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.

She was kept in bed for five weeks.  Massage was used at first once daily, and after a fortnight twice a day, while milk was given, and in a week made the exclusive diet.  Her average of loss for thirty days was a pound a day, and the diet was varied by the addition of broths after the third week, so as to keep the reduction within safe limits.  Her pulse at first was 90 to 100 in the morning, and at night 80 to 95, her temperature being always a half degree to a degree below the normal.  At the third week the latter was as is usual in health, and the pulse had fallen to 80 in the morning, and 80 to 90 at night.

After two weeks I gave her the lactate of iron every three hours in full doses.  In the fourth week additions were made to her diet-list, and Swedish movements were added to the massage, which was applied but once a day; and during the fifth week she began to sit up and move about.  At the seventh week her pulse was 70 to 80, her temperature natural, and her blood-globules much increased in number.  Her weight had now fallen to one hundred and forty-five pounds, and her appearance had decidedly improved.  She left me after three and a half months, able to walk with comfort three miles.  She has lived, of course, with care ever since, but writes me now, after two years, that she is a well and vigorous woman.  Her periodical flow came back five months after her treatment began, and she has since had a child.

Early in the spring of 1876, Mrs. C., aet. 40, came under my care with partial hysterical paralysis of the right and hemi-anaesthesia of the left side.  She had no power to feel pain or to distinguish heat from cold in the left leg and arm, though the sense of touch was perfect.  The long strain of great mental suffering had left her in this state and rendered her somewhat emotional.  Her appetite was fair, but she was strangely white, and weighed one hundred and sixty-three pounds, with a height of five feet five inches.  As she had had endless treatment