The HCG + diet method can bring relief to every case of obesity, but the method is not simple. It is very time consuming and requires perfect cooperation between physician and patient. Each case must be handled individually, and the physician must have time to answer questions, allay fears and remove misunderstandings. He must also check the patient daily. When something goes wrong he must at once investigate until he finds the reason for any gain that may have occurred. In most cases it is useless to hand the patient a diet-sheet and let the nurse give him a “shot.” The method involves a highly complex bodily mechanism, and even though our theory may be wrong the physician must make himself some sort of picture of what is actually happening; otherwise he will not be able to deal with such difficulties as may arise during treatment. I must beg those trying the method for the first time to adhere very strictly to the technique and the interpretations here outlined and thus treat a few hundred cases before embarking on experiments of their own, and until then refrain from introducing innovations, however thrilling they may seem. In a new method, innovations or departures from the original technique can only be usefully evaluated against a substantial background of experience with what is at the moment the orthodox procedure. I have tried to cover all the problems that come to my mind. Yet a bewildering array of new questions keeps arising, and my interpretations are still fluid. In particular, I have never had an opportunity of conducting the laboratory investigations which are so necessary for a theoretical understanding of clinical observations, and I can only hope that those more fortunately placed will in time be able to fill this gap. The problems of obesity are perhaps not so dramatic as the problems of cancer, or polio, but they often cause life long suffering. How many promising careers have been ruined by excessive fat; how many lives have been shortened. If some way -however cumbersome – can be found to cope effectively with this universal problem of modern civilized man, our world will be a happier place for countless fellow men and women. GLOSSARY[9] ACNE . . . Common skin disease in which pimples, often containing pus, appear on face, neck and shoulders. ACTH . . . Abbreviation for adrenocorticotrophic hormone. One of the many hormones produced by the anterior lobe of the pituitary gland. ACTH controls the outer part, rind or cortex of the adrenal glands. When ACTH is injected it dramatically relieves arthritic pain, but it has many undesirable side effects, among which is a condition similar to severe obesity. ACTH is now usually replaced by cortisone. ADRENALIN . . . Hormone produced by the inner part of the Adrenals. Among many other functions, adrenalin is concerned with blood pressure, emotional stress, fear and cold. ADRENALS . . . Endocrine glands. Small bodies situated atop the kidneys and hence also known as suprarenal glands. The adrenals have an outer rind or cortex which produces vitally important hormones, among which are Cortisone similar substances. The adrenal cortex is controlled by ACTH. The inner part of the adrenals, the medulla, secretes adrenalin and is chiefly controlled by the autonomous nervous system. ADRENOCORTEX… See adrenals. AMPHETAMINES . . . Synthetic drugs which reduce the awareness of hunger and stimulate mental activity, rendering sleep impossible. When used for the latter two purposes they are dangerously habit-forming. They do not diminish the body’s need for food, but merely suppress the perception of that need. The original drug was known as Benzedrine, from which modern variants such as Dexedrine, Dexamil, and Preludin, etc., have been derived. Amphetamines 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 use may lead to malnutrition and addiction. ARTERIOSCLEROSIS . . . Hardening of the arterial wall through the calcification of abnormal deposits of a fatlike substance known as cholesterol. ASCHHIEIM-ZONDEK . . . Authors of a test by which early pregnancy can be diagnosed by injecting a woman’s urine into female mice. The HCG present in pregnancy urine produces certain changes in the vagina of these animals. Many similar tests, using other animals such as rabbits, frogs, etc. have been devised. ASSIMILATE . . . Absorb digested food from the intestines. AUTONOMOUS . . . Here used to describe the independent or vegetative nervous system which manages the automatic regulations of the body. BASAL METABOLISM . . . The body’s chemical turnover at complete rest and when fasting. The basal metabolic rate is expressed as the amount of oxygen used up in a given time. The basal metabolic rate (BMR) is controlled by the thyroid gland. CALORIE . . . The physicist’s calorie is the amount of heat required to raise the temperature of 1 cc. of water by 1 degree Centigrade. The dieticiari’s Calorie (always written with a capital C) is 1000 times greater. Thus when we speak of a 500 Calorie diet this means that the body is being supplied with as much fuel as would be required to raise the temperature of 500 liters of water by 1 degree Centigrade or 50 liters by 10 degrees. This is quite insufficient to cover the heat and energy requirements of an adult body. In the HCG method the deficit is made up from the abnormal fat-deposits, of which 1 lb. furnishes the body with more than 2000 Calories. As this is roughly the amount lost every day, a patient under HCG is never short of fuel. CEREBRAL . . . Of the brain. Cerebral vascular disease is a disorder concerning the blood vessels of the brain, such as cerebral thrombosis or hemorrhage, known as apoplexy or stroke. CHOLESTEROL . . . A fatlike substance contained in almost every cell of the body. In the blood it exists in two forms, known as free and esterified. The latter form is under certain conditions deposited in the inner lining of the arteries (see arteriosclerosis). No clear and definite relationship between fat intake and cholesterol-level in the blood has yet been established. CHORIONIC . . . Of the chorion, which is part of the placenta or after-birth. The term chorionic is justly applied to HCG, as this hormone is exclusively produced in the placenta, from where it enters the human mother’s blood and is later excreted in her urine. COMPULSIVE EATING. . . A form of oral gratification with which a repressed sex-instinct is sometimes vicariously relieved. Compulsive eating must not be confused with the real hunger from which most obese patients suffer. CONGENITAL . . . Any condition which exists at or before birth. CORONARY ARTERIES . . . Two blood vessels which encircle the heart and supply all the blood required by the heart-muscle. CORPUS LUTEUM . . . A yellow body which forms in the ovary at the follicle from which an egg has been detached. This body acts as an endocrine gland and plays an important role in menstruation and pregnancy. Its secretion is one of the sex hormones, and it is stimulated by another hormone known as LSH, which stands for luteum stimulating hormones. LSH is produced in the anterior lobe of the pituitary gland. LSH is truly gonadotrophic and must never be confused with HCG, which is a totally different substance, having no direct action on the corpus luteum. CORTEX . . . Outer covering or rind. The term is applied to the outer part of the adrenals but is also used to describe the gray matter which covers the white matter of the brain. CORTISONE . . . A synthetic substance which acts like an adrenal hormone. It is today used in the treatment of a large number of illnesses, and several chemical variants have been produced, among which are prednisone and triamcinolone. CUSHING . . . A great American brain surgeon who described a condition of extreme obesity associated with symptoms of adrenal disorder. Cushing’s Syndrome may be caused by organic disease of the pituitary or the adrenal glands but, as was later discovered, it also occurs as a result of excessive ACTH medication. DIENCEPHALON . . . A primitive and hence very old part of the brain which lies between and under the two large hemispheres. In man the diencephalon (or hypothalamus) is subordinate to the higher brain or cortex, and yet it ultimately controls all that happens inside the body. It regulates all the endocrine glands, the autonomous nervous system, the turnover of fat and sugar. It seems also to be the seat of the primitive animal instincts and is the relay station at which emotions are translated into bodily reactions. DIURETIC. . . Any substance that increases the flow of urine. DYSFUNCTION . . . Abnormal functioning of any organ, be this excessive, deficient or in any way altered. EDEMA . . . An abnormal accumulation of water in the tissues. ELECTROCARDIOGRAM . . . Tracing of electric phenomena taking place in the heart during each beat. The tracing provides information about the condition and working of the heart which is not otherwise obtainable. ENDOCRINE . . . We distinguish endocrine and exocrine glands. The former produce hormones, chemical regulators, which they secrete directly into the blood circulation in the gland and from where they are carried all over the body. Examples of endocrine glands are the pituitary, the thyroid and the adrenals. Exocrine glands produce a visible secretion such as saliva, sweat, urine. There are also glands which are endocrine and exocrine. Examples are the testicles, the prostate and the pancreas, which produces the hormone insulin and digestive ferments which flow from the gland into the intestinal tract. Endocrine glands are closely inter dependent of each other, they are linked to the autonomous nervous system and the diencephalon presides over this whole incredibly complex regulatory system. EMACIATED . . . Grossly undernourished. EUPHORIA . . . A feeling of particular physical and mental well being. FERAL . . . Wild, unrestrained. FIBROID . . . Any benign new growth of connective tissue. When such a tumor originates from a muscle, it is known as a myoma. The most common seat of myomas is the uterus. FOLLICLE . . . Any small bodily cyst or sac containing a liquid. Here the term applies to the ovarian cyst in which the egg is formed. The egg is expelled when a ripe follicle bursts and this is known as ovulation (see corpus luteurn). FSH . . . Abbreviation for follicle-stimulating hormone. FSH is another (see corpus luteum) anterior pituitary hormone which acts directly on the ovarian follicle and is therefore correctly called a gonadotrophin. GLANDS . . . See endocrine. GONADOTROPHIN . . . See corpus luteum, follicle and FSH. Gonadotrophic literally means sex gland-directed. FSH, LSH and the equivalent hormones in the male, all produced in the anterior lobe of the pituitary gland, are true gonadotrophins. Unfortunately and confusingly, the term gonadotrophin has also been applied to the placental hormone of pregnancy known as human chorionic gonadotrophin (HCG). This hormone acts on the diencephalon and can only indirectly influence the sex-glands via the anterior lobe of the pituitary. HCG . . . Abbreviation for human chorionic gonadotrophin HORMONES . . . See endocrine. HYPERTENSION . . . High blood pressure. HYPOGLYCEMIA . . . A condition in which the blood sugar is below normal. It can be relieved by eating sugar. HYPOPHYSIS . . . Another name for the pituitary gland. HYPOTHESIS . . . A tentative explanation or speculation on how observed facts and isolated scientific data can be brought into an intellectually satisfying relationship of cause and effect. Hypotheses are useful for directing further research, but they are not necessarily an exposition of what is believed to be the truth. Before a hypothesis can advance to the dignity of a theory or a law, it must be confirmed by all future research. As soon as research turns up data which no longer fit the hypothesis, it is immediately abandoned for a better one. LSH . . . See corpus luteum. METABOLISM . . . See basal metabolism. MIGRAINE . . . Severe half-sided headache often associated with vomiting. MUCOID . . . Slime-like. MYOCARDIUM . . . The heart-muscle. MYOMA . . . See fibroid. MYXEDEMA . . . Accumulation of a mucoid substance in the tissues which occurs in cases of severe primary thyroid deficiency. NEOLITHIC . . . In the history of human culture we distinguish the Early Stone Age or Paleolithic, the Middle Stone Age or Mesolithic and the New Stone Age or Neolithic period. The Neolithic period started about 8000 years ago when the first attempts at agriculture, pottery and animal domestication made at the end of the Mesolithic period suddenly began to develop rapidly along the road that led to modern civilization. NORMAL SALINE . . . A low concentration of salt in water equal to the salinity of body fluids. PHLEBITIS . . . An inflammation of the veins. When a blood-clot forms at the site of the inflammation, we speak of thrombophlebitis. PITUITARY . . . A very complex endocrine gland which lies at the base of the skull, consisting chiefly of an anterior and a posterior lobe. The pituitary is controlled by the diencephalon, which regulates the anterior lobe by means of hormones which reach it through small blood vessels. The posterior lobe is controlled by nerves which run from the diencephalon into this part of the gland. The anterior lobe secretes many hormones, among which are those that regulate other glands such as the thyroid, the adrenals and the sex glands. PLACENTA . . . The after-birth. In women, a large and highly complex organ through which the child in the womb receives its nourishment from the mother’s body. It is the organ in which HCG is manufactured and then given off into the mother’s blood. PROTEIN . . . The living substance in plant and animal cells. Herbivorous animals can thrive on plant protein alone, but man must have some protein of animal origin (milk, eggs or flesh) to live healthily. When insufficient protein is eaten, the body retains water. PSORIASIS . . . A skin disease which produces scaly patches. These tend to disappear during pregnancy and during the treatment of obesity by the HCG method. RENAL . . . Of the kidney. RESERPINE . . . An Indian drug extensively used in the treatment of high blood pressure and some forms of mental disorder. RETENTION ENEMA . . . The slow infusion of a liquid into the rectum, from where it is absorbed and not evacuated. SACRUM . . . A fusion of the lower vertebrate into the large bony mass to which the pelvis is attached. SEDIMENTATION RATE . . . The speed at which a suspension of red blood cells settles out. A rapid settling out is called a high sedimentation rate and may be indicative of a large number of bodily disorders of pregnancy. SEXUAL SELECTION . . . A sexual preference for individuals which show certain traits. If this preference or selection goes on generation after generation, more and more individuals showing the trait will appear among the general population. The natural environment has little or nothing to do with this process. Sexual selection therefore differs from natural selection, to which modern man is no longer subject because he changes his environment rather than let the environment change him. STRIATION . . . Tearing of the lower layers of the skin owing to rapid stretching in obesity or during pregnancy. When first formed striae are dark reddish lines which later change into white scars. SUPRARENAL GLANDS . . . See adrenals. SYNDROME . . . A group of symptoms which in their association are characteristic of a particular disorder. THROMBOPHLEBITIS . . . See phlebitis. THROMBUS . . . A blood-clot in a blood-vessel. TRIAMCINOLONE . . . A modern derivative of cortisone. URIC ACID . . . A product of incomplete protein-breakdown or utilization in the body. When uric acid becomes deposited in the gristle of the joints we speak of gout. VARICOSE ULCERS . . . Chronic ulceration above the ankles due to varicose veins which interfere with the normal blood circulation in the affected areas. VEGETATIVE . . . See autonomous. VERTEBRATE . . . Any animal that has a back-bone. Literary References to the Use of Chorionic Gonadotrophin In Obesity THE LANCET Nov. 6, 1954 Article Simeons Nov. 15, 1958 Letter to Editor Simeons July 29, 1961 Letter to Editor Lebon Dec. 9, 1961 Article Carne Dec. 9, 1961 Letter to Editor Kalina Jan. 6, 1962 Letter to Editor Simeons Nov. 26, 1966 Letter to Editor Lebon THE JOURNAL OF THE AMERICAN GERIATRIC SOCIETY Jan. 1956 Article Simeons Oct. 1964 Article Harris& Warsaw Feb. 1966 Article Lebon THE AMERICAN JOURNAL OF CLINICAL NUTRITION Sept.-Oct. 1959 Article Sohar March 1963 Article Craig et al. Sept. 1963 Letter to Editor Simeons March 1964 Article Frank Sept. 1964 Letter to Editor Simeons Feb. 1965 Letter to Editor Hutton June 1969 Editorial Albrink June 1969 Special Article Gusman THE JOURNAL OF PLASTIC SURGERY (British) April 1962 Article Lebon THE SOUTH AFRICAN MEDICAL JOURNAL Feb 1963 Article Politzer, Berson & Flaks A.T.W. SIMEONS POUNDS AND INCHES Privately printed: obtainable only from A.T.W. Simeons, Salvator Mundi International Hospital, Rome, Italy VETSUCHT (Netherlands Edition) Wetenschappelijke Uitgeverij, N.V. Amsterdam MAN’S PRESUMPTUOUS BRAIN Longman’s, Green, London E.P. Dutton, New York (hardback) Dutton Paperbacks, New York [1] A list of references to the more important articles is given at the end of this booklet. [2] “Current account” is the British name for what Americans call a checking account. [3] There is some clinical evidence to suggest that those symptoms of Cushing’s Syndrome which resemble true obesity are caused by the same mechanism which causes common obesity, while the other symptoms of the syndrome are directly due to adrenocortical dysfunction. [4] World War II. [5] Confinement = the concluding state of pregnancy [6] As we are speaking of purely regulatory disorders, we obviously exclude all such cases in which there are gross organic lesions of the pituitary or of the sex-glands themselves. [7] We use 1 tablet of hygroton. [8] NOTE: This practice is obsolete. Modern sanitary methods dictate throwing away used needles and syringes and using new ones for each injection. [9] Wherever unfamiliar terms are used, they will be found in their respective alphabetical place. The lay reader can therefore make his own cross-reference.