The
massage must be very thoroughly done to be of service, and it is often
difficult to get operators to perform it properly, as the manipulation
of very fat people is excessively hard work. As to other details, the
management should be much the same as that which I shall presently
describe in connection with cases of another kind.
I add two cases in illustration of the use of rest, milk, and massage
in the treatment of persons who are both anaemic and overloaded with
fat.
Mrs. P., aet. 45, weight one hundred and ninety pounds, height five feet
four and a half inches, had for some years been feeble, unable to walk
without panting, or to move rapidly even a few steps. Although always
stout, her great increase of flesh had followed an attack of typhoid
fever four years before. Her appearance was strikingly suggestive of
anaemia.
She was subject to constant attacks of acid dyspepsia, was said to be
unable to bear iron in any form, and had not menstruated for seven
months. She had no uterine disease, and was not pregnant. Two years
before I saw her she had been made very ill owing to an attempt to
reduce her flesh by too rapid Banting, and since then, although not a
gross or large eater, she had steadily gained in weight, and as steadily
in discomfort.
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