The indications for a fattening cure are exceedingly numerous, and it is not my intention within the narrow frame of these lectures to exhaustively discuss them, for nearly everything that I might say in this respect is already familiar to every practitioner. I will limit myself to a few salient considerations.

1. Pulmonary Tuberculosis - Indications For Fattening Cures

In Pulmonary Tuberculosis the use of fattening cures was recognized earlier and they were employed more methodically than in any other disease. If we omit the inadequate and incomplete tendencies in this direction that became manifest many years ago, then we must acknowledge our debt primarily to Brehmer (Gobersdorf) and to Dettweiler (Falkenstein) for having introduced fattening cures into the treatment of pulmonary tuberculosis and for having methodically developed this system of treatment. In the meantime fattening cures have become recognized and valued as one of the most important means at our disposal to combat this disease. The results no doubt are good, although chiefly in early stages of the disease. One must acknowledge unreservedly that a good state of nutrition is necessary to prevent the progress of the disease, and one cannot, therefore, blame the managers of tuberculosis sanatoria if they place the greatest emphasis upon attaining such an improved state of the general nutrition. Nevertheless, the matter may be overdone. Only too often other no less important factors in phthisiotherapy are sacrificed to efforts directed too exclusively towards attaining an imposing gain in weight. Especially are hardening measures often relegated to the background. One need only compare what has been said by H. Weber, Brehmer and Dettweiler in their fundamental publications in regard to important factors other than nutrition with what is actually advocated and carried out to-day in order to see the great change that has taken place; hardening factors, it will be found, especially hydrotherapy, are decidedly crowded into the background in most sanatoria. The penalty for this neglect is often paid as soon as the patients return home. Overfeeding in institutions is sometimes carried too far. We would be glad to welcome our patients back from the sanatorium in a good, medium state of nutrition; frequently, however, we are confronted by actually obese individuals, and this is by no means of advantage to the ventilation of the lungs and the working capacity of the heart. I uttered a warning against such exaggerated tendencies a long time ago, and cannot refrain from urgently repeating this warning to-day, since I find myself fortified in my opinions by repeated experiences of this character.