
When present, obesity will develop at an early age in
could
spiteexplain
of normal whyfeeding;
among brothers
this and sisters eating the same food at the same ta
ble second
others
(2)
The somedobecome
Other not.
Diencephalic
way inobese
whichandDisorders
obesity can become established is the lowering of a prev
iously normal
capacity owingfat-banking
to some other diencephalic disorder. It seems to be a general rul
e that when one
diencephalic centers
of theismany particularly overtaxed; it tries to increase its capacit
y atthethemenopause
In expense and of other
aftercenters.
castration the hormones previously produced in the se
x-glands
the body.noInlonger
the presence
circulate of normally
in functioning sex-glands their hormones act
as asex-gland
the brake on stimulating
the secretionhormonesof of the anterior pituitary. When this brake is
enormously
removed theincreases
anteriorits pituitary
output of these sex-gland stimulating hormones, though
they are nowInnothelonger
effective. absence of any response from the non-functioning or missing se
x glands,
stop the anterior
there ispituitary
nothing tofrom producing more and more of these hormones. This
strain
situationon the
causes
diericephalic
an excessive center which controls the function of the anterior p
ituitary. Inburden
additional ordertheto center
cope with appears
this to draw more and more energy away from othe
r centers,with
concerned suchemotional
as those stability, the blood circulation (hot flushes) and othe
r autonomous
regulations,
The so calledparticularly
nervous
stable type of alsodiabetes
from theinvolves
not so the
vitally
diencephalic
importantblood
fat-bank.
sugar regu
latingtocenter
tries meet this
the diencephalon
abnormal load by switching energy destined for the fat bank o
ver to the
center, withsugar-regulating
the result that the fat-banking capacity is reduced to the point at
which it is forced to establish a
fixed deposit and thus initiate the disorder we call obesity. in this case one w
ouldprimary
the have tocause
consider
of thetheobesity,
diabetesbut it is also possible that the process is re
versed in the
overworked fat-center
sense that draws
a deficient
energy from
or the sugar-center, in which case the obes
ity would
type of diabetes
be the in cause
which
of the
thatpancreas is not primarily involved. Finally, it is
Syndrome
conceivablethosethat
symptoms
in Cushing's
which resemble obesity arc entirely due to the withdrawa
l of energy from
diencephalic fat-bank
the in order to make it available to the highly disturbed cent
er whichobesity
pituitary
Whether governs
adrenocortical
isthecaused
anterior
system.
by a marked inherited deficiency of the fat-center or
by some entirely
diencephalic regulatory
differentdisorder, its insurgence obviously has nothing to do wit
h overeating
obesity is certain
and intoeither
develop
caseregardless of dietary restrictions. In these cases
upanyfrom
enforced
essential
foodfat deficit
reserves
is made
and normal structural fat, much to the disadvanta
ge ofthere
(3)
But ThetheExhaustion
patient's
is still aofgeneral
third
the Fat-bank
way
health.
in which obesity can become established, and that
fat-center
is when a is presumably
suddenly-thenormalemphasis is on suddenly-called upon to deal with an e
normousofinflux
excess momentary
of foodrequirements.
far in At first glance it does seem that here we have
overeating
a straight-forward
being responsible
case of for obesity, but on further analysis it soon become
s clear
and effectthatisthe
notrelation
so simple. of In
cause
the first place we are merely assuming that the
capacity
while it is
of possible
the fat center
and even
is probable
normal that the only persons who have some inher
ited trait
become
Secondly, obese
ininmany
merely
thisofdirection
bythese
overeating.
cases
can the amount of loud eaten remains the same and i
t is which
fuel only the is suddenly
consumption decreased,
of as when an athlete is confined to bed for many
when
weeksa man
withleading
a brokena highly
bone oractive life is suddenly tied to his desk in an offic
e and to television
Similarly, when a person,
at home.grown up in a cold climate, is transferred to a tropic
al country
before, he may
and develop
continuesobesity
to eatbecause
as in the heat far less fuel is required to
maintain
When
temperature.
a person
the normal
suffersbody a long period of privation, be it due to chronic illness,
poverty,
of war, hisfamine
diencephalic
or the exigencies
regulations adjust themselves to some extent to the low
suddenly
food intake.
theseWhen
conditions
then change and he is free to eat all the food he wants, th
is is liablecenter.
regulating to overwhelm
During the
his last
fat- war about 6000 grossly underfed Polish refuge
es whoinhadRussia
years spentwere
harrowing
transferred to a camp in India where they were well housed,
rations
given normal
and some
British
cash toarmybuy a few extras. 'Within about three months 85% were s
uffering
In a personfromeating
obesity.coarse and unrefined food the digestion is slow and only a li
ttle nourishment
assimilated from the
at aintestinal
time is tract. When such a person is suddenly able to ob
tain highly
sugar, whiterefined
flour, butter
foods such
and oil
as these are so rapidly digested and assimilated
which
that occurs
the rushatofevery
incoming
meal may
fueleventually overpower the diecenphalic regulatory
mechanismsThis
obesity. andisthus
commonly
lead toseen in the poor man who suddenly becomes rich enough
to buy the
refined foods,
morethough
expensivehis total caloric intake remains the same or is even less
than has
Psychological
Much before.
been written
Aspects about the psychological aspects of obesity. Among its many
isfunctions
also thethe seatdiencephalon
of our primitive animal instincts, and just as in an emergency
it can to
center switch
another,
energysofromit seems
one to be able to transfer pressure from one instinct
unhappy
to another.
personThus
deprived
a lonelyof all
and emotional comfort and of all instinct gratificati
on except
and thirstthe canstilling
use theseofashunger
outlets for pent up instinct pressure and so develop
happened,
obesity. no Yetamount
once thatof psychotherapy
has or analysis, happiness, company or the grat
ification
will correctof the
othercondition.
instincts
No end of injustice
Compulsive Eating is done to obese patients by accusing them of compulsive eat
ing,gratification.
sex which is a formMost of obese
divertedpatients do not suffer from compulsive eating; the
y suffer torturing
gnawing, genuine hunger-real,
hunger-which has nothing whatever to do with compulsive eatin
g. Even
for sweets
their
is merely
sudden the
desireresult of the experience that sweets, pastries and alco
holthe
allay
On will
the
other
most
pangs
hand,
rapidly
of compulsive
hunger.
of allThis
foods
eating
has nothing
does occur
to doinwith
somediverted
obese patients,
instincts.
particul
arlyearly
or in girls
twenties.
in their
Fortunately
late teensfrom the obese patients' greater need for food, i
t comes on with
associated in attacks
real hunger,
and is anever
fact which is readily admitted by the patients. T
hey onlyTwofeel
stuff. Pounds
a feral
of chocolates
desire to may be devoured in a few minutes; cold, greasy f
ood from
stale bread,
the leftovers
refrigerator,on stacked plates, almost anything edible is crammed down
Iwith
ferocity.
haveterrifying
occasionallyspeed
beenandable to watch such an attack without the patient's know
ledge,spectacle
ugly and it istoabehold,
frightening,
even if one does realize that mechanisms entirely beyo
nd theApatient's
work. careful enquiry
controlintoare what
at may have brought on such an attack almost inva
riably reveals
preceded by a strong
that itunresolved
is sex-stimulation, the higher centers of the brain
diencephalic
having blockedinstinct
primitive
gratification. The pressure is then let off through anothe
r primitive channel,
gratification. In my experience
which is oral the only thing that will cure this condition is
uninhibitedwhich
procedure sex,isa hardly
therapeutic
ever feasible, for if it were, the patient would have
adopted it nor
prompting, without
wouldprofessional
this in any way correct the associated obesity. It would on
ly raise suffering
problems
Patients newused
if and as
often
from
a therapeutic
greater
real compulsive
measure.
eating are comparatively rare. In my pra
cticeTreating
2%. they constitute
them for obesity
about 1-is a heartrending job. They do perfectly well betw
een attacks,
occurring while
butunder
a single
treatment
bout may annul several weeks of therapy. Little wonde
r that such patients
discouraged. In thesebecome
cases I have found that psychotherapy may make the patient
mechanism,
fully understand
but it does
the nothing to stop it. Perhaps society's growing sexual perm
issiveness
compulsive
Whether a patient
will make
eating evenreally
is rarer.suffering from compulsive eating or not is hard to d
ecideobese
many beforepatients
treatmentthink
because
that their desire for food-to them unmotivated__ is du
e tothe
all compulsive
time it is
eating,
merelywhile
a greater need for food. The only way to find out is t
o treatfrom
suffer suchreal
patients.
compulsive
Thoseeating
that continue to have such attacks, while those wh
o arepatients
never
Reluctance
Some not an
get compulsive
toattack
Losedeeply
are Weight
during
eatersattached
treatment.
to their fat and cannot bear the thought of lo
sing it.and
popular If successful
they are intelligent,
in spite of their handicap, this is a source of pride. So
me fat girls
condition as alook
safeguard
upon theiragainst erotic involvements, of which they are afraid.
They work
which theiroutobesity
a pattern
playsofalife
determining
in role and then become reluctant to upset
thislife
of pattern
whichand
willface
be entirely
a new kinddifferent after their figure has become normal an
d often
that people
verywill
attractive.
like themThey-orfear
be jealous-on account of their figure rather than
orhecharacter
attractedonly.
by their
Someintelligence
have a feeling that reducing means giving up an almost c
herished andInintimate
themselves. many ofparttheseofcases psychotherapy can be helpful, as it enables t
hese patients
situation in the
to full
sec the
lightwhole
of consciousness An affectionate attachment to abnor
mal became
who fat is obese
usuallyinseen
childhood,
in patients
but this is not necessarily so.
In all other cases the best psychotherapy can do in the usual treatment of obesi
ty is toandrender
hunger never-theending
burdendietary
of restrictions slightly more tolerable. Patients
whoerotic
an have successfully
transfer to their
established
psychiatrist are often better able to hear their suf
feringare
There as thus
a secret
a large
labornumber
of love.
of ways in which obesity can be initiated though t
he the
to disorder
same mechanism,
itself is always
an inadequacy
due of the diencephalic fat-center and the layi
ng down
fat deposits
of abnormally
in abnormal fixed
places. This means that once obesity has become establi
shed,
by eliminating
it can nothose
more factors
be curedwhich brought it on than a fire can be extinguished
conflagration.
by removing theThus cause
a discussion
of the of the various ways in which obesity can become
preventative
established point
is useful
of view,
from but
a it has no bearing on the treatment of the establ
ished
of factors
condition.
which are
The clearly
elimination
hastening the course of the disorder may slow down
its by
they
Not
Weight
progress
canalone
Weight
neveris
oralone
correct
evenahalt
not satisfactory
it.it, but criteria on by which to judge whether a perso
n iscall
we suffering
obesityfrom
or not.
the Every
disorderphysician is familiar with the sylphlike lady who
enters theemphatically
declares consulting that
room she
and is getting horribly fat and wishes to reduce. Man
y an honestatand
physician oncesympathetic
concludes that he is dealing with a Ònut.Ó If he is busy he will g
ive time
has her short
he willshrift,
weighbutherifandheshow her tables to prove that she is actually und
I have never yet seen or heard of such a lady being convinced by either procedur
erweight.
e. The reason
experience theislady
thatisinnearly
my always right and the doctor wrong. When such a pat
ient ismany
finds carefully
signs ofexamined
potentialoneobesity, which is just about to become manifest as
distinctly
overweight.feels
The that
patientsomething is wrong with her, that a subtle change is takin
g placeare
alarms
There her.
inaher
number
body,ofand
signs
thisand symptoms which are characteristic of obesity. In
often
manifest
all these
obesitysigns
manyand
andsymptoms are present. In latent or just beginning case
s some be
should areaalways
rule that
found,
if two
and orit more of the bodily signs are present the case mu
st bebodily
immediate
Signs
The regarded
and help.
symptoms
signsasmay
one
ofbeobesity
that
divided
needsinto such as have developed before puberty, indi
cating aand
factor, strong
thoseinherited
which develop at the onset of manifest disorder. Early signs a
re the
of a disproportionately
two upper front teeth,
large the
sizefirst incisor, or a dimple on both sides of th
e sacral bone
buttocks. Whenjust
the arms
aboveare
theoutstretched with the palms upward, the forearms app
ear sharply
from the upperangled
arms.outward
The same applies to the lower extremities. The patient cann
ot bring
without
The beginning
the
hisknees
feet
accumulation
together of abnormal
overlapping; he is, infatfact,
showsknock-kneed.
as a little pad just below the
nape ofasthe
known theneck,
Duchess'
colloquially
Hump. There is a triangular fatty bulge in front of the ar
mpit whenthethebody.
against arm When
is held
the skin is stretched by fat rapidly accumulating under i
t, it many
layers. Whensplit
largeinand
thefresh,
lower such tears are purple, but later they are transfor
med into white
striation, as itscar-tissue.
is called, commonly
Such occurs on the abdomen of women during pregn
ancy, but mfound
frequently obesity
on the
it isbreasts, the hips and occasionally on the shoulders. In
many the
that casessmall
striation
white lines
is so are
fineonly just visible. They are always a sure sign of
slight
obesity,at the
and time
thoughofthis
examination
may be such patients can usually remember a period in
excessively
Another
their childhood
typical
chubby.
sign
whenisthey
a pad
wereof fat on the insides of the knees, a spot where n
ormal fatThere
stored. reserves
may bearea fold
neverof skin over the pubic area and another fold may str
etch round both sides of the
chest, where a loose roll of fat can be picked up between two fingers. In the ma
le aninexcessive
fat the breasts accumulation
is always indicative,
of while in the female the breast is usual
ly, but notexcessive
Obviously necessarily,
fat onlarge.
the abdomen, the hips, thighs, upper arms, chin and s
houlders
it is important
are characteristic,
to remember that and any number of these signs may be present in per
sons whose weight
statistically normal;
is particularly of they are dieting on their own with iron de
Common clinical symptoms which are indicative only in their association and in t
termination.
he frameare:
picture of thefrequent
whole headaches
clinical rheumatic pains without detectable bony abnormal
ity; a feeling
lethargy, oftenofboth
laziness
physical andand mental and frequently associated with insomnia
, thewant
they patients
is tosaying
rest; the
thatfrightening
all feeling of being famished and sometimes we
ak withafter
hours hunger
a hearty
two tomeal
threeand an irresistible yearning for sweets and starchy fo
od whichquite
patient oftensuddenly
overcomesandtheis sometimes substituted by a desire for alcohol; con
stipation colon
irritable and a are
spastic
unusually
or common among the obese, and so are menstrual disor
Returning once more to our sylphlike lady, we can say that a combination of some
ders.
few
of of
thesethesymptoms
typical bodily
with a signs is sufficient evidence to take her case seriousl
y. Aonly
can humanbefigure,
judged in maletheornude;
female,
any opinion based on the dressed appearance can
be quite
the mark,fantastically
and I feel myselfwide driven
off to the conclusion that apart from frankly psy
chotic patients
anorexia nervosasucha < morbid
as casesweightof fixation > does not exist. I have yet to see
a remember
complain
IThepatient
Emaciated
after
who
theLady
continues,
the figure
case of a lady
tohas who
beenwas
rendered
escorted
normal
intobymyadequate
consulting
treatment.
room while I w
as front
in telephoning.
of my desk,
She sat
anddown
when I looked up to greet her I saw the typical picture
skin
of advanced
hung loosely
emaciation.
over theHerbonesdry of her face, her neck was scrawny and collarbon
es andhollows.
deep ribs stuck
I immediately
out from thought of cancer and decided to which of my colleag
ues ather.
refer the Indeed,
hospitalIIfelt woulda little annoyed that my assistant had not explained t
o her
my specialty.
that herIncase answer
did tonotmyfallquery
under
as to what I could do for her, she replied t
hathide
to she mywanted
surprise,
to reduce.
but she I tried
must have noted a fleeting expression, for she smil
ed andI'm
think saidmad,
ÒI but
knowjust
thatwait.Ó
you With that she rose and came round to my side of the
waist
By
desk.
using
she
Jutting
ahad
technique
enormous
out from
which
hips
a tiny
will
and presently
thighs. be described, the abnormal fat on her
hipsherwasbody
of transferred
emaciatedtobythe months
restof very severe dieting. At the end of a treatmen
t lasting
small woman,fivehadweeks
lostshe,
8 inches
a round her hips, while her face looked fresh and f
lorid, the
visible andribs
her weight
were nowas longer
the same to the ounce as it had been at the first con
Fat buta person
sultation.
While not Obese who is statistically underweight may still be suffering from the
disorder
is also possible
which causes
for aobesity,
person toitbe statistically overweight without suffering f
rom obesity.
weight is no problem,
For such as persons
they can gain or lose at will and experience no difficu
lty in reducing
intake. They aretheir
masterscaloric
of their weight, which the obese are not. Moreover, the
ir excess fat
preference forshows
certain
no typical regions of the body, as does the fat in all cases
whether
of obesity.
a borderline
Thus, thecasedecision
is really suffering from obesity or not cannot be made
The
tables.
If
merely
obesity
Treatment
by is
consulting
of Obesity
always due
weight
to one very specific diencephalic deficiency, it follow
s that the
correct thisonly
deficiency.
way to cure At first
it is this
to seemed an utterly hopeless undertaking. T
he greatest obstacle was that one
could hardly hope to correct an inherited trait localized deep inside the brain,
number
and while
of drugs
we didwhose
possess
pointa of action was believed to be in the diencephalon non
e of them
effect on the
had fat-center.
the slightestThere was not even a pointer showing a direction in wh
ich pharmacological
could move to find aresearch
drug that had such a specific action. The closest approach
weeCurious
A-the
Mullingthe
amphetamines-----
appetite-reducing
over
Observation
this depressing
butdrugs
these
situation,
cured nothing.
I remembered a rather curious observatio
n made At
India. manythat
years
timeagoweinknew very little about the function of the diencephalon,
and pituitary
the my interestgland.
centered
Proehlich
round had described eases of extreme obesity and sexual
suffering
underdevelopment
from a new-growth
in youths of the anterior pituitary lob, producing what then b
ecame known
disease. However,
as Froehlich's
it was very soon discovered that the identical syndrome, thoug
h runningwasa quite
course, less fulminating
common in patients whose pituitary gland was perfectly normal.
boysÓ
Thesewith
are long,
the so-called
slender hands,
Òfat breasts any flat-chested maiden would be proud to
posses,
and thighs
large
withhips,
striation,
buttocksknock-knees and underdeveloped genitals, often with u
ndescended
It also became
testicles.
known that in these cases the sex organs could he developed by gi
ving the patients
substance extractedinjections
from the urine
of a of pregnant women, it having been shown that
when thisinto
injected substance
sexuallyWasimmature rats it made them precociously mature. The amoun
t of substance
produced this effect
which in one rat was called one International Unit, and the purif
ied extract
ÒHuman Chorionic
was accordingly
GonadotrophinÓcalled
whereby chorionic signifies that it is produced in t
he placenta
gonadotropin
The usual wayandthat
of treating
its actionÒfatisboys'
sex gland
with underdeveloped
directed. genitals is to inject sev
eral hundred
Units twice ainternational
week. Human Chorionic Gonadotrophin which we shall henceforth simp
ly call
and as Òfat
HCG boysÓ
is expensive
are fairly common among Indians I tried to establish the smallest
effective
of this study
dose.three
In theinteresting
course things emerged. The first was that when fresh pr
egnancy-urine
ward was givenfrom
in quantities
the femaleof about 300 cc. by retention enema, as good result
s could bethe
injecting obtained
pure substance.
as by The second was that small daily doses appeared to
be justones
larger as effective
given twiceas amuch
week. Thirdly, and that is the observation that concer
ns usgiven
were here,small
when daily
such patients
doses they seemed to lose their ravenous appetite though
rises' neither
weight. Strangelygained
enough
norhowever,
lost their shape did change. 1 bough they were not
restricted
distinct
Fat
Remembering
on thedecrease
inthis,
Movediet,it
inthere
the circumference
occurred
was to
a me thatofthe
their
change
hips.in shape could only be expla
ined from
away by a abnormal
movement deposits
of fat on the hips, and if that were so there was just a ch
ance that while
transition it might
suchbefatavailable
was in to the body as fuel. This was easy to find out,
would
as inbethat
ablecase
to replace
fat on thefood.
moveIt should then he possible to keep a Òfat boyÓ on a s
aeverely
feelingrestricted
of hunger,dietin spite
withoutof a rapid loss of weight. When I tried this in ty
Ipical
foundcases
thatofasFroehlich's
long as suchsyndrome,
patients were given small daily doses of HCG they c
ould comfortably
usual occupationsgoonabout
a diettheir
of only 500 Calories daily and lose an average of ab
out one
also perfectly
pound perevident
day. that
It wasonly abnormal fat was being consumed, as there were
no signsfat.
normal of Their
any depletion
skin remained
of fresh and turgid, and gradually their figures be
came entirely
daily administration
normal,ofnorHCGdidappear
the to have any side-effects other than beneficia
lFrom this point it was a small step to try the same method in all other forms of
eases
obesity.
to establish
It took abeyond
few hundred
reasonable doubt that the mechanism operates in exactl
y the same
without exception
way andinseemingly
every case of obesity. I found that, though most patients w
ere treated gross
department, in thedietary
out patients
errors rarely occurred on the contrary most patients c
omplained that the two meals of
250 Calories each were more than they could manage, as they continually had a fe
elingthis
large
Pregnancy
Once of just
meal. and Obesity
trail having
was opened
had a further observations seemed to fall into line, it is,
during
for instance,
pregnancywell an.known
obesethatwoman can very easily lose weight. She can drasticall
y reducehunger
feeling her diet or discomfort
without and lose weight without in am nay harming the child
surprising
in her womb. to what
It isextent
also a woman can suffer from pregnancy vomiting without com
ing to anyisreal
Pregnancy an obese
harm. woman's one great chance to reduce her excess weight. 1 ha
t sheopportunity'
this so rarely makes is dueusetoofthe erroneous notion, usually fostered by her elder
relations,
mouths to feedÓ
that andshe must
now has Òkeep
Òtwoup her strength for the coming event.' All modern obs
tetricians
is nonsenseknow and that thethismore superfluous fat is lost the less difficult will be
hesitate
tile confinement,
to prescribe though
a dietsomesufficiently
still low in Calories to bring about a drast
Aicwoman
reduction.
may gain weight during pregnancy, but she never becomes obese dl tile st
rict sense
Under the influence
of the word.of the HCG which circulates in enormous quantities in her bo
dy during pregnancy,
diencephalic banking capacity
her seems to be unlimited, and abnormal fixed deposits
confinement
are never formed.
she is suddenly
At deprived of HCG, and her diencephalic fat-center rev
ertsonly
is to then
its normal
that tile
capacity.
abnormally
It accumulated fat is locked away in a fixed depo
sit. From seems
suffering
Pregnancy that obesity
from moment
to be the
onandshe
only
isissubject
normal human
to allcondition
its consequences.
in which the dicncephalic
fat bankingItcapacity
unlimited. is onlyisduring pregnancy that fixed fat deposits can be transferre
d hack into
account and freely
the normal
drawncurrent
upon to make up for any nutritional deficit. During pre
gnancy
fat is placed
every ounceat tile
of disposal
reserve of the growing fetus. Were this not so, an obese
woman, whose
already depleted,
normalwould
reserves
have the
are greatest difficulties in bringing her pregnancy
considerable
to full term.evidence
There isto suggest that it is the HCG produced in large quantities
about
Though
in thethis
weplacenta
may
diencephalic
be able
whichtobrings
change.
increase the dieneephalic fat banking capacity by injec
ting HCG,
itself affect
thisthedoesweight,
not injust as transferring monetary funds from a fixed depos
it into
make a mana current
any poorer;
account to become
does notpoorer it is also necessary that he freely spen
ds the money
becomes available.
which Inthuspregnancy the needs of the growing embryo take care of thi
s to some of
treatment extent,
obesitybutthere
in theis no embryo, and so a very severe dietary restrictio
n mustwhen
duration
Only take
ofthetreatment.
itsfatplace
whichforisthein transit under the effect of HCG is actually consum
ed cantile
from morefixed
fat deposits.
be withdrawn In pregnancy it would be most undesirable if the fetus
when
werethere
offered is aample
highfood
influx onlyfrom the intestinal tract. Ideal nutritional conditi
ons for the
achieved whenfetus
the mother's
can only blood
be is continually saturated with food, regardless
of whetherashe
otherwise period
eatsoforstarvation
not, as might hamper the steady growth of the embryo. I
t seems
this continual
that HCGsaturation
brings about of the blood, which is the reason why obese patients u
nderis
feel
The
HCG Nature
treatment
hungry
neverofinfound
Human
withinChorionic
spite HCG
ofthetheir
never
humanGonadotroplsin
drastically
body exceptreduced
duringfood
pregnancy
intake.and in those rare c
ases in which
placental tissuea residue
continues of to grow in the womb in what is known as a chorionic e
pithelioma.
tile male. The It human
is nevertypefound
of chorionic
in gonadotrophin is found only during the pr
egnancyapes.
great of women
It isandproduced
the in enormous quantities, so that during certain phases
excrete
of her as pregnancy
much asaone woman million
may International Units per day in her urine - enough
to render a million infantile rats
precociously mature. Other mammals make use of a different hormone, which can be
serum
extracted
but notfromfrom
theirtheir
blood
urine. Their placenta differs in this and other respect
s fromThis
apes. thatanimal
of manchoriollic
and the greatgonadotrophin is much less rapidly broken down in t
he often
it
As human
is alsohappens
body
lessthan
suitable
inHCG,
medicine,
and
for the
muchtreatment
confusionofhas
obesity.
been caused by giving HCG its n
ame before
action was understood.
its true modeItofhas been explained that goncidotrophin literally means
ora hormone,
sex-glandand directed
this issubstance
quite misleading. It dates from the early days when it w
as firstinfantile
render found that sexHCGglands
is able
mature,
to whereby it was entirely overlooked that it h
as no stimulating
whatsoever on normally
effectdeveloped and normally functioning sex-glands. No amount
of HCG isaever
increase normal
ablesextofunction it can only improve an abnormal one and in the yo
ung hastenHowever,
puberty. the onset thisofis no direct effect. HCG acts exclusively at a diencephal
ic level and increase
considerable there bringsin the
about
functional
a capacity of all those centers which are
working
The
Two RealatGonadotrophins
hormones maximum
known incapacity.
the female as follicle stimulating hormone (FSH) and corpu
s luteum(LSH)
hormone stimulating
are secreted by the anterior lobe of tile pituitary gland. These h
ormones they
because are realdirectly
gonadotropilins
govern the function of the ovaries. The anterior pituitary
diencephalon,
is in turn governed
and so when
by thethere is an ovarian deficiency the diencephalic center
correct
concerned
matters
is hard
by increasing
put to the secretion from the anterior pituitary of FSH o
r LSH, deficiency
sexual as the caseismayclinically
be. When present, this is a sign that the diencephalic ce
nter concerned
maximal exertion, is tounable,
cope with
in spite
the demand
of for anterior pituitary stimulation. Wh
en then
HCG increases
the administration
the functionalofcapacity of the diencephalon, all demands can be fu
lly satisfied
deficiency
That this isistheandtrue
corrected.
the mechanism
sex underlying the presumed gonadotrophic action of
HCG iswhen
that confirmed
the pituitary
by the gland
(act of infantile rats is removed before they are given
their
HCG, sex-glands.
the latter has HCGnocannot
effecttherefore
on have a direct sex gland stimulating actio
n like thatgonadotrophins,
pituitary of the anterioras FSH and LSH are justly called. The latter are entir
ely different
which can be extracted
substancesfrom frompregnancy
that urine and which, unfortunately, is called
chorionic
would he nogonadotiophin.
more clumsy, and It certainly far more appropriate, if HCG were hencefo
rthcannot
HCG
dienccphalotrophin.
It called
no SexheHormone
chorionic
sufficiently emphasized that HCG is not sex- hormone, that its acti
on is identical
children and in those
in men,cases
women,in which the sex-glands no longer function owing to
old age orThetheir
removal. onlysurgical
sexual change it can bring about after puberty is an improveme
nt ofnever
But a prestimulation
existing deficiency.
beyond the normal in an indirect way via the anterior pitu
itary HCG regulates
menstruation and facilitates conception, but it never virilizes a woman or femin
izes breasts
grow a man. Itnorneither
does itmakes
interfere
men with their virility, though where this was de
ficientwomen
makes it maygrowimprove
a beardit.orItdevelop
never a gruff voice. I have stressed this point on
ly for thebecause,
readers, sake ofitmyislayour daily experience that when patients heat the word ho
rmoneconclusion
the they immediately
that thisjump musttohave something to do with the sex- sphere. They at
e not to
think
Importance
Owing accustomed
thyroid
theandfact
insulin,
Potency
asthat
we HCG
are,HCG
cortisone,
of has
to no direct
adrenalin
action
etc,onasany
hormones.
endocrine gland, its enor
mousbeen
has importance
overlooked
in pregnancy
and its potency underestimated bough a pregnant woman can pr
oduce asunits
million much per
as oneday, we find that the injection of only 125 units per day is a
mple to one
roughly reducepound
weight
per day,
at theeven
rateinofa colossus weighing 400 pounds, when associat
ed with a 500-Calorie diet.
It is no exaggeration to say that the flooding of the female body with HCG is by
hormonal
far the event
most spectacular
in pregnancy. It has an enormous protective importance for mother
far andaschild,
to sayandthat
I even
no woman,
go so and certainly not an obese one, could carry her pre
gnancy
If I cantobeterm
forgiven
withoutforit.comparing my fellow-endocrinologists with wicked Godmot
hers,their
been HCG has
Cinderella,
certainlyand I can only romantically hope that its extraordinary e
ffect
to
HCG behasits
onbeen
abnormal
Fairy
known
Godmother.
fat
forwill
overprove
half a century it is the substance which Aschheim an
d Zondek
to diagnose so early
brilliantly
pregnancy
usedout of the urine. Apart from that, the only thing it
laboratory
did in thewas experimental
to produce-precocious rats, and that was not particularly stimula
ting much
when to further
more thrilling
research endocrinological
at a time discoveries were pouring in from all s
ides,complicating
stiller
Complicating
Some sweeping,
back Disorders
waters.
HCGdisorders
into theare often associated with obesity, and these we must
important
briefly discuss.
associatedThedisorders
most and the ones in which obesity seems to play a pre
cipitating orrole
aggravating at arc
leasttheanfollowing the stable type of diabetes, gout, rheumatism
pressure
and arthritis,
and hardening
high bloodof the arteries, coronary disease and cerebral hemorrhage
.Apart from the fact that they are often-though not necessarily-associated with o
besity,inthese
things common.
disorders
In allhave
of them
two modern research is becoming more and more incli
ned to believeregulations
diencephalic that play a dominant role in their causation. The other comm
on factororisdothat
improve not occur
they either
during pregnancy. In the latter respect they are joined
by many otherassociated
necessarily disorderswithnot obesity. Such disorders are, for instance, colitis,
duodenal
allergies,
If HCG + diet
orpsoriasis,
gastric
does inulcers,
lossobese
the ofcertain
hair,
bringbrittle
about those
fingernails,
diencephalic
migraine,
changes
etc.which are
one characteristic
would expectoftopregnancy,
see an improvement in all these conditions comparable to tha
t seen
administration
In
Diabetes
an obese
in real
patient
pregnancy.
of HCGsuffering
doesThein from
fact adofairly
this inadvanced
a remarkable
case ofway.
stable diabetes of
many years
blood sugarduration
may rangeinfromwhich3-400
the mg%, it is often possible to stop all anti diab
etesdays
few medication
of treatment.
after the Thefirst
blood sugar continues to drop from day to day and oft
3enweeks.
reachesAsnormal
in pregnancy,
values inthis 2- phenomenon is not observed ill the brittle type o
f diabetes,
that are predominantly
and as somestable
cases may have a small brittle Factor in their clinical
makeup,
Ato brittle
he keptalldiabetes
under
obeseadiabetics
veryprimarily
is careful
havedoe
and to
expert
tilewatch.
inability of the pan to produce suff
icientdiencephalic
type insulin, whileregulations
in the stable
seem to he of greater importance. That is possibly
responds
the reason so well
why theto the
stable
HCGform
method of treating obesity, whereas the brittle type
generally
does not.suffering
Obese patients
from the
arestable type, but a stable type may gradually change
usually
into a associated
brittle one,with which
a loss
is of weight. Thus when an obese diabetic finds that
orhetreatment,
is losing he weight
should
without
at oncediethave his diabetes expertly attended to. There is
the
somechange
evidence
fromtostable
suggestto brittle
that is more liable to occur in patients who are ta
king insulin for their stable
diabetes.
Rheumatism
All rheumatic pains, even those associated with demonstrable bony lesions, impro
ve subjectively
days of treatment,
within
and often
a few require neither cortisone nor salicylates. Again th
is is a wellandknown
pregnancy, whilephenomenon
under treatment
in with HCG + diet the effect is no less drama
tic. As it the
pregnancy, doespain
not ofalter
deformed joints returns alter treatment, but smaller dose
s of to
able pain-relieving
control it satisfactorily
drugs seem after weight reduction. In any case, the HCG m
ethod makespatients
arthritic it possible
to interrupt
in obeseprolonged cortisone treatment without a recurren
ce of pain.
welcome, butThis
thereinisitself
the added
is mostadvantage that the treatment stimulates the secr
etion of ACTH manner
physiological in a and that this regenerates the adrenal cortex, which is apt
to suffer
cortisone
The
Cholesterol
exact extent
under prolonged
treatment.
to which the blood cholesterol is involved in hardening of the
arteries,disease
coronary high blood
is not
pressure
as yetandknown, but it is now widely admitted that the blo
od diencephalic
by cholesterol level
mechanisms.
is governed
The behavior of circulating cholesterol is therefore
the
of treatment
particularofinterest
obesityduring
with HCG. Cholesterol circulates in two forms, which we
Normally
call freethese
and fractions
esterified.are present in a proportion of about 25% free to 75gb e
sterified
the lattercholesterol,
fraction whichanddamages
it is the walls of the arteries. In pregnancy this p
roportion
he taken for
is granted
reversedthat
and arteriosclerosis
it may never gets worse during pregnancy for
Tothis
my knowledge,
very reason.the only other condition in which the proportion of free to est
erified
is duringcholesterol
the treatmentis reversed
of obesity with HCG+ diet, when exactly the same phenome
nonimportant
an takes place.
indication
This seems
of how closely a patient under HCG treatment resembles a
diencephalic
When
pregnant
the total
woman
behavior.
amount
in of circulating cholesterol is normal before treatment, thi
s absolute amount
significantly increased
is neither
nor decreased. But when an obese patient with an abnorma
lly highshowing
already cholesterol
signsandof arteriosclerosis is treated with HCG, his blood pressur
e drops and seems
circulation his coronary
to improve, and yet his total blood cholesterol may soar to he
ights
At first
never
thisbefore
greatly
reached.
alarmed us. But when we saw that the patients came to no h
arm even ifandtreatment
continued we foundwasin follow-up examinations undertaken some months after tr
eatment
we foundwas
in follow-up
continued examinations
and undertaken some months before treatment. As t
he increase
form of the not
is mostly
dangerous
in the
form of the free cholesterol, we gradually came to wel
comebelieve
we the phenomenon.
that the rise
Todayis entirely due to the liberation of recent cholesterol
undergone
An
Gout
deposits
identical
thatbehavior
calcification
have notisin
yet
found
the in
arterial
the blood
walluric
and acid
therefore
levelhighly
of patient
beneficial.
suffering
patients
from gout.
getPredictably
an acute andsuchoften severe attack after the first few days of HCG tr
eatment
free of pain,
but then
in spite
remainofentirely
the fact that their blood uric acid often shows a mark
ed increase
several months
which
alter
maytreatment.
persist forThose patients who have regained their normal we
ight remainoffree
regardless whatofthey
symptoms
eat, while those that require a second course of treatme
nt getasanother
soon the second
attack
course
of gout
is initiated.
as We do not yet know what dioncephalic mec
hanisms arc
possibly emotional
involvedfactors
in goutplay
; a role, and it is worth remembering that the dis
ease clues notage.
childbearing occur
We now
in women
give 2oftablets daily of ZYLORIC to all patients ho give
high
a history
blood uric
of gout
acidandlevel.
have In
a this way we can completely avoid attacks during t
reatment.
Patients
Blood Pressure
who have brought themselves to the brink of malnutrition by exaggerated
have
dieting,
an abnormally
laxativeslowetc,blood
oftenpressure. In these cases the blood pressure rises t
o normal values
beginning of treatment
at the and then very gradually drops, as it always does in patie
nts with aNormal
pressure. normalvalues
blood are always regained a few days after the treatment is ov
er. Ofpressure
blood this lowering
duringoftreatment
the the patients are not aware. When the blood press
ure is abnormally
provided there arehigh,
no detectable
and renal lesions, the pressure drops, as it usuall
y duesvery
often in pregnancy.
rapid, So rapid
The drop in fact
is that sometimes advisable to slow down the pro
cess with pressure
medication until thesustaining
circulation has had a few days time to adjust itself the ne
w situation.
among the thousands
On the cases
other treated
hand, we have never seen any untoward incident which
rather
When
coulda woman
be attributed
sudden suffering
drop intohigh
from
theblond
high blood
pressure.
pressure becomes pregnant her blood press
ure very
after hersoon
confinement
drops, butit may gradually rise back to its former level. Similarly,
before
a highHCGblood
treatment
pressuretends
present
to rise again after the treatment is over, though thi
s is nothigh
former always
levels
theare
case.
rarely
But reached,
the and we have gathered the impression that
suchourrelapses
orthodox
Peptic
In Ulcers
cases
drugsofrespond
such
obesity
asbetter
reserpine
with gastric
to thanorbefore
duodenal
treatment.
ulcers we have noticed a surpri
sing sub1ective
spite of a diet which
improvement
would generally
in be considered most inappropriate for an ul
cer patient.with
similarity Here,
pregnancy,
too, there in which
is a peptic ulcers hardly ever occur. However we
have seenhistory
previous two casesof several
with a hemorrhages in which a bleeding occurred within 2 we
eksinofpregnancy,
Psoriasis,
As the Fingernails,
end ofpsoriasis
treatment.
Hairgreatly
Varicoseimproves
Ulcersduring treatment but may relapse whe
n the treatment
patients spontaneously
is over.report
Most a marked improvement in the condition of brittle f
ingernails. The
infrequently associated
loss of with
hair obesity
not is temporarily arrested, though in very rar
e cases
has beenanreported.
increasedI remember
loss of hair a case in which a patient developed a patchy baldn
-essafter
- soacalled
severealopecia
emotionalareata
shock, just before she was about to start an HCG trea
tment. Ourthe
diagnosed dermatologist
case as a particularly severe one, predicting that all the hair wo
uld reducing
the be lost. treatment,
He counseledbutagainst
in view of my previous experience and as the patient
postpone
was veryreducing,
anxious notI discussed
to the matter with the dermatologist and it was agre
ed that,
the patient
having
withfully
the situation,
acquaintedthe treatment should be started. During the trea
tment, which
further development
lasted offourtheweeks,
bald patches
the was almost, if not quite, arrested; howe
ver, within
finished theacourse
week ofofhaving
HCG, all the remaining hair fell out as predicted by the
dermatologist.
point is that theThetreatment
interesting was able to postpone this result but not to prevent
it.obese
new
In The patient
shock patients
of hairhaswith
ofnow
which
large
grown
shevaricose
ais justlyulcers
proud.
we were surprised to find that thes
e ulcers heal
treatment withrapidly
HCG. Weunder
have since treated non obese patients suffering from vari
coseÒPregnant"
injections
The
When aulcers
maleofpatient
with
HCG
Male
daily
onhears
normalthatdiethewith
is about
equally
to be
goodputresults.
into a condition which in s
ome respectsheresembles
pregnancy, is usually shocked and horrified. The physician must therefore car
efullythat
mean explain
he will
thatbethis
feminized
does notand that HCG in no way interferes with his sex. H
e mustinbethemade
that interest
to understand
of the propagation of the species nature provides for a per
fect functioning of the regulatory
head quarters in the diencephalun during pregnancy and that we are merely using
this natural
means of correcting
safeguardtheasdicncephalic
a disorder which is responsible for his overw
I must warn the lay reader that what follows is mainly for the treating physicia
Warnings
Technique
eight.
n and mostprimer.
yourself certainly
Manynot
of the
a doexpressions
it- used mean something entirely different
to a qualified
which their commondoctor
usethan
implies,
that and only a physician can correctly interpret the
during
symptomstreatment.
which mayAnyarise
patient who thinks he can reduce by taking a few ÒshotsÓ and e
ating
to be disappointed
less is not only but may
surebe heading for serious trouble. The benefit the patie
nt canofderive
part the book fromisreading
a fullerthisrealization of how very important it is for him to
follow
In
instructions.
treating
to theobesity
letterwith
his the
physician's
HCG + diet method we are handling what is perhaps t
he mostbody.
human complex
The diencephalon's
organ in the functional equilibrium is delicately poised, so t
hat whatever
part has repercussions
happens ininoneothers. In obesity this balance is out of kilter and c
an about
am only betorestored
describeifisthefollowed
technique
implicitly.
I Even seemingly insignificant deviat
ions, sight
first particularly
seem tothose
be anthat
improvement,
at are very liable to produce most disappoin
ting results
effect completely.
and evenForannul
instance,
the if the diet is increased from 500 to 600 or 700
quite
Calories,
unsatisfactory.
the loss ofIfweight
the daily
is dose of HCG is raised to 200 or more units da
ily its action
reversed, possibly
oftenbecause
appearslarger
to bedoses evoke diencephalic counter-regulations.
On the other is
diencephalon hand,
an extremely
the robust organ in spite of its unbelievable intricacy
. Fromitanisevolutionary
view one of the oldest
point organs
of in our body and its evolutionary history dat
es back'This
years. more has
thantendered
500 million
it extraordinarily adapt able to all natural exigencie
s, and that
reasons why the
is one
human
of species
the mainwas able to evolve what its evolution did not prep
arewhich
to
History
When ita patient
for
taking
human
werefirst
culture
the conditions
presents
and civilization
himself forexpose
treatment,
it. we take a general history a
nd noteofthe
signs overweight
time whenweretheobserved.
first We try to establish the highest weight the pa
tient has ever
(obviously excluding
had inpregnancy),
his life when this was and what measures have hitherto b
eenhas
It
reduce.
taken
beeninour
an experience
effort to that those patients who have been taking thyroid prep
arations lower
slightly for longaverage
periods
losshave
of weight
a under treatment with HCG than those who ha
ve even
is neversotaken
in those
thyroid.
patients
This who have been taking thyroid because they had an ab
normally
rate. In many
low basal
of these
metabolic
cases the low BMR is not due to any intrinsic deficiency
of athelack
to thyroid
of diencephalic
gland, but stimulation
rather of the thyroid gland via the anterior pitu
itary
to be taken
lobe. during
We nevertreatment,
allow thyroid
and yet a BMR which was very low before treatment
is usually
after a weekfound
or twoto of
be HCG
normal+ diet. Needless to say, this does not apply to those
deficiency
cases in whichhas been
a thyroid
produced by the surgical removal of a part of an overactive
gland.
to ascertain
It is whether
also mosttheimportant
patient has taken diuretics (water eliminating pills) a
s thisunder
loss
Returningalsotothe
decreases
ourHCGprocedure,
regimen.
the weight
we next ask the patient a few questions to which he
is heldortoÒnoÓ.
ÒyesÓ replyThese
simply
questions
with are: Do you suffer from headaches? rheumatic pains? menst
rual disorders?breathlessness or exertion? swollen ankles? Do you consider yourse
constipation?
lf greedy?
need to eatDosnacks
you feel
between
the meals?
The patient then strips and is weighed and measured. The normal weight for his h
eight, age,
muscular build
skeletal
is established
and from tables of statistical averages, whereby in wo
menallowance
an it is often fornecessary
particularlyto make
large and heavy breasts. The degree of overweight
is then
the duration
calculated,
of treatment
and fromcanthis
be roughly assessed on the basis of an average los
s of weight
pound say 300-400
of a little
grams-per
lessinjection
than a and day. It is a particularly interesting
feature
in reasonably
of thecooperative
HCG treatment patients
that this figure is remarkably constant, regardles
s ofDuration
The
overweight.
Patients
sex,who
ageneed
ofandTreatment
degree
to loseof15 pounds (7 kg.) or less require 26 days treatment wi
th 23 days
three dailyareinjections.
needed because
The extra
all patients must continue the 500- Calorie diet f
or three days
injection. Thisafter
is athe
verylast
essential part of the treatment, because if they start
even
eating
a trace
normally
of HCGas in
longtheir
as there
body they
is put on weight alarmingly at the end of th
e treatment.
when all the HCGAfterhasthree
beendays
eliminated this does not happen, because the blood is
then and
food no longer
can thus saturated
accommodate
with an extra influx from the intestines without increa
singnever
We
water.its give
volumea treatment
by retaining lasting less than 26 days, even in patients needing to
that
loseeven
onlyin5 the
pounds.
mildest
It seems
cases of obesity the diencephalon requires about three
weeks resttofrom
exertion whichtheitmaximal
has been previously subjected in order to regain fully its
normal fat this
Clinically banking expresses
capacity. itself -in the fact that when in these mild cases trea
tment isisstopped
weight normal,aswhich soonmay
as be
theachieved in a week, it is much more easily regain
ed soon
23
As than as
injections.
after
sucha patients
full coursehaveoflost all their abnormal superfluous fat, they at o
nce begin
hungry in she
to feelof continued
ravenouslyinjections. This is because HCG only puts abnormal fa
t into
in the doses
circulation
used, liberate
and cannot, normal fat deposits; indeed, it seems to prevent the
ir consumption.normal
statistically As soon
weight
as their
is reached, these patients are put on 800-1000 calor
ies diet
The for the
is arranged
rest of the in such
treatment.
a way that the weight remains perfectly stationary
and isafter
days thusthecontinued
23rd injection.
for threeOnly then are the patients free to eat anything t
hey please
starches
Such earlyforcases
except
the are
next
sugar
common
three
and among
weeks.actresses, models, mannequins and persons who
are tired
having seenofitsobesity,
ravages in other members of their family. Film actresses frequen
tly explain
less than normal.
that theyWithmust
thisweigh
request we flatly refuse to comply, first, because w
e undertake
not to createtoacure new one,
a disorder,
and second, because it is in the nature of the HCG meth
od that completely
becomes it is self ineffective
limiting. Itas soon as all abnormal fat is consumed. Actresse
s with a having
obesity, slight tried
tendency
alltomanner of reducing methods, invariably come to the con
clusion that only
satisfactory theirwhen
figuretheyisare underweight, simply because none of these method
s remove
fat deposits.
theirWhensuperfluous
they see that under HCG their figure improves out of all prop
ortionthey
lost, to theareamount
nearlyofalways
weightcontent to remain within their normal weight-range.
When a patient has more than 15 pounds to lose the treatment takes longer but th
e maximum
course is 40
we injections,
give in a singlenor do we as a rule allow patients to lose more than 34
treatment
lbs. (15 isKg.)stopped
at a time.
when either
The 34 lbs. have been lost or 40 injections have be
en given.
make is inThetheonly
caseexception
of grotesquely
we obese patients who may be allowed to lose an
additional
before
Immunity
The reason
thetofor
5-6
40
HCGinjections
lbs. if this
limiting aare
course
occurs
up. to 40 injections is that by then some patients
may begin Though
immunity. to showthis signsphenomenon
of HCG is well known, we cannot as yet define the unde
rlying mechanism. Maybe
after a certain length of time the body learns to break down and eliminate HCG v
ery rapidly,
prolonged treatment
or possibly
leads to some sort of (ouncrregulation which annuls the denc
epbahic40effect.
After daily injections it takes about six weeks before this so called immunit
y is lost
fully effective.
and HCGUsually
again becomes
after about 40 injections patients may feel the onset o
f immunity absent.
previously as hungerInwhich
thosewas
comparatively rare cases in which signs of immunity
develop
of 40 injections
before thehasfullbeencourse
completed-say at the 35th injection- treatment must he
continued
stopped attheonce,
patients
becausebegin
if to
it look
is weary and drawn, feel weak and hungry and a
ny furtherisloss
achieved thenofalways
weightat the expense of normal fat. This is not only undesirab
le, but normal
instantly
Patients who
regained
need
fatonly
is soon
as also
23 injections
as the patient
may beisinjected
returneddaily,
to a free
including
diet. Sundays, a
s they never
immunity. In those
developthat take 40 injections the onset of immunity can be delayed
if they areagiven
injections week,only
leaving
six out Sundays or any other day they choose, provided th
at the
On it isdays
always
on which
the same
theyday.
do not receive the injections they usually feel a slig
ht thought
we sensationthat
of this
hunger.might
At be
first
purely psychological, but we found that when norma
l saline
the
During
Menstruation
patient's
menstruation
is injected
knowledge
nowithout
injections
the same phenomenon
are given,occurs.
but the diet is continued and cause
s no hardship;isyet
menstruation over,
as the
soonpatients
as the become extremely hungry unless the injections
impressive
are resumedtoatseeonce.
the suffering
It is veryof a woman who has continued her diet for a day
or two without
period beyond thecoming
end for
of the
her injection and then to hear the next day that all h
unger the
after ceased
injection
within and
a fewtohours
see her once again content, florid and cheerful. Whil
e onmust
it thehequestion
added that
of menstruation
in teenaged girls the period may in some rare cases he del
ayed and exceptionally
altogether. If then later stopthis is artificially induced some weight may be regain
Further Courses
ed.
Patients requiring to lose more than 34 lbs. must have a second or even more cou
rses. A after
started secondancourse
interval
can of
be not less than six weeks, though the pause can be mo
re thanorsixeven
fourth weeks.
fifthWhen
course
a third,
is necessary, the interval between courses should be
Between
made progressively
a second andlonger.
third course eight weeks should elapse, between a third and
between
fourth acourse
fourthtwelve
and fifth
weeks,course twenty weeks and between a fifth and sixth cou
rse six months.
possible to bringInabout
this awayweight
it isreduction of 100 lbs. and more if required with
outgeneral,
In
patient.
the leastmenhardship
do slightly
to thebetter than women and often reach a somewhat higher
average daily
advanced casesloss.
do a little
Very better than early ones, but it is a remarkable fact t
hatthe
statistically
Conditions
On thisbasis
difference
that
ofsignificant.
mustisbedata
these only
accepted
the
justprobable
before duration
treatmentof treatment can he calculated
with is
this considerable
explained toaccuracy,
the patient.
and It is made clear to him that during the course
clinic
of treatment
daily tohebemust
weighed,
attendinjected
the and generally checked. All patients that li
ve in Rome
friends or relations
or have resident
with whom they can stay are treated as out-patients, but pa
tientsincoming
stay the hospital,
from abroad
as nomust
hotel or restaurant can be relied upon to prepare th
e dietpatients
These with sufficient
have theiraccuracy.
meals, sleep and attend the clinic in the hospital, bu
t areasotherwise
time they please
freeintothespend
citytheir
and its surroundings sightseeing bathing or thea
ter-going.
It is also made clear that between courses the patient gets no treatment and is
free tostarches
except eat anything
and sugar
he pleases
during the first 3 weeks. It is impressed upon him tha
t he will have
prescribed diettotofollow
the letter
the and that after the first three days this will cost
hunger
him noandeffort,
may indeed
as he have
will difficulty
feel no in getting down the 500 Calories which he
will be given.
conditions are not
If these
acceptable the case is refused, as any compromise or half mea
sure isabound
disappointing
Though patientto can
proveonly
patient utterly
and
consider
physician
himself
alikereally
and iscured
a waste
whenofhetime
has been
and energy.
reduced
weight,
to his westatistically
do not insist normal
that he commit himself to that extent. Even a partial l
oss of overweight
beneficial, and itisishighly
our experience that once a patient has completed a first c
oursewith
ease he iswhich
so enthusiastic
the-to him surprising-results
about the are achieved that he almost invari
ably comescan
certainly backbefor
no doubt
more. that
Therein my clinic more time is spent on damping over-e
nthusiasm
the
Examining
Only rules
when agreement
thanthe
of
the patient
ontreatment
insisting
is reached
bethat
observed.
on the points so far discussed do we proceed with
patient.
the examination
A note isofmade
the of the size of the first upper incisor, of a pad of fat
on the
and on the
napeinside
of theofneck,
the knees.
at the Theaxilla
presence of striation, a suprapubic fold, a
thoracic
and knee joint,
fold, angulation
breast-development
of elbow in men and women, edema of the ankles and the
development
Wherever
state ofthis
genital
inseems
the male
indicated
are noted.
we X-ray the sella turcica, as the bony capsule wh
ichcalled,
is containsmeasure
the pituitary
the basalgland
metabolic rate, X-ray the chest and take an electro
cardiogram.
and a sedimentation
We do a rate
blood-count
and estimate uric acid, cholesterol, iodine and sugar i
n thebefore
Gain
Patients
fasting
whose
Loss
blood.
general condition is low, owing to excessive previous dieting, mu
st eatbefore
week to capacity
startingfortreatment,
about oneregardless of how much weight they may gain in t
he process.
patient comfortably
One cannoton 500
keepCalories
a unless his normal fat reserves are reasonabl
y well also
reason stocked.
thatItevery
is for
case,
thiseven those that are actually gaining must eat to ca
pacitycanofget
they thedown
mostuntil
fattening
they have
food had then third injection. It is a fundamental
mistake toasput
Calories soona as
patient
the injections
on 500 are started, as it seems to take about three
injections
deposited
We distinguish
fat
before
begins
between
abnormally
tothe
circulate
first three
and thus
injections,
become available.
which we call 'non-effective'
concerned,
as far as andthe the
losssubsequent
of weight injections
is given while the patient is dieting, whi
ch we call
average lossÒeffectiveÓ.
of weight isThecalculated on the number of effective injections and f
rom of
day thethe
weight
thirdreached
injections
on thewhich may he well above what it was two days earlier
Most
given.
whenpatients
the firstwhoinjection
have beenasstruggling with diets for years and know how rapidly
themselves
they gain go if are
theyvery
let hard to convince of the absolute necessity of gorging for
must
at least
he insisted
two days,uponandcategorically
yet this if the further course of treatment is to run
have
smoothly.
to be put
Thoseonpatients
forced feeding
who for a week before starting the injections usual
ly gaininweight
pounds 24 hours
rapidly-
is notfour
unusual-but
to six after a day or two this rapid gain general
ly levels
whole gainoff.
is usually
In any lost
case in
thethe first 48 hours of dieting. It is necessary to
proceed
gain re-stocks
in thisthemanner
depleted
because
normal
the reserves, whereas the Subsequent loss is from
Patients
the abnormal
in a satisfactory
deposits only.general condition and those who have not just previou
sly restricted
forced feeding ontheir
thediet
day of
startthe first injection. Some patents say that they can
stomach
no longerhasovereat
shrunk after
becauseyears
theirof restrictions. While we know that no stomach ev
er shrinks, we compromise by
insisting that they eat frequently of highly concentrated foods such as milk cho
colate,sugar,
cream pastries
friedwith
meats
whipped
particularly pork, eggs and bacon, mayonnaise, bread wi
th thick
The time and
buttertrouble
and jam,
spentetc.
on pressing this point upon incredulous or reluctant
patients afterwards
rewarded is always amplyby the complete absence of those difficulties which patients
instructions
During
who havethedisregarded
twoaredays
liable
ofthese
forced
to experience.
feeding from the first to the third injection - ma
ny patients
contrary to their
are surprised
previousthatexperience they do not gain weight and some even lose
. The cases
these explanation
there is athat compensatory
in flow of urine, which drains excessive water
from seems
this the body.to beToasome
direct
extent
action of HCG, but it may also be due to a higher prot
einmenstruating
protein-deficient
Starting
In intake,treatment
as wewomen
knowthe
diet thatbest
makes athetime
bodytoretain
start treatment
water. is immediately after a pe
riod. Treatment
started later, but mayitalso
is advisable
be to have at least ten days in hand before the
onsetendofofthea course
the next period.
of onsetSimilarly,
should never be made to coincide with menstruation.
work
If things
out that should
way,happen
it is better
to to give the last injection three days before the
aexpected
normal dietdatecanof he
theresumed
menses atso onset.
that Alternatively, at least three injections
should bebygiven
followed the usual
after three
the period,
days of dieting This rule need not be observed in su
ch patients
their normalwho weight
havebefore
reachedthe end of treatment and are already on a higher calo
ric diet.who require more than the minimum of 23 injections and who therefore sk
Patients
ip one dayimmunity
postpone a week toin HCG
ordercannot
to have their third injections on the day before th
e interval.
to skip Sundays,
Thus the
if ittreatment
is decided can be started on any day of the week except Thur
sdays. Supposing
Thursday, they willtheyhave
start
theiron third injection on Saturday, which is also the da
y on which
Calorie diet.
theyThey
start
would
their
then500base no injection on the second day of dieting, th
is exposes them
unnecessary hardship,
to an as without the injection they will feel particularly hungr
y. Of course,
overcome by exceptionally
the difficulty injecting
can be them on the first Sunday. If this day falls
between the second
first and andsecond
third injection,
or we usually prefer to give the patient th
e extra
which
The Diet
500thecalorie
daymajority
of forced
dietrapturously
isfeeding,
explained enjoy.
on the day of the second injection to those pa
tients
own food,
whoandwillitbeispreparing
most important
their that the person who will actually cook is pre
sent -asthethewife,
cook, casethe
maymother
be. Hereor in
theItaly patients are given the following diet sh
eet.
Teaone-half
Breakfast:
tablespoonful
other
1.
Lunch:
white
must
meat
grilled
herring,
chicken
2.
following:
green
radishes,
3.
4.
or
Dinner
The 100
One
An
ormust
same
juice
beapple
sweeteners
fish,
salad,
coffee
grams
type
:breadstick
carefully
without
must
dried
four
bespinach,
cucumbers,
of lobster,
of
or
grapefruit.
ofchoices
weighed
be
tomatoes,
one
inan
oforremoved
vegetable
veal,
additional
any
milk
may
lemon
removed
pickled
(grissino)
orange
chard,
quantity
be
crab,
raw.
asparagus,
allowed
beef,
ascelery,
daily
used.
from
only
or
lunch.
before
It
fish
orachicken
fat.
chicory,
must
the
or
is
without
in
shrimp.
to
handful
are
fennel,
Salmon,
cabbage.
one
allowed
24benot
cooking,
bird.
be hours.
breast,
chosen
beet-greens,
Melba
boiled
sugar.
All
of
allowed.
onions,
eel,
for
strawberries
visible
and
toast.
Saccharin
from
fresh
or
all
Only
tuna,
the
red
Thefat
the
purposes.
oneor Salt, pepper, vinegar,
basil,
mustardparsley,
powder,thyme,garlic,majoram,
sweet etc., may be used for seasoning, but no oil, but
ter orcoffee,
Tea, dressing.
plain water, mineral water are the only drinks allowed, but they ma
y befact
all
In times.
takentheinpatient
any quantity
should drink
and atabout 2 liters of these fluids per day. Many pa
tients are
because theyafraid
fear that
to drink
thissomaymuchmake them retain more water. This is a wrong not
ion fruit
inclined
The as thetoorbody
store
theisbreadstick
water
more whenmay thebeintake
eatenfalls
betweenbelow
meals
itsinstead
normal of
requirements.
with lunch or
dinner,
four
No medicines
itemsbutlisted
not
or cosmetics
more
forthan
lunchother
than and than
dinnerlipstick
may be eyebrow
eaten atpencil
one meal.
and powder may he u
sed without
Every
permission
item inspecial
the list is gone over carefully, continually stressing the point t
hat no may
listed variations
be introduced.
other thanAllthose
things not listed are forbidden, and the patient i
s assured
has been left thatout.nothing
The 100
permissible
grams of meat must he scrupulously weighed raw after
all visible
removed to dofatthis hasaccurately
been the patient must have a letter-scale, as kitchen s
calesthearebutcher
and not sufficiently
should certainly
accurate not be relied upon. Those not uncommon patients
food
There
who is
feel
istoo
nothat
mucheven
objection
forsothem,
tolittle
breaking
can omitupanything
the two meals.
they wish.
For instance having a breads
tickanand
or orange
an apple
beforeforgoing
breakfast
to bed, provided they are deducted from the regular me
als.breadsticks
two The whole daily or tworation
fruitsofmay not be eaten at the same time, nor can any ite
m saved
be addedfromon thethefollowing
previous day.
day In the beginning patients are advised to check ev
ery mealstarting
before again their to eatdiet
andsheet
not to rely on their memory. It is also worth pointin
g outdiet
this thatwithout
any attempt
HCG will
to observe
lead to trouble in two to three days. We have had cas
es in which
proudly flaunted
patientstheirhave
dieting powers in front of their friends without mentioni
ng the facttreatment
receiving that theywith areHCG.
alsoThey let their friends try the same diet, and when
itthis
necessarily
proves tomust be a-failure
the patient- as starts raking in unmerited kudos for superhuma
n willpower.
It should also be mentioned that two small apples weighing as much as one large
one never
higher caloric
the less
valuehaveandaare therefore not allowed though there is no restrictio
n on thedosize
people not realize
of one apple.
that aSome
tangerine is not an orange and that thicken breast
doesmost
other
The not
fowl,
meannorthedoes
tiresome breast
patients
it mean
ofareany
a those
wing orwhodrumstick.
start counting Calories and then come u
p with all which
variations mannertheyof ingenious
compile from their little books. When one has spent years
of weary
make a dietresearch
as attractive
trying toas possible without jeopardizing the loss of weight, c
ulinary
improve
Making
The dietuptheir
geniuses
used
the inunhappy
Calories
who are
conjunction
lotout
arewith
tohardHCG
to must
take.not exceed 500 Calories per day, and
the way
made up isthese
of utmost
Caloriesimportance.
are For instance, if a patient drops the apple and
eatswill
he an not
extrabebreadstick
getting more instead,
Calories but he will not lose weight. There are a nu
mbervegetables,
and of foods, particularly
which have the fruits
same or even lower caloric values than those list
ed asthat
find permissible,
they interfere
and yetwithwe the regular loss of weight under HCG, presumably o
wing tothis
composition.
While thediet
nature
Pimiento
works
of satisfactorily
their
peppers, okra, in
artichokes
Italy, certain
and pears modifications
are exampleshave
of to
this.
be
made in other
instance, American
countries.
beef hasForalmost double the caloric value of South Italian bee
f, which
This marbling
is notismarbled
impossiblewithtofat.remove. In America, therefore, low-grade veal sho
uld be(excluding
fish used for all one those
meal andspecies such as herring, mackerel, tuna, salmon, eel,
etc.,allwhich
and dried,
havesmoked
a highorfatpickled
content,
fish), chicken breast, lobster, crawfish, pawns
the
shrimps,
other meal.
crabmeat Where
or the
kidneys
Italian
for breadsticks, the so-called grissini, are not a
vailable
used instead,
one Melba
thoughtoast
theymayarebepsychologically less satisfying. A Melba toast has
very
Inabout
many
porous
the
countries
same
grissini
weight
specially
which
as the
isprepared
much more
unsweetened
to look atandandlowtoCalorie
chew. foods are freel
y available,
can be tentatively
and some used.of When
theselocal conditions or the feeding habits of the popu
lationbemake
must bornechanges
in mindnecessary
that theittotal daily intake must not exceed 500 Calories i
f the
be obtained,
best possible
that theresults
daily ration
are to should contain 200 grams of fat-free protein
and aasvery
Just thesmall
dailyamount
dose ofofHCGstarch.
is the same in all cases, so the same diet proves
to be satisfactory
elderly lady of leisurefor aorsmall
a hard working muscular giant. Under the effect of HC
G the
to obtain
obeseallbody
theisCalories
always itableneeds from the abnormal fat deposits, regardless o
f whether
per day. Ititmust
usesbeupmade1500very
or 4000
clear to the patient that he is living to a far gr
eaterpatients
losing
Many extent
than ononask
what
thewhyhe
fateggs
eats.
which
arehenotisallowed. The contents of two good sized eggs
are roughly
grams of meat,equivalent
but fortunately
to 100 the yolk contains a large amount of fat, which is
weundesirable.
allow egg -Very boiled,
occasionally
poached or raw -to patients who develop an aversion to me
at, the
add but white
in thisofcase
threetheyeggsmust
to the one they eat whole. In countries where cottag
e cheese
milk is available
made from100 skimmed
grams may occasionally be used instead of the meat, but no
Strict
Vegetarians
other vegetarians
cheeses are such allowed.
as orthodox Hindus present a special problem, because mi
lk and protein
animal curds arethey thewill
onlyeat. To supply them with sufficient protein of animal o
rigin they
skimmed milkmust
perdrink
day, though
500 cc.partof of this ration can be taken as curds. As far a
s fruit, vegetables
concerned, their dietandisstarch
the same areas that of non- vegetarians; they cannot be al
lowed theirproteins
vegetable usual intake
from leguminous
of plants such as beans or from wheat or nuts, n
or can they have their
customary rice. In spite of these severe restrictions, their average loss is abo
ut half
presumably
Faulty
Few patients
Dieting
thatowing
of non
will totake
vegetarians,
the one's
sugarwordcontent
for it
of that
the milk.
the slightest deviation from the d
iet has as
results under
farHCGas the
disastrous
weight is concerned. This extreme sensitivity has the adva
ntage that the
immediately detectable
smallestaterrorthe daily
is weighing but most patients have to make the
experience
believe
Persons it.high
in beforeofficial
they willpositions such as embassy personnel, politicians, senio
r executives,
obliged to attendetc.,social
who arefunctions to which they cannot bring their meager meal
must be told
official dinnerbeforehand
will costthatthemanthe loss of about three days treatment, however c
areful they
friendly andarewould-be
and incooperative
spite of a host. 'We generally advise them to avoid all-r
ound embarrassment,
almost inevitable turn theof conversation to their weight problem and the outpourin
g of lay by
partners counsel
not letting
from their
it betable
known that they are under treatment. They should t
ake dainty servings
everything, bide whatofthey can under the cutlery and book the gain which may tak
e three
one of the
dayssacrifices
to get ridwhichof astheir profession entails. Allowing three days for th
eir jeopardize
not correction the suchtreatment,
incidents provided
do they do not occur all too frequently in w
hich case
postponed
Vitamins
Sooner orand
treatment
to
later
a socially
anemia
mostshould
patients
morebepeaceful
express aseason.
fear that they may be running out of vit
aminsmake
may or them
that anemic.
the restricted
On thisdietscore the physician can confidently relieve their
apprehension
that every time by they
explaining
lose a pound of fatty tissue, which they do almost daily, o
nly vitamins,
the the actualthe fatproteins
is burnedtheup;blood
all and the minerals which this tissue contains
the
in body
abundance
Actually,
are feda low
backblood
intocount not due to any serious disorder of the bloo
d forming
during treatment,
tissues and improves
we have never encountered a significant protein deficiency
innorthe
The
On patients
First
signs
dayDays
ofwhothe
aofare
lack
Treatment
third
dieting
of injection
vitamins
regularly.
it is almost routine to hear two remarks. One
is: ÒYou
it's onlyknow,
psychological,
Doctor, I'mbutsure I already feel quite differentÓ. So common is this re
mark, eventhat
patients fromwevery
hesitate
skeptical
to accept the psychological interpretation. The other
typical
have beenremark
allowedis:toÒNow
eatthat
anything
I I want, I can't get it down. Since yesterday I
doesn't
feel likeseema to
stuffed
interest
pig.meFoodanyjust
more, and I am longing to get on with your dietÓ.
Manypassing
are patientsmore notice
urinethat
andthey
that the swelling in their ankles is less even before
Onthey
thestart
day ofdieting.
the fourth injection most patients declare that they are feeling f
ine. They
pounds or more,
have usually
some saylosttheytwofeel a bit empty but hasten to explain that this d
oes not amount
complain of a mildto hunger.
headacheSomeof which they have been forewarned and for which the
y have the
permission
During beensecond
togiven
takeandaspirin.
third day of dieting - that is, the fifth and sixth inject
ion-these
while the weight
minor complaints
continues to improve
drop at about double the usually overall average o
f almost
that a moderately
one poundsevereper day,casesomay by the fourth day of dieting have lost as much
Itasis8-usually
10 lbs.at this point that a difference appears between those patients who
during
have literally
the firsteatentwo days
to capacity
of treatment and those who have not. The former feel r
emarkablynorwell;
hunger, do they
theyfeel
havetempted
no when others eat normally at the same table. The
y feel and
headed lighter,
noticemore a desire
clear-to move quite contrary to their previous lethargy. Th
ose who have disregarded the
advice to eat to capacity continue to have minor discomforts and do not have the
being
same until
euphoricabout
sense
a week
of self-
later. It seems that their normal fat reserves require
thatfully
are
Fluctuations
After much
the fourth
moreintime
stocked. weight
or fifth
before
lossday
theyof dieting the daily loss of weight begins to decr
easeclay,
per to oneandpound
thereorissomewhat
a smaller lessurinary output. Men often continue to lose regu
larlyirregular
more at that rate,
in spite
but ofwomen
faultless
are dieting. There may be no drop at all for tw
o or which
loss three reestab1ishes
days and then the a sudden
normal average. These fluctuations are entirely due
and
The
to weight
variations
elimination
registered
inofthe
water,
retention
by the
whichscale
areismore
determined
marked inbywomen
two processes
than in men.
not necessaril
y synchronized
influence of HCGunder
fat is
thebeing extracted from the cells, in which it is stored in
are
theempty
fattyandtissue.
therefore
When serve
these ocells
purpose the body breaks down the cellular struct
ureofanduseless
up absorbscells,
it, but
connective
breakingtissue, blood vessels, etc., may lag behind the
process
this happens
of fat-extraction.
the body appears Whento replace some of the extracted fat with water wh
ichwater
As is retained
is heavierfor than
this fat
purpose.
the scales may show no loss of weight, although suc
ient fat to
consumed hasmake
actually
up forbeen
the deficit in the 500-Calorie diet. When then such tiss
ue is is
water finally
liberated
brokenanddown,
theretheis a sudden flood of urine and a marked loss of wei
ght. is
what Thisreally
simpleaninterpretation
extremely complex of mechanism is the one we give those patients
who want
that on certain
to knowdayswhy they
it isdo not lose, though they have committed no dietary err
Patients who have previously regularly used diuretics as a method of reducing lo
or.
se fatweeks
three duringofthetreatment
first twowhich
or shows in their measurements, but the scale may sh
ow little
they are replacing
or no lossthebecause
normal water content of their body which has been dehydra
ted.distinguish
used
Interruptions
We Diuretics
for reducing.
offour
should
Weight
types
never
Loss
ofbeinterruption in the regular daily loss. The first i
s the one in
mentioned thatwhich
has the
already
weightbeenstays stationary for a day or two, and this occurs
a, course,
Theparticularly
Plateauintype
second almost
towards
of interruption
every
thecase.
end ofwe call a ÒplateauÓ. A plateau lasts 4-6 days and fr
equentlyhalf
second occurs
of aduring
full course,
the particularly in patients that have been doing well
nearly
and whose
a pound
overall
per effective
average ofinjection has been maintained. Those who are losing
amore
plateau
thansooner
the average
or later.
all Ahaveplateau always corrects, itself, but many patients
who havedaily
regular becomelossaccustomed
get unnecessarily
to a worried and begin to bet. No amount of expl
anation
plateau
In such cases
convinces
does not
we consider
mean
themthat
thatitthey
apermissible,
are no longer
for purely
responding
psychological
normally toreasons,
treatment.
to b
reak in
done up two
the ways.
plateau.OneThis
is acanso-called
be Òapple dayÓ. An apple-day begins at lunch and c
ontinues
lunch of the
untilfollowing
just before
day. The patients are given six large apples and are told
desire
to eatthough
one whenever
six applestheyisfeel
thethemaximum allowed. During an apple-day no other fo
od or are
water liquids
allowed
exceptandplain
of water they may only drink just enough to quench an unco
mfortable
apple stillthirst
leavesifthem
eatingthirsty.
an Most patients feel no need for water and are qu
ite happytowith
Needless say,their
an apple-
six apples.
day may never be given on the day on which there is n
o injection.
produces a gratifying
The apple-day
loss of weight on the following day, chiefly due to the el
imination
not regained
of when
water.theThis
patients
water resume
is their normal 500- Calorie diet at lunch, a
nd on thetofollowing
continue lose weight
dayssatisfactorily.
they
The other way to break up a plateau is by giving a non- mercurial diuretic for o
ne day. but
patient Thisweisprefer
simplertheforapple-day
the as we sometimes find that though the diureti
c is very day
following effective
it mayontakethetwo to three days before the normal daily reduction is
into
resumed,
a newthrowing
fit of despair.
the patientIt is useless to give either an apple-day or a diuret
ic unless the
stationary forweight
at leasthasfour
beendays without any dietary error having been committe
Reaching
d.
The thirdatype
Former
of interruption
Level in the regular loss of weight may last much longe
r-ten days toittwoisweeks.
Fortunately, rare and only occurs in very advanced cases, and then hardly
ever duringIttheisfirst
treatment. seen only
courseinofthose patients who during some period of their liv
es haveofmaintained
degree obesity for a certain
ten yearsfixed
or more and have then at some time rapidly incre
ased in
then beyond
the course
that weight.
of treatment
When the former level is reached, it may take two wee
ks offourth
and
Menstrual
The diet,
no loss,
before
Interruption
typeinoffurther
spite
interruption
ofreduction
HCG is theis normally
one whichresumed.
often occurs a few days before
and induring
somethewomen
menstrual
at the time
periodof ovulation. It must also be mentioned that when
a womantreatment
during becomes pregnant
- and this is by no means uncommon - she at once ceases to lose
ofweight.
reduction
An unexplained
has on several arrest
occasions raised our suspicion before the first peri
od was missed.isIfdelayed,
menstruation in suchweeases
stop injecting and do a precipitation test five days
belater.
carried
No out
pregnancy
earliertestthanshould
five days after the last injection, as otherwise the
Oral
result.
Dietary
Any
HCGinterruption
mayErrors
contraceptives
give a false
of the
maypositive
be usedloss
normal during
of weight
treatment.
which does not fit perfectly into
one to
due of some
thosepossibly
categories veryisminor
alwaysdietary error. Similarly, any gain of more than
100 grams
result of some
is invariably
transgression
the or mistake, unless it happens on or about the day o
f ovulation
days precedingor the
during
onset
theofthree
menstruation, in which case it is ignored. In all ot
her patient
must
The cases
be established
thewhoreason
frankly
atforonce.
admits
the gain
that he has stepped out of his regimen when told
thatnosomething
is problem. He hasisgone
always
wrongsurprised at being found out, because unless he has
seen thisthat
believe himself
a salted
he will
almond,
not a couple of potato chips, a glass of tomato juice
aordefinite
Veryanoften
extraheincrease
orange
wantswill
in know
to his
bring
weight
whyabout
extra
on the
foodfollowing
weighingday.
one ounce should increase hi
s by in
this sixthe
ounces.
following
We explain
way: Under the influence of HCG the blood is saturated wit
h food
has adapted
and theitself
bloodsovolume
that it can only just accommodate the 500 Calories which c
omethe
in in course
from theofintestinal
the day. Any tract
additional income, however little this may be, can
not beisaccommodated
blood therefore forced
and theto increase its volume sufficiently to hold the extra
food, which
diluted form.itThus
can it
onlyisdonotinthe
a very
weight of what is eaten that plays the determin
ing role
water
This can
which
butillustrated
be the
rather
bodythemustby
amount
retain
mentioning
ofto accommodate
the case ofthis
salt.
food.
In order to hold one tea
spoonful
one literofofsalt
water,theasbody
it cannot
requiresaccommodate salt in any higher concentration. T
hus, if a person
teaspoonfull of salt
eatshis
oneweight will go up by more than two pounds as soon as th
is salt is absorbed from his
intestine.
To this explanation many patients reply: Well, if I put on that much every time
I eatmya weight
hold little after
extra,thehowtreatment
can I It must therefore be made clear that this onl
y happens
under HCG.asWhen
longtreat
as they
meltareis over, the blood is no longer saturated and can eas
ily accommodate
without having toextra
increase
food its volume. Here again the professional reader will h
ae simplification
aware that thisofinterpretation
an extremely intricate
is physiological process which actually
accounts
Salt
While and
we are
for on
Reducing
thethe
phenomenon.
subject of salt, I can take this opportunity to explain that
ofwesalt
makeand no insist
restriction
that the
in the
patients
use drink large quantities of water throughout
the treatment.
abnormal fat andWeare
arenot
outintothe
reduce
least interested in such illusory weight losses
as can
the bodybeofachieved
salt andbybydepriving
desiccating it. Though we allow the free use of salt, th
e daily the
roughly amount
same,
taken
as ashould
suddenbeincrease will of course be followed by a correspon
ding increase
shown by the scale.
in weight
An increase
as in the intake of salt is one of the most common
causesonefordayantoincrease
from the next.
in Such
weightan increase can be ignored, provided it is accoun
ted regular
the
Patients
Waterfor, areit loss
inusually
noofwayfat.
hard
influences
to convince that the amount of water they retain has n
othingthey
water to dodrink.
with When
the amount
the bodyof is forced to retain water, it will do this at al
l costs. If the
insufficient to provide
fluid intake
all the
is water required, the body withholds water from th
e kidneys
scanty andand
highly
the concentrated,
urine becomes imposing a certain strain on the kidneys. If tha
t is be
will insufficient,
with-drawn fromexcessive
the intestinal
water tract, with the result that the feces bec
ome hard
hand if aandpatient
dry. drinks
On the more
otherthan his body requires, the surplus is promptly an
d easilythe
prevent eliminated.
body fromTrying
retaining
to water by drinking less is therefore not only fut
ileexcess
An
Constipation
but even of water
harmful.keeps the feces soft, and that is very important in the obese
, who commonlyandsuffer
Constipation a spastic
from colon. While a patient is under treatment we never pe
rmit the taken
laxative use ofbyanymouth.
kind We
of explain that owing to the restricted diet it is perf
ectlyansatisfactory
have evacuation of andthe
normal
boweltoonly once every three to four days and that, pro
vidednever
this plentyleads
of fluids
to anyaredisturbance.
taken, Only in those patients who begin to fret af
terafour
of suppository.
days do wePatients
allow thewhouse
observe this rule find that after treatment they
have the
action
Investigating
When a and
perfectly
reason
thisDietary
delights
for
normal
a slight
Errors
bowel
manygain
of them
in weight
almostisasnot
muchimmediately
as their loss
evident,
of weight.
it is ne
cessary who
patient to investigate
is unaware of further.
havingAcommitted an error or is unwilling to admit a m
istaketold
when protests
he hasindignantly
done something he ought not to have done. In that atmosphere no
conducted;
fruitful investigation
so we calmly explain
can be that we are not accusing him of anything but tha
t weinconsiderable
not know for certain experience
from ourthat something has gone wrong and that we must now
and
sittry
downandquietly
find outtogether
what it was. Once the patient realizes that it is in his ow
n interest
not merely athat passive
he play
roleaninactive
this search,
and the reason for the set-hack is almost
invariably
through hundreds
discovered.
of suchHaving
sessions,
been we are nearly always able to distinguish the
deliberate
who
Liars
When isweand
merely
seeFools
liar
obese
fooling
from
patients
the
himself
patient
there
or are
is really
generally
unaware
two of us
having
present
erred.
in order to spe
ed upweroutine
when have tohandling.
investigate
Thusa rise in weight, a glance is sufficient to make sur
e that we agree or disagree. If
after a few questions we both feel reasonably sure that the patient is deliberat
ely opinion
our lying, weandtell
warnhimhimthat
thatthis
unless
is he comes clean we may refuse further treatm
ent. The way
furnishes additional
he reactsproofto this
whether we are on the right track or not we now very
rarely
If the patient
make a mistake.
breaks down and confesses, we melt and are all forgiveness and tr
eatment proceeds.
performances have toYetbeifrepeated
such more than two or three times, we refuse further
less
treatment.
than 1%This
of our
happens
cases.inIf the patient is stubborn and will not admit what he
himhasone
beenmore
up chance
to, we and
usually
continue
give it mean even though we have been unable to find
many
the such
reasoncases
for there
his gain.
is noInrepetition, and frequently the patient does then con
fesspatient
thought
The a few
things
days
whoover.
later
is fooling
afterhimself
he has is the one who has committed some trifling, o
ffense
who hasagainst
been ablethetorules
convince
but himself that this is of no importance and cannot p
ossibly Women
weight. accountseem
forparticularly
the gain in prone to getting themselves entangled in such de
lusions.
does frequently
On the happen
other hand,
that aitpatient will in the midst of a conversation unthin
kingly
Athat
mother
hespear
has
preparing
already
an olivefood
eaten
orfor
forget
histhebreadstick.
family may out of sheer habit forget that she mu
st not taste
whether it needs
the more
saucesalt.
to seeSometimes a rich maiden aunt cannot be offended by r
efusingshea has
which cup put
of tea
twointo
teaspoonful of sugar, thoughtfully remembering the patient
's taste from
occasions. Suchprevious
incidents are legion and are usually confessed without hesitatio
n, but someable
genuinely patients
to forget
seemthese lapses and remember them with a visible shock onl
y after
In theseinsistent
cases we go questioning.
carefully over the day. Sometimes the patient has been invi
ted to a mealnaively
restaurant, or gonebelieving
to a that the food has actually been prepared exactly a
ccording
will say:to'Yes,
instructions.
now that IThey come to think of it the steak did seem a bit bigger t
han taste
did the onebetter;
I havemaybe
at home,
thereandwasita little fat on it, though I specially told th
em to cut itwere
breadsticks all broken
awayÓ. andSometimes
a few fragments
the eaten, and ÒMaybe they were a little m
ore than for
uncommon oneÓ.patients
It is notto place too much reliance on their memory of the diet-she
et andorstart
beans peaseating
and then
carrots,
to seem genuinely surprised when their attention is calle
d to no
forbidden,
When
Cosmetics
thedietary
fact
as they
that
error
these
haveisnot
arebeen listed.
elicited we turn to cosmetics. Most women find it hard
to believe
and ointmentsthatapplied
fats, tooils,
thecreams
skin are absorbed and interfere with weight reducti
on byeaten.
been HCG justThisasalmost
if theyincredible
had sensitivity to even such very minor increases
peculiar
in nutritional
featureintake
of theisHCGa method. For instance, we find that persons who habit
ually
as workers
handleinorganic
beauty parlors,
fats, suchmasseurs, butchers, etc. never show what we consid
er apoint
unless
The satisfactory
theyiscan
so important
avoid
lossfatof that
weightI will
coming into illustrate
contact withittheir
with two
skin.cases. A lady who w
as cooperating
increased half aperfectly
pound. Careful
suddenlyquestioning brought nothing to light. She had ce
rtainly
nor had she
madeused
no dietary
any kinderror
of face cream, and she was already in the menopause. A
s weimplicitly,
her felt that wewecould
left the
trustquestion suspended. Yet just as she was about to lea
ve the consulting
suddenly stopped, turned
worn sheand snapped her fingers. ÒI've got itÓ she said. This is wh
at had herself
bought happeneda:new Sheset
hadof make-up pots and bottles and, using her fingers, had
oftransferred
cosmetics toherthe
large
newassortment
containers in anticipation of the day she would be able
to use
The
treatment.
other
themcase
again
concerns
after aherman who impressed us as being very conscientious. He w
as about
hut did not
20 lose
lbs. satisfactorily
overweight from the onset of treatment. Again and again we
tried
no success,
to finduntil
the one
reason
daybut
he said:ÒI
with never told you this, but I have a glass eye.
In fact, I have a whole set of
them. I frequently change them, and every time I do that I put a special ointmen
t in could
that my eyesocket..
have anythingDo youtothink
do with it?' As we thought just that, we asked him t
o stop
from
We arethat
using
particularly
daythis
on his
ointment,
averse
weight-loss
toandthose
wasmodern
regular.
cosmetics which contain hormones, as
any interference
endocrine regulations
with during treatment must be absolutely avoided. Many women wh
oseyears
of skin become
has in adjusted
the courseto the use of fat containing cosmetics find that their
skin gets
using them.dryInassuch
sooncases
as they
we permit
stop the use of plain mineral oil, which has no n
utritional
hand, mineral
value.
oil should
On the nototherbe used in preparing the food, first because of its
second
undesirable
becauselaxative
it absorbsquality,
some fat-soluble
and vitamins, which are then lost in the
stool. We powder
lipstick, do permit andthe
suchuselotions
of as are entirely free of fatty substances. We a
lso hair
the allowbutbrilliantine
it must nottobeberubbed
used oninto the scalp. Obviously sun-tan oil is proh
Many women are horrified when told that for the duration of treatment they canno
ibited.
t use face
facial massages.
creamsTheyor have
fear that this and the loss of weight will ruin their comp
lexion. TheyUnder
reassured. can treatment
be fully normal fat is restored to the skin, which rapidly bec
omesexpression
the fresh and much
turgid,moremaking
youthful. This is a characteristic of the HCG method wh
ich is to
wonder a constant
patientssource
who haveof experienced or seen in others the facial ravages pro
duced by the
reducing. An obese
usual woman
methodsofof70 obviously cannot expect to have her pued face red
uced to normal
wrinkle, hut itwithout
is remarkable
a how youthful her face remains in spite of her age.
Incidentally,
The Voice another interesting feature of the HCG method is that it does not
ruin aprima
obese singingdonna
voice.
usually
The finds
typically
that when she tries to reduce the timbre of her
voice is liablethis
understandably to change,
terrifiesandher. Under HCG this does not happen; indeed, in ma
ny cases
and the breathing
the voiceinvariably
improves does. We have had many cases of professional singer
s very voice
expert carefully
teachers,
controlled
and theby macsw have been so enthusiastic that they now fre
quentlyfrom
Other
Apart Reasons
senddiet
usforand
patients.
a cosmetics
gain there can be a few other reasons for a small rise
in weight. Some
unwittingly takepatients
chewing gum, throat pastilles, vitamin pills, cough syrups etc.
, without
or fats theyrealizing
containthatmay interfere
the sugar with a regular loss of weight. Sex hormones o
r cortisone
forms must beinavoided,
its variousthough
modern
oral contraceptives are permitted. In fact the onl
y self-medication
aspirin for a headache,
we allow though
is headaches almost invariably disappear after a wee
k ofthetreatment,
of
Occasionally
migrainewe allow
particularly
type. a sleeping
if tablet or a tranquilizer, but patients should b
e toldneed
they thatandwhile
may get
underlesstreatment
sleep. For instance, here in Italy where it is custom
ary tolasts
which sleepfrom
duringonethe
to four
siestain the afternoon most patients find that though the
y lie
We
sleep.
encourage
down theyswimming
are unable
and sun
to bathing during treatment, but it should be remembe
red thatproduces
always a severea temporary
sunburn rise in weight, evidently due to water retention. Th
e same may
patient getsbeaseen
commonwhencold
a during treatment. Finally, the weight can temporarily
this
increase
may sound
- paradoxical
after an exceptional
though physical exertion of long duration leading t
o a feeling
game of tennis,
of exhaustion.
a vigorous swim,
A a run, a ride on horseback or a round of golf d
o not ahave
trek, daythis
of skiing,
effect;rowing
but a orlongcycling or dancing into the small hours usually
following
result inday,a gainunless
of weight
the patient
on theis in perfect training. In patients coming fro
m abroad,
their cars,where
we often
they see
alwaysthisuseeffect after a strenuous day of shopping on foot,
sightseeing
and museums.and Though
visits
thetoextra
galleries
muscular effort involved does consume some additio
nalbeCalories,
to offset bythis theappears
retention of water which the tired circulation cannot at onc
e eliminate.
We hardly ever useDrugs
Appetite-reducing amphetamines, the appetite-reducing drugs such as Dexedrin, D
examil,seems
there Preludin,
to be noetc.,
needasfor them during the HCG treatment. The only time we fi
nd them is
patient useful
for impelling
is when a and unforeseen reason obliged to forego the injections
foranthree
wishes
Unforeseen
If interruption
to continue
tointerruptions
four days
thetreatment
of andofyet
diet so that
treatment
lasting
he need
morenot
thaninterrupt
four daystheiscourse.
necessary, the pa
tient 800
least mustCalories
increasebyhisadding
diet meat,
to at eggs, cheese, milk to his diet after the thir
d day, assootherwise
himself hungry andheweakwillthat
findhe is unable to go about his usual occupation. I
f the the
weeks interval
patientlasts
canless
directly
than resume
two injections and the 500-Calorie diet, but i
f theaagain
must
When interruption
patienteat knows
normally
lasts
beforehand
until
longerhethat
hehas he
hadwill
his have
thirdtoinjection.
travel and he absent for mo
re thantofour
better stopdays,
injections
it is always
three days before he is due to leave so that he can ha
ve theare
which threenecessary
days ofafter
strictthedieting
last injection at home. This saves him from the al
mostarrange
to impossible
the 500
taskCalorie
of having
diet while en route, and he can thus enjoy a much gre
aterofdietary
day his departure.
freedom fromInterruptions
the occurring before 20 effective injections hav
e been given because
undesirable, are mostwith less than that number of injections some weight is lia
ble toinjection
20th
Muscular
Towards bethe
Fatigue
regained.
end-of
an unavoidable
aAfter
full course
the interruption
when a goodisdeal
merely
of fat
a loss
hasofbeen
time.
rapidly lost,
some patients
lifting a weightcomplain
or climbing
that stairs requires a greater muscular effort than befo
re. They feel neither
breathlessness nor exhaustion but simply that their muscles have to work harder.
disappears
This phenomenon,
soon after
whichthe end of the treatment, is caused by the removal of abno
rmalaround
and fat deposited
the muscles.
between,
The removal
in of this fat makes the muscles too long, and
so in order
skeletal movement
to achieve
- sayathe certain
bending of an arm - the muscles have to perform grea
ter conatraction
Within short whilethanthebefore.
muscle adjusts itself perfectly to the new situation, b
ut under
rapid thatHCGthis
theadjustment
loss of fatcannotis sokeep up with it. Patients often have to be rea
ssuredarethat
they Ògetting
this does
weakÓ.
notThis
meanphenomenon
that does not occur in patients who regularly ta
kenever
Icontinue
Massage
vigorous
allow
to doexercise
any
so kind
during
andoftreatment.
massage during treatment. It is entirely unnecessary a
nd merelyprocess
delicate disturbswhich
a veryis going on in the tissues. Few indeed are the masseurs a
nd masseusestowho
temptation knead
canandresist
hammer
theabnormal fat deposits. In the course of rapid red
uction
to pickitupisa fold
sometimes
of skinpossible
which has not yet had time to adjust itself, as it alw
ays doesThis
figure. underfoldHCG,contains
to the itschanged
normal subcutaneous fat and may be almost an inch
objects
thick. ofIt the
is one
HCGoftreatment
the mainto keep that fat there. Patients and their masseurs
and
do hopefully
not alwaysgive understand
this fatthisa working- over. I have seen such patients who were
as my
received
In black
opinion,
aandsound
blue
massage,
thrashing.
as if thumping
the had rolling, kneading and shivering undertaken for
the purpose
abnormal fatofcanreducing
do nothing but harm. We once had the honor of treating the prop
rietress of that
institution a highspecialized
class in such antics. She had the audacity to confess tha
t she washer
convince taking
clients
our oftreatment
the efficacy
to of her methods, which she had found useless
in her own case.
How anyone in his right mind is able to believe that fatty tissue can be shifted
vanish
mechanically
by squeezing
or be ismadebeyond
to my comprehension. The only effect obtained is seve
re bruising.
then forms scars,
The torn
and these
tissueslowly contract making the fatty tissue even harder
Aandlady
moreonce
unyielding.
consulted us for her most ungainly legs. Large masses of fat bulged
overthere
and the ankles
were about
of her40tiny
lbs.feet,
too much on her hips and thighs. We assured her tha
t this
and thatoverweight
her anklescould
wouldbemarkedly
lost improve in the process. Her treatment progres
sed surprise
our most satisfactorily
there was nobutimprovement
to in her ankles. We then discovered that she
every
had for
kindyears
of mechanical,
been takingelectric and heat treatment for her legs and that she
had madesurgery
plastic
Re-examiningup her
theif
mind
fatweabove
tofailed.
resort
her ankles,
to we found that it was unusually hard. We a
ttributed
minor injuries
this inflicted
to the countless
by kneading. These injuries had healed but had left a t
ough network
tissue in whichof the
connective
fat wasscar-
imprisoned. Ready to try anything, she was put to be
d for
of herthe
first
remaining
course with
threeherweeks
lower legs tightly strapped in unyielding bandages.
increased.
Every day The
the combination
pressure wasof HCG, diet and strapping brought about a marked imp
rovement
her ankles.in At
thethe
shapeendofof her first course she returned to her home abroad. Thre
e months
her secondlater
course.
she She
camehad
hackmaintained
for both her weight and the improvement of her
was
ankles.
repeated,
The same
and after
procedure
five weeks she left the hospital with a normal weight an
d legs that,
shapely, wereifatnot
least
exactly
unobtrusive. Where no such injuries of the tissues have b
een inflicted
methods
Blood
Towards Sugar
of treatment,
the endbyofinappropriate
a course
these or
drastic
when ameasures
patientare
hasnever
nearlynecessary.
reached his normal weig
ht itblood
the occasionally
sugar drops happens
belowthat
normal, and we have even seen this in patients who h
ad an before
sugar abnormally
treatment.
high blood
Such an attack of hypoglycemia is almost identical with
the one
have taken
seentooinmuch
diabetics
insulin,whoThe attack comes on suddenly, there is the same fee
ling of light-headedness,
weakness In the knees, trembling and unmotivated sweating; but under HCG hypogly
cemiafeeling
any does not
of hunger.
produce All these symptoms are almost instantly relieved by takin
g two
In
sugar.
theheaped
courseteaspoonful
of treatmentofthe possibility of such an attack is explained to tho
se patients
which a dropwhoin blood
are insugar
a phase
mayinoccur. They are instructed to keep sugar or gluc
ose sweets
when drivinghandy,
a car.particularly
They are also held to watch the effect of taking sugar very
carefully day.
following and report
This istheimportant, because anxious patients to whom such an attac
k hassugar
take been unnecessarily,
explained are apt in which
to case it inevitably produces a gain in weight
and symptoms
the does not fordramatically
which it wasrelieve
taken, proving that these were not due to hypoglyc
emia.effects
the Some patients
of emotional
mistakestress for hypoglycemia. When the symptoms are quickly
relieved
that theybywere
sugar
indeed
thisdueis to
proof
an abnormal lowering of the blood sugar, and in tha
t case on
weight there
theisfollowing
no increaseday.inWethe
always suggest that sugar be taken if the patien
t is such
Once in doubt.
an attack has been relieved with sugar we have never seen it recur on
the immediately
days, and only very
subsequent
rarely does a patient have two such attacks separated by sev
eral days during
treatment. In patients
a coursewhoofhave not eaten sufficiently during the first two days
sugar
of treatment
when theweminor
sometimes
symptomsgiveusually felt during the first there days of treatm
ent in
and continue
some cases
beyondthis
thathastime,
seemed to speed up the euphoria ordinarily associated
The
Anwith
interesting
Ratio
the of
HCGPounds
method.
featureto of
Inches
the HCG method is that, regardless of how fat a patien
-t abdomen
is, the orgreatest
hips ascircumference
the case may-be is reduced at a constant rate which is extr
aordinarily
kilogram of weight
close tolost.
1 cm.Atper
the beginning of treatment the change in measurement
s is somewhat greater than
this, but at the end of a course it is almost invariably found that the girth is
number
as manyofcentimeters
kilograms byless which
as the weight has been reduced. I have never seen this
patients
Preparing
Human
clearchorionic
cutthat
the
relationship
trygonadotrophin
Solution
to reduce in bycomesdieting
on the
only.market as a highly soluble powder whi
ch is the from
extracted pure the
substance
urine of pregnant women. Such preparations are carefully stan
dardized,
by a reliable
and pharmaceutical
any brand made company is probably as good as any other. The subst
anceurine
the shouldandbenot
extracted
from thefrom placenta, and it must of course be of human and not o
f animalinorigin.
sealed ampoulesTheorpowder
in rubber-capped
is bottles in varying amounts which are stat
ed inform
this International
HCG is stable;
Units.however,
In only such preparations should he used that hav
e thedate
the dateofofexpiry
manufacture
clearlyand stated on the label or package. A suitable solvent is
ampoule
Once
always
HCGin
supplied
isthe
in solution
same
in package.
a separate
it is far less stable. It may be kept at room-temperatur
e for twomust
solution to three
be keptdays,
longer
but itif should
the always be refrigerated. When treating onl
y one or two cases
simultaneously, vials containing a small number of units say 1000 I.U. should be
which
used.isThesupplied
10 cc. byof the
solvent
manufacturer is injected into the rubber- capped bottle
powder
containing
must dissolve
the HCG, instantly.
and the Of this solution 1 .25 cc. are withdrawn for eac
h injection.
1000 I.U. therefore
One suchfurnishes
bottle of8 injections. When more than one patient is being
treated,
have theirthey
ownshould
bottlenot buteach
rather all be injected from the same vial and a fresh
solution
As we aremade
usually
whentreating
this is aempty.fair number of patients at the same time, we prefer
units.
to useWith
vialsthese
containing
the manufactures
5000 also supply 10 cc. of solvent. Of such a solu
tion 0,25
Which is the
cc.standard
contain close
the 125forI.U. all cases and which should never be exceeded. Th
is smallaccurately
handle amount is(it awkward
requiresto an insulin syringe) and is wasteful, because ther
e isthea syringe
of loss of and
solution
in theinneedle.
the nozzleWe therefore prefer a higher dilution, which w
e prepare
The solventinsupplied
the following
is injected
way: into the rubbercapped bottle containing the 500
0 I.U to
small . Ashold
these
morebottles
solvent, arewetoowithdraw 5 cc., inject it into an empty rubber-ca
pped bottle
normal salineandtoadd
each5 bottle.
cc. of This gives us 10 cc. of solution in each bottle, a
nd ofproduces
125
HCG
Injecting
I.this
U. This
solution
little
amountor
0.5isnocc.
convenient
tissue-reaction,
containsto inject it is
withcompletely
an ordinary
painless
syringe.
and in the
many given
have thousands
we have
of injections
never seenwean inflammatory or suppurative reaction at the sit
e ofshould
One the injection.
avoid leaving a vacuum in the bottle after preparing the solution or
after withdrawal
required for the injections
of the amount as otherwise alcohol used for sterilizing a frequent
ly perforated
drawn into therubber
solution.cap When
mightsharp
be needles are used, it sometimes happens that
a little
out of thebitrubber
of rubber
cap and is can
punched
be seen as a small black speck floating in the sol
ution. Asthan
heavier these
thebits
solution
of rubber
they rapidly
are settle out, and it is thus easy to avoid
drawing
We use very
themfine
intoneedles
the syringe.
that are two inches long and inject deep intragluteally
the
in buttocks.
the outer Theupperinjection
quadrantshouldof if possible not be given into the superficial
patients
fat layers,
mustwhich
be compressed
in very obeseso as to enable the needle to reach the muscle. Obvi
ouslybeneedles
must carefully
and washed,
syringessterilized and handled aseptically. It is also importa
nt given
be that theat intervals
daily injection
as close should
to 24 hours as possible. Any attempt to economize
atinlonger
Theretime
arebyhardly
intervals
givinganylarger
iscontraindications
doomed
dosesto producetolessthe HCG
satisfactory
method. Treatment
results. can be conti
nued in thesuppuration,
abscesses, presence of large infected wounds and major fractures. Surgery and g
eneral anesthesia are no reason
to stop and we have given treatment during a severe attack of malaria. Acne or b
oils areusually
former no contraindication
clears up, andthe furunculosis comes to an end. Thrombophiebitis is
no contraindication,
have treated several obese and wepatients with HCG and the 500 Calorie diet while suff
ering from has
impression thisbeencondition.
that inOur obese patients the phlebitis does rather better and
certainly
usual treatment
no worse alone.
thanThis
underalsotheapplies to patients suffering from varicose ulc
ers which
While
Fibroids
uterine
tendfibroids
to heal seem
rapidly.to be in no way affected by HCG in the doses we use,
large,
we haveexternally
found thatpalpable
very uterine myomas are apt to give trouble. We are convin
ced rather
the that this
sudden
is entirely
disappearance
due toof fat from the pelvic bed upon which they rest
and that
tumor pressing
it is onthetheweight
underlying
of the tissues which accounts for the discomfort or pa
in which mayWhile
treatment. ariseweduring
disregard even fair-sized or multiple myomas, we insist that
before
very large
treatment.
ones beWeoperated
have had patients present themselves for reducing fat from
their stones
signs
Small
Gallstones
abdomen
of obesity,
inwhothebut
showed
gall
hadbladder
noa largemay
abdominal
in patients
tumor.who have recently had typical c
olics treatment
under cause morewith frequent
HCG. This
colicsmay be due to the almost complete absence of fat
fromnormal
she the diet,
emptying
whichofprevents
the gall bladder. Before undertaking treatment we explain
risk
to such
of more
patients
frequentthatand
therepossibly
is a severe miles and that it may become necessary
prepared
to operate.
to take
If they
thisarerisk and provided they agree to undergo an operation if we
proceed
considerwith
thistreatment
imperative as after
we weight reduction with HCG the operative risk is
consider
obese patient.
ably reduced
In suchincasesan we always give a drug which stimulates the flow of
bile, nothing
cases and in the untoward
majorityhappens.
of On the other hand, we have looked for and not fo
und any
that theevidence
HCG treatment
to suggest
leads to the formation of gallstones as pregnancy sometim
es does.
The
Disorders
Heart of the heart are not as a rule contraindications. In fact, the removal
the
of heart-
abnormalmuscle
fat -and particularly
from the surrounding
from of the coronary arteries - can only b
e beneficialweakness,
myocardial in casesand of many such patients are referred to us by cardiologists.
treatment
Within theallfirst
patients
week -ofnot only heart cases - remark that they have lost much
of obese
Coronary
In their patients
breathlessness
Occlusion who have recently survived a coronary occlusion we adopt the f
ollowing procedure
collaboration with the
in cardiologist. We wait until no further electrocardiograph
ic changes
period of three
have months.
occurredRoutine
for a treatment is then started under careful control
and it is usual to find
electrocardiographic improvement
a furtherof a condition which was previously stationary.
In the thousands of cases we have treated we have not once seen any sort of coro
nary incident
shortly after treatment.
occur duringTheorsame applies to cerebral vascular accidents. Nor ha
ve we ever of
thrombosis seenanya sort
case develop
of during treatment, even though a high blood pressu
re is and
respect,
Teeth
Patients
rapidly
too,
whose
Vitamins
lowered.
the
teethHCGare
treatment
Ininthispoorresembles
repair sometimes
pregnancy.get more trouble under prolong
ed treatment,
occur in pregnancy.
just asInmaysuch cases we do allow calcium and vitamin D, though not
in an vitamin
other oily solution.
we permit Theisonly
vitamin C, which we use in large doses combined with
an aantihistaminic
of common cold. Thereat theisonset
no objection to the use of an antibiotic if this is r
equired, for instance by the dentist.
In cases of broncial asthma and hay fever we have occasionally resorted to corti
sone triamcinolone
that during treatment is the
and least
find likely to interfere with the loss of weight, but
HCG
Obese
Alcohol
manyalone.
asthmatics
heavy drinkers,
improveevenwith
those bordering on alcoholism, often do surprisingly
well under HCG
exceptional forand
themittoistake a drink while under treatment. When they do, they f
ind that of
quantity a relatively
alcohol produces
small intoxication. Such patients say that they do not fe
el thebeneed
part due to the
drinkeuphoria
This maywhich
in the treatment produces and in part to the comp
lete absence
quick
Though sustenance
we haveofhad
the
from
aneed
few
which
formostthat
cases obese
havepatients
continued
suffer.
abstinence long after treatme
nt, others
they are back
relapse
on a normal
as soondiet.
as We have a few Òregular customersÓ who, having once b
een reduced
normal weight,
to start
their to drink again though watching their weight. Then after som
e monthsinthey
overeat order
purposely
to gain sufficient weight for another course of HCG which tempo
rarily gets
drinking routine.
them out
We do
of not
theirparticularly welcome such cases, hut we see no reaso
n for
It
Tuberculosis
is interesting
refusing theirthatrequest.
obese patients suffering from inactive pulmonary tubercul
osis under
have can bevery
safely
careful
treated.
control
We treated patients as early as three months after
theyhave
and werenever
pronounced
seen ainactive
relapse occur during or shortly after treatment. In fact,
we only in
records havewhich
one active
case ontuberculosis
our developed in a young man about one year aft
er a treatment
lasted three weeks.
whichEarlier
had X-rays showed a calcified spot from a childhood infe
ction which
clinical symptoms.
had notThere
produced
was a family history of tuberculosis, and his illness s
tartedcertainly
which under adverse
had nothing
conditionsto do with the treatment. Residual calcifications fr
om obese
exceedingly
The
In anPainful
early
patients
infection
common,
Heal whoandhave
arewe been
nevertrying
considerdesperately
them a contraindication
to keep their weight
to treatment.
down by
severe dieting,
symptom sometimesa occurs.
curious They complain of an unbearable pain in their heels whi
ch they feel
standing or walking.
only whileAs soon as they take tile weight off their heels the pain c
eases.
the rheumatologists
Th5 cases areand theorthopedic
bane of surgeons who have treated them before they co
me to us. All the
investigations areusual
entirely negative, and there is not the slightest response to
physiotherapy.
anti- rheumaticThemedication
pain may be or so severe that the patients are obliged to give u
p their
not infrequently
occupation,labeled
and they
as aare
case of hysteria. When their heels are carefully e
xaminedthan
softer one normal
finds that
and that
the sole
the heel
is bone - the calcaneus - can be distinctly fe
lt,interpret
normal
We which
foot.
is the
not condition
the case inasaa lack of the hard fatty pad on which the calcaneu
s rests
the boneand
andwhich
the skin
protects
of theboth
sole from pressure. This fat is like a springy cush
ion which
body. Standing
carries
on atheheel
weight
in which
of thethis fat is missing or reduced must obviously
be keep
to very their
painful.
weight
In their
down these
effortspatients have consumed this normal structural fa
Those patients who have a normal or subnormal weight while showing the typically
t.
toobese
eat to
fatcapacity,
deposits often
are mademuch against their will, for one week. They gain weigh
t rapidly butinthere
improvement the painful
is no heels. They are then started on the routine HCG treat
ment. Overweight
treated immediately.
patients
In botharecases the pain completely disappears in 10-20 days
of dieting,
15th day of treatment,
usually aroundand so
thefar no case has had a relapse, though we have been
for
ableyears.
to follow up such patients
We are particularly interested in these cases, as they furnish further proof of
the contention
Calories not only thatremoves
HCG + abnormal
500 fat but actually permits normal fat to be rep
laced,intake.
food in spite It isof certainly
the deficientnot so that the mere loss of weight reduces the pai
n, because
before the weight
it frequently
the patient
disappears
had prior to the period of forced feeding is reach
The doctor
ed.
Any Skeptical whoPatient
starts using the HCG method for the first time will have consider
ablehimself
he difficulty,
is notparticularly
fully convinced,if in making patients believe that they will not
that
feeltheir
hungryface on will
500 Calories
not collapse.
and New patients always anticipate the phenomena
they knowtreatments
previous so well from and diets and are incredulous when told that these will not
occur. Wenewovercome
letting patientsallspendthisabylittle time in the waiting room with older hands, w
ho canthese
allay alwaysfearsbe relied
with evangelistic
upon to zeal, often demonstrating the finer points o
An waiting-room
their own body. filled with obese patients who congregate daily is a sort of grou
p therapy.
and pop backThey intocompare
the waiting
notes room after the consultation to announce the score
of the lastaudience.
enthralled 24 hours Theyto ancross-check on their diets and sometimes confess sins
which they
usually withtrythetoresult
hide from
thatus,
the patient in whom they have confided palpitatingl
y tattles
story
Concluding
When the
to three
usthe
awith
Course
whole
days
a ÒBut
disgraceful
of dieting
don't letafter
herthe
knowlast
I told
injection
youÓ. are over, the patients a
re told that
anything theythey
please,
may except
now eatsugar and starch provided they faithfully observe o
ne simple
they must have
rule.their
This own
ruleportable
is that bathroom-scale always at hand, particularly wh
ile traveling.
without fail weightThey themselves
must every morning as they get out of bed, having firs
t emptied
are
It takes
in theabout
their
habit3bladder.
of having
weeks before
Ifbreakfast
they
the weight
in bed,
reached
theyatmust
theweigh
end ofbefore
the treatment
breakfast.bec
omes stable,
violent fluctuations
i.e. doesafternot an
showoccasional excess. During this period patients mus
t realize that that
carbohydrates, the so-called
is sugar, rice, bread, potatoes, pastries etc, are by far th
e most dangerous.
carbohydrates whatsoever
If no are eaten, fats can be indulged in somewhat more libera
llyalcohol,
of and evensuch a small
as aquantity
glass of wine with meals, does no harm, but as soon as fat
s andvery
are starch
liablearetocombined
get outthings
of hand. This has to be observed very carefully durin
g the
treatment
Skipping
As longfirst
asaistheir
Meal
3ended
weeksweight
otherwise
afterstays
thedisappointments
within two pounds areofalmost
the weight
sure toreached
occur.on the day
should
of thetakelastnoinjection,
notice ofpatients
any increase but the moment the scale goes beyond two p
ounds,
few ounces,
even they
if this mustisononly
thata same day entirely skip breakfast and lunch but tak
e plentythey
evening to drink.
must eatIn athehuge steak with only an apple or a raw tomato. Of course
morning
this rule weight.
applies Ex-obese
only topatients
the should never check their weight during the day
, asisthere
fluctuations
It of utmost
mayandbeimportance
these
wide are that
merelythealarming
meal isand
skipped
confusing.
on the same day as the scale
than
registers
two pounds
an increase
and thatofmissing
more the meals is not postponed until the following
day.inIfwhich
day a meala gain
is skipped
is registered
on the in the morning this brings about an immediate
droptheofskipping
if often over of the
a pound.
meal -Butand skipping means literally skipping not just hav
ing a lightclues
phenomenon meal not- isoccur
postponed
and several
the days of strict dieting may be necessary t
o correct
Most patientsthe hardly
situation.ever need to skip a meal. If they have eaten a heavy lunch
they feelandnoindesire
dinner, this case
to eatnotheir
increase takes place. If they keep their weight at t
he point reached at the end of the
treatment, even a heavy dinner does not bring about an increase of two pounds on
not
thetherefore
next morningcalland
fordoes
any special measures. Most patients are surprised bow sma
ll their
yet how much
appetite
they can
has eat
becomewithout
and gaining weight. They no longer suffer from an
abnormal appetite
satisfied with muchandless
feelfood than before. In fact, they are usually disappointe
d that
first
Losing
An ex-patient
normal
they Weight
more cannot
meal,
shouldwhich
manage
neverthey
their
gainhave
morebeen
thanplanning
two pounds
for without
weeks. immediately correct
ing this, butthat
undesirable it more
is equally
than two lbs. he lost after treatment, because a greater l
oss is always
expense of normal
achieved
fat. Any
at the
normal fat that is lost is invariably regained as soo
n asdifficulties
often
Trouble
Two more
happens
After
foodTreatment
that
ismay
taken,
this
be encountered
rebound
and it overshoots
in the immediate
the upper post
two lbs.
treatment
limit.period when
a patient
his abnormalhasfat
consumed
or whenallafter a full course the injection has temporarily lost
its efficacy
having gradually
owingevolved
to theabody
counter regulation, the patient at once begins to fee
l muchInmore
weak. spite
hungry
of repeated
and evenwarnings, some over-enthusiastic patients do not repo
rt this.
days the fact
However,
thatinthey
about
aretwo
being undernourished becomes visible in their faces,
once.
and treatment
In such cases
is then
- and
stopped
only in
at such cases - we allow a very slight increase i
n thegrams
150 diet,ofsuch
meatasorantwoextra
or three
apple,extra breadsticks during the three days of die
ting abnormal
When after thefat lastisinjection.
no longer being put into circulation either because it has
been consumed
immunity has set
or in.
because
his is always felt by the patient as sudden, intolerable an
d constant
HCG method ishunger.
completely
in thisself-limiting.
sense the With HCG it is impossible to reduce a pa
tient, his
beyond however
normal
enthusiastic,
weight. As soon as no more abnormal fat is being issued the bo
dy starts
fat, and this
consuming
is always
normal
regained as soon as ordinary feeding is resumed. The pat
ientlost
has thenduring
finds the
thatlast
the days
2 3 lbs.
of treatment
he are immediately regained. A meal is s
kippedThe
lost. andnext
maybedaya this
poundpound
is is regained, in spite of a careful watch over the
foodthat
patient
All intake.
isisback
happening
In in
a few
theis
days
consulting
that
a tearful
the essential
room, convinced
fat lost
thatather
thecase
end 0f
is the
a failure.
treatment
, owingatomuch
report thegreater
patient's
hunger,
reluctance
is beingto replaced. The weight at which such a pati
ent must
lbs. higherstabilize
than thethus
weight
liesreached
2-3 at the end of the treatment. Once this highe
r basic difficulties
further level is established,
in controlling the weight at the new point of stabilization
Beware
The
hardly
other
ofarise.
Over-enthusiasm
trouble which is frequently encountered immediately after treatment is
Some
againpatients
due to cannot
over-enthusiasm
believe that they can eat fairly normally without regaining
advice
weight.toThey
eat anything
disregardthey
the please except sugar and starch and want to play safe
. They trythemore
continue 500-Calorie
or less todiet on which they felt to well during treatment and ma
ke replacing
as only minorthe variations,
meat withsuch
an egg, cheese or a glass of milk. To their horror th
ey find their
bravura that inweight
spitegoes
of this
up. So, following instructions, they skip one meager l
unch and
salad andatdrink
nighta pot
eat of
onlyunsweetened
a little tea, becoming increasingly hungry and weak.
that
The they
next have
morning
increased
they findyet another pound. They feel terrible, and even the dre
aded swelling
back. Normallyofwetheir
checkankles
our patients
is one week after they have been eating freely
, butdays.
few theseEither
casestheir
returneyes
in are
a filled with tears or they angrily imply that whe
n we just
were told fooling
them to them.
eat normally we
Here toodeficiency
Protein the explanation is quite simple. During treatment the patient has been
only justdeficiency
protein above theand verge
hasofhad the advantage of protein being fed back into his
systemtissue.
fatty I from Once
the breakdown
the treatment
of is over there is no more HCG in the body and th
is process
Unless an adequate
no longeramount
takesofplace.
protein is eaten as soon as the treatment is over p
rotein deficiency
develop, and this inevitably
is bound tocauses the marked retention of water known as hunge
r- edema.
The treatment is very simple. The patient is told to eat two eggs for breakfast
and a huge
dinner followed
steakbyfora large
lunch helping
and of cheese and to phone through the weight the
instructions
next morning.areWhenfollowed
these a stunned voice is heard to report that two lbs. have
vanished
are normalovernight,
but that sleep
that thewasankles
disturbed, owing to an extraordinary need to pass
large
patient
As
Relapses
a general
quantities
havingrule
learned
ofonewater.
can
thissay
The
lesson
that 60-70%
usuallyour
hascases
no further
experience
trouble.
little or no diff
iculty in holding
permanently. Relapses
theirmayweight
be due to negligence in the basic rule of daily weighi
ng. Many
this is unnecessary
patients think and that they can judge any increase from the fit of their c
lotheswith
scale somethem
do not
on acarry
journey
theiras it is cumbersome and takes a big bite out of the
ir luggage-allowance
flying. This is a disastrous
when mistake, because after a course of HCG as much as 1
0 lbs.
any noticeable
can be regained
change inwithout
the fit of the clothes. The reason for this is that aft
er treatment
first evenly distributed
newly acquired andfatdoesisnot
at show the former preference for certain par
ts of the or
Pregnancy body.
the menopause may annul the effect of a previous treatment. Women w
ho take
one yeartreatment
after theduring
last menstruation - that is at the onset of the menopause - d
o justtheasrelapse
them well asrate
others,
is higher
but among
until the menopause is fully established the per
iod of one year
menstruation applies
afteronly
the tolastwomen who are not being treated with ovarian hormon
es. Ifteenage
premenopausal
Late these girls
are
period
taken,
whomaysuffer
the
be indefinitely
from attacksprolonged.
of compulsive eating have by far the
worst record
relapses
Patients are have
who of allonce
concerned.as taken
far asthe treatment never seem to hesitate to come back f
or another
soon as theyshort
notice
course
thatastheir weight is once again getting out of hand. They co
me quite cheerfully
hopefully, assured thatand they can be helped again. Repeat courses are often even
more satisfactory
treatment and havethan
the advantage,
the first as do second courses, that the patient already
, knows
comfortable
Plan
125 I.U.
of athat
ofNormal
throughout.
HCG
he daily
will
Coursefeel
(except during menstruation) ui injections have been given
.Until 3rd injection 500
After forced
Calorie
feeding.
diet to be continued 72 hours after the last inj
For the following 3 weeks all foods allowed except starch and sugar in any form
ection.
(careful
After 3 weeks
with very gradually
sweet fruit). add starch in small quantities, always controlled b
y morning weighing.
CONCLUSION
The HCG + diet method can bring relief to every case of obesity, but the method
is not simple.
consuming and requires
It is veryperfect
time cooperation between physician and patient. Each c
ase must be handled
individually, and the physician must have time to answer questions, allay fears
andmust
He remove
alsomisunderstandings.
check the patient daily. When something goes wrong he must at once
investigate
reason for any
until
gainhethat
findsmaythehave occurred. In most cases it is useless to hand
the method
nurse
The patient
give involves
him
a diet-sheet
a "shot."
a highly
and complex
let the bodily mechanism, and even though our theor
y may be wrong
physician must make
the himself some sort of picture of what is actually happening;
other
Ito must
dealwise
beg
withthose
hesuch
willtrying
difficulties
not betheable
method
as mayforarise
the first
duringtime
treatment.
to adhere very strictly to
interpretations
the technique and heretheoutlined and thus treat a few hundred cases before embarkin
g onuntil
and experiments
then refrain
of their
fromown,
introducing innovations, however thrilling they may
seem. In a new
innovations or departures
method from the original technique can only be usefully evalu
ated
Ibackground
haveagainst
triedofto
aexperience
substantial
cover allwiththe problems
what is atthat
thecome
moment
to my
themind.
orthodox
Yet aprocedure.
bewildering a
rray of new
arising, andquestions
my interpretations
keeps are still fluid. In particular, I have never had
laboratory
an opportunity
investigations
of conductingwhichtheare so necessary for a theoretical understanding
canof only
clinical
hopeobservations,
that those more andfortunately
I placed will in time be able to fill th
is gap.
The problems of obesity are perhaps not so dramatic as the problems of cancer or
long
polio,
suffering.
but theyHow often
manycause
promising
life careers have been ruined by excessive fat; ho
w many livesIfhave
shortened. somebeen
way -however cumbersome - can be found to cope effectively wi
th thiscivilized
modern universalman,problem
our world
of will be a happier place for countless fellow men
ACNE
GLOSSARY
and .women.
. . Common skin disease in which pimples, often containing pus, appear on
ACTH
face,. .neck
. Abbreviation
and shoulders. for adrenocorticotrophic hormone. One of the many hormon
es produced
anterior lobebyofthethe pituitary gland. ACTH controls the outer part, rind or cort
ex ofistheinjected
ACTH adrenalitglands.
dramatically
When relieves arthritic pain, but it has many undesi
arable
condition
side effects,
similar toamong
severe
whichobesity.
is ACTH is now usually replaced by cortisone
.ADRENALIN . . . Hormone produced by the inner part of the Adrenals. Among many o
ther functions,
adrenalin
ADRENALS .is. .concerned
Endocrinewithglands.
bloodSmall
pressure,
bodiesemotional
situatedstress,
atop thefear
kidneys
and cold.
and henc
e also known
glands. The adrenals
as suprarenal
have an outer rind or cortex which produces vitally Importa
nt hormones,
Cortisone similar
amongsub-stances.
which are The adrenal cortex is controlled by ACTH. The inn
er part ofsecretes
medulla, the adrenals,
adrenalintheand is chiefly controlled by the autonomous nervous
ADRENOCORTEX...
system.
AMPHETAMINES . .See
. Synthetic
adrenals.drugs which reduce the awareness of hunger arid sti
mulate mental
rendering sleepactivity,
impossible. When used for the latter two purposes they are dange
rously
not diminish
habit-forming.
the body'sThey
needdofor food, but merely suppress the perception of tha
t need.asThe
known benzedrine,
original from
drug which
was modern variants such as dexedrine, dexamil, prel
udin, etc.,
derived. Amphetamines
have been may help an obese patient to prevent a further increase in
weight but are unsatisfactory
for reducing, as they do not cure the underlying disorder and as their prolonged
and
ARTERIOSCLEROSIS
useaddiction.
may lead to .malnutrition
. . Hardening of the arterial wall through the calcification
of abnormal
fatlike
ASCHFIE1M-ZONDEK
substance
deposits .known
. .ofAuthors
a cholesterol.
as of a test by which early pregnancy can be diagnos
ed by injecting
woman's urine into a female mice. The HCG present in pregnancy urine produces cert
ain changes
these animals.in Many
the vagina
similaroftests, using other animals such as rabbits, frogs, e
tc. have been
ASSIMILATE
AUTONOMOUS . .devised.
. Here
Absorbed
useddigested
to describe
foodthe
fromindependent
the intestines.
or vegetative nervous sys
tem which
automatic
BASAL METABOLISM
manages.the
regulations . .ofThethebody's
body.chemical turnover at complete rest and when fa
sting. Therate
metabolic basalis expressed as the amount of oxygen used up in a given time. The
controlled
CALORIE
basal metabolic
. .by. The
theratethyroid
physicist's
(BMR)gland.
iscalorie is the amount of heat required to raise th
e temperature
by 1 degree Centigrade.
of 1 cc. ofThewater dieticiari's Calorie (always written with a capital
C) iswe1000
when speak
timesof agreater.
500 Calorie
Thus diet this means that the body is being supplied w
ith as much
required to raise
fuel asthewould temperature
be of 500 liters of water by 1 degree Centigrade
or 50 insufficient
quite liters by 10 to degrees.
cover theThisheat
is and energy requirements of an adult body. I
n theupHCGfrom
made method
the abnormal
the deficit fat-isdeposits, of which 1 lb. furnishes the body with
more is
this thanroughly
2000 Calories.
the amountAslost every day, a patient under HCG is never short of
CEREBRAL
fuel. . . . Of the brain. Cerebral vascular disease is a disorder concerning
the blood
brain,
CHOLESTEROL
such- .as
vessels
.cerebral
. A fatlike
of the
thrombosis
substance
or contained
hemorrhage,inknown
almostasevery
apoplexy
cellorofstroke.
the body
. Informs,
two the blood
knownitasexists free and
in esterified. The latter form is under certain condit
ionsthedeposited
of arteriesin(see thearteriosclerosis).
inner lining No clear and definite relationship betwe
en the
in
CHORIONIC
fat blood
intake
. .has.andOfyet
cholesterol-level
thebeen
chorion,
established.
which is part of the placenta or after-birth. Th
e term chorionic
applied to HCG, asisthis justly
hormone is exclusively produced in the placenta, from wh
ere it enters
mother's
COMPULSIVE blood
EATING.
the
andhuman
.is.later
A formexcreted
of oralingratification
her urine. with which a repressed sex-i
nstinct is sometimes
vicariously relieved. Compulsive eating must not be confused with the real hunge
r from which
patients
CONGENITAL
CORONARY suffer.
ARTERIES
. .most. Any.obese
.condition
. Two blood which
vessels
existswhich
at orencircle
before the
birth.
heart and supply al
l theheart-
the
CORPUS blood
LUTEUM
muscle.
required
. . . Abyyellow body which forms in the ovary at the follicle from
which an egg
detached. Thishasbody beenacts as an endocrine gland and plays an important role in me
nstruationisandonepregnancy.
secretion of the sexItshormones, and it is stimulated by another hormone kn
own as stimulating
luteum LSH, which stands hormones.
for LSH is produced in the anterior lobe of the pituita
ry gland. LSI-Iandismust
gonadotrophic trulynever he confused with HCG, which is a totally different
substance,
action on the
havingcorpus no luteum.
direct
CORTEX . . . Outer covering or rind. The term is applied to the outer part of th
e adrenalsthe
describe
CORTISONE .but
.gray
.isA synthetic
also used
matter which
to covers which
substance the white
actsmatter
like anofadrenal
the brain.
hormone. It is
today
of a large
used number
in the of treatment
illnesses, and several chemical variants have been produced
, among
and
CUSHING
triaincinolone.
.which
. . Aaregreat
prednisone
American brain surgeon who described a condition of extrem
e obesityofassociated
symptoms adrenal disorder.
with Cushing's Syndrome may be caused by organic diseas
e of theglands
adrenal pituitarybut,orasthewas later discovered, it also occurs as a result of exces
sive ACTH medication.
DIENCEPHALON . . . A primitive and hence very old part of the brain which lies b
etweenhemispheres.
large and under theIntwo man the diencephalon (or hypothalamus) is subordinate to t
he higher
yet it ultimately
brain orcontrols
cortex, all and that happens inside the body. It regulates all th
e endocrine
nervous system,
glands,the turnover
the autonomous
of fat and sugar. It seems also to be the seat of t
he primitive
the
DIURETIC.
DYSFUNCTION
relay .station
.animal
.Any. Abnormal
atinstincts
substance
which functioning
emotions
that
andincreases
isareoftranslated
any
theorgan,
flowinto
ofbeurine.
bodilyexcessive,
this reactions.deficien
t or in. .any. An
EDEMA
ELECTROCARDIOGRAM
wayabnormal
altered.
. . . Tracing
accumulation
of electric
of waterphenomena
in the tissues.
taking place in the heart
during each
tracing provides
beat.information
The about the condition and working of the heart which
is not otherwise
ENDOCRINE . . . Weobtainable.
distinguish endocrine and exocrine glands. The former produce
regulators,
hormones, chemical
which they secrete directly into the blood circulation in the gland
and from
over the body.
where Examples
they are of carried
endocrine
all glands are the pituitary, the thyroid and t
he adrenals.
produce a visible
Exocrine
secretion
glandssuch as saliva, sweat, urine. There are also glands
which areare
Examples endocrine
the testicles,
and exocrine.
the prostate and the pancreas, which produces the ho
rmone insulin
ferments whichand flowdigestive
from the gland into the intestinal tract. Endocrine glands a
re closely
each other,inter
they aredependent
linkedofto the autonomous nervous system and the diencephalo
n presides
incredibly
EMACIATED
EUPHORIA
FERAL
FIBROID. ....complex
over
.Wild,
.Any
.ACrossly
this
feeling
unrestrained.
benigi
regulatory
whole
undernourished.
of particular
newgrowth
system.
of Connective
physical andtissue.
mentalWhen
wellsuch
being.
a tumor origi
nates as
known
FOLLICLE
from.a .myoma.
a .muscle,
AnyThe
small
itmost
isbodily
commoncyst
seatorofsacmyomas
containing
is theauterus.
liquid. Here the term a
ppliesthe
which to egg
the is ovarian
formed.cystTheinegg is expelled when a ripe follicle bursts and thi
s is.known
corpus
FSH .luteurn).
. Abbreviation
as ovulationfor (seefollicle-stimulating hormone. FSH is another (see cor
pus luteum)
hormone whichanterior
acts directly
pituitary on the ovarian follicle and is therefore correctly c
alled a.gonadotrophin.
GLANDS . . See endocrine.
GONADOTROPHIN . . . See corpus luteum, follicle and FSH. Gonadotrophic literally
directed.
means sexFSH, gland- LSH and the equivalent hormones in the male, all produced in the
anteriorarelobe
gland, trueofgonadotrophins.
the pituitary Unfortunately and confusingly, the term gonadotr
o phin
the placental
has alsohormone been applied
of pregnancy
to known as human cborionic gonadotrophin (HCG).
the
Thisdiencephalon
hormone actsandoncan only indirectly influence the sex-glands via the anteri
or lobe
HCG
HORMONES
HYPERTENSION
HYPOGLYCEMIA
. . .of.Abbreviation
.the. .See
pituitary.
. AHigh
endocrine.
condition
for
blood
human
pressure.
inchorionic
which thegonadotrophin
blood sugar is below normal. It can
he relieved.by. .eating
HYPOPHYSIS
sugar.
HYPOTHESIS AAnother
tentative
nameexplanation
for the pituitary
or speculation
gland. on how observed facts an
d isolated
can be brought scientific
into andataintellectually satisfying relationship of cause and effec
t. Hypotheses
directing further are research,
useful forbut they are not necessarily an exposition of what i
s believed can
hypothesis to beadvance
the truth.
to theBefore
dignity
a of a theory or a law, it must be confirmed
asbyresearch
all future turnsresearch.
up dataAswhich
soonno longer fit the hypothesis, it is immediately
abandoned
LSH
METABOLISM
MIGRAINE
MUCOID
MYOCARDIUM
MYOMA
MYXEDEMA
. .....See
for .See
.Slime-like.
aAccumulation
corpus
.Severe
better
fibroid.
See heart-muscle.
The luteum.
basal
half-sided
one.metabolism.
of a mucoid
headachesubstance
often associated
in the tissues
with vomiting.
which occurs in
thyroid
NEOLITHIC
cases ofdeficiency.
.severe
. . Inprimary
the history of human culture we distinguish the Early Stone A
ge or Paleolithic,
Middlye Stone Age ortheMesolithic and the New Stone Age or Neolithic period. The N
eolithic
about 8000periodyearsstarted
ago when the first attempts at agriculture, pottery and animal
domestication
the Mesolithicmade period
at suddenly
the end ofbegan to develop rapidly along the road that led
to modern
NORMAL SALINEcivilization.
. . . A low concentration of salt in water equal to the salinity o
f body fluids.
PHLEBITIS . . . An inflammation of the veins. When a blood- clot forms at the si
te of of
speak
PITUITARY
thethrombophiebitis.
.inflammation,
. . A very complex
we endocrine gland which lies at the base of the sku
ll, consisting
anterior and a posterior
chiefly oflobe.
an The pituitary is controlled by the dienccphalon,
which
by means
regulates
of hormones the anterior
which reach
lobeit through small bloodvessels. The posterior lo
be is run
which controlled
from thebydiencephalon
nerves into this part of the gland. The anterior lobe s
ecretesaremany
which those hormones,
that regulate
among other glands such as the thyroid, the adrenals and
the sex glands.
PLACENTA . . . The after-birth. In woman a large and highly complex organ throug
h which
womb receives
the child its nourishment
in the from the mother's body. It is the organ in which H
CG is off
given
PROTEINmanufactured
. .into
. The theliving
and then
mother's substance
blood. in plant and animal cells. Herbivorous animal
alone,
can thrive
but manon must
plantbase
protein
some protein of animal origin (milk, eggs or flesh) to
live healthily.
protein
PSORIASIS is.eaten,
. . AWhentheinsufficient
skin body
disease
retains
whichwater.
produces scaly patches. These tend to disap
pear during
during
RENAL
RESERPINE
.the
. .treatment
pregnancy
.Of .the
An Indian
kidney.
ofandobesity
drug extensively
by the HCG used
method.
in the treatment of high blood p
ressuredisorder.
mental
RETENTION andENEMA
some.forms
. . The of slow infusion of a liquid into the rectum, from where
it is absorbed
SACRUM
evacuated.
. . . A fusion
and notof the lower vertebrate into the large bony mass to which
the pelvis is RATE
SEDIMENTATION attached.
. . . The speed at which a suspension of red blood cells sett
les is
out out.called
A rapid a high
settling
sedimentation rate and may be indicative of a large number
of bodily
SEXUAL
pregnancy.
SELECTION
disorders . .of. A sexual preference for individuals which show certain tr
aits. If this
selection goespreference
on generation or after generation, more and more individuals showing
the
thegeneral
trait will population.
appear amongThe natural environment has little or nothing to do with
therefore
this process.
differs Sexual
fromselection
natural selection, to which modern man is no longer subje
ct because.he.rather
environment
STRIATION .changes
Tearing
thanhisof
letthe
thelower
environment
layers of
change
the skin
him. owing to rapid stretchin
g in obesityWhen
pregnancy. or first
duringformed striae are dark reddish lines which later change in
to white .scars.
SUPRARENAL
SYNDROME .GLANDS
. A group
. . .ofSeesymptoms
adrenals.which in their association are characteristic
THROMBOPIILEBITIS
THROMBUS
TRIAMCINOLONE
URIC
of aACID
particular
......AA.blood-clot
disorder.
. A. modern
product. Seeofin
phlebitis.
derivative
incomplete
a blood-vessel.
of cortisone.
protein-breakdown or utilization in the
body. When
becomes
VARICOSE deposited
ULCERS
uric .acid.the. Chronic
gristle ulceration
of the jointsabove
we the
speakankles
of gout.
due to varicose veins
which interfere
normal
VEGETATIVE
VERTEBRATE
blood. .circulation
.with
See animal
Any the in that
autonomous.
the affected
has a back-bone.
areas.