If we attempt to make so speedy a change in weight while the patient is afoot, the loss is apt to be gravely felt; but with the precautions here advised it is interesting and pleasant to see how great a reduction may be made in a reasonable time without annoyance and with no obvious result except a gain in health and comfort. Cases of anæmia in women with excess of flesh have to be managed in a somewhat similar fashion, but with the utmost care. In such persons we have a loss of red blood-globules, perhaps lessened hæmoglobin, weak heart, rapid pulse, and general feebleness, with too much fat, but not, or at least rarely, extreme obesity. The milder cases may profit by iron, with rest and very vigorous massage, but in old cases of this kind--they are, happily, rare--the best plan is to put the patient at rest, to use massage, restrict the diet to skimmed milk, or to milk and broths free from fat, and with them, when the weight has been sufficiently lowered, to give iron freely, and by degrees a good general diet, under which the globules rise in number, so that even with a new gain in flesh there comes an equal gain in strength and comfort. 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 anæmic and overloaded with fat. Mrs. P., æt. 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 anæmia. 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.