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and however slow that waste may
to have lived without food or drink, were under the pressure of these two causes, and sustained that pressure, we are told, four years!
We are thus forced to reject all narratives of absolute fasting prolonged over three months; and having considered the effects of total abstinence, we may now inquire into the effects of partial abstinence. An animal deprived of food perishes whenever its loss of weight reaches a certain point; and, curiously enough, insufficiency of food causes death at precisely the same point, i. e. as soon as the original weight is reduced to six-tenths. Men, therefore, reduced to an insufficient allowance, whether from famine, shipwreck, or siege, will inevitably perish unless the allowance be increased, just as if they had received no food at all, only they will be longer before they succumb. An important lesson is contained in this fact, and one which should never be forgotten in the management of prisons, schools, or workhouses.
Terrible are the aspects of starving men; and it is well that we should know these aspects, lest we be the dupes of impostors, or confound the truly wretched with the professional mendicant. The first noticeable point is the excessive thinness of starving men, which is not the leanness of lean men, but manifests itself as unmistakable emaciation. The face is always lividly pale, the cheeks are sunken, the eyes-oh! what an expression in the eyes! never to be forgotten by those who have once seen it all the vitality of the body seems centred there, in feverish brightness; the pupil is dilated, and the eye is fixed in a wild stare which is never veiled by the winking lids. All movements of the body are slow and difficult: the hand trembles; the voice is feeble; intelligence seems gone; the wretched sufferers, when asked what they feel, have but one answer, "We are hungry."
There is one remarkable fact with reference to starvation which may here be noted, and that is the resistance opposed by the nervous substance to the effects of emaciation. Instead of being the first to suffer
*REDI: Osservazioni intorno agli animali virenti.
from deficient food, as its complexity and the lateness of its appearance in the animal series would lead us to suppose, the nervous tissue is the last affected. From the experiments of Chossat we learn that, in 100 parts, 93 are lost of fat, 52 of the liver, 42 of the muscles, 16 of the bones, and only 2 of the nerve-substance, by the time starvation has terminated in death. The idea of our solid bones, principally composed of inorganic matter, losing eight times as much as our semi-liquid nerves, which are so predominantly organic in their structure, will seem very paradoxical; and the paradox is increased when we learn that, in spite of fat being beyond all proportion the most destructible tissue in the body, Von Bibra finds the fat in the brain scarcely affected in starvation, although the fat in the muscles has been greatly wasted.* It is this which enables us to explain the sleeplessness of men and animals suffering from hunger. A starving man has been known to remain seven days and nights without sleep. This nervous excitability, which often manifests itself as delirium, probably arises from the disengagement of the brain from those organic activities which in the normal state call so largely on its energies; for, as I have elsewhere endeavoured to show, the energies of the brain are not expended only on intelligence and emotion, but likewise, and to a great extent, on the functions of nutrition and locomotion. Considering the brain as a centre or fountain of influence, we may detect three streams in which the influence flows- a nutritive stream, a locomotive stream, and a sensitive stream. If the demand from the nutritive stream be large, the supply to the sensitive and locomotive streams will be proportionately reduced. Deep thought or anxiety disturbs the digestion and circulation; violent and protracted exercise amounting to fatigue, incapacitates for thinking; the habitually trained athlete is nearly an idiot, the over-eater little better. When, therefore, a man is starving, the amount of nervous activity usually expended
on his nutritive system is disengaged, and as his feebleness diminishes his muscular activity, the amount of nervous influence usually expended on locomotion is reduced, leaving the brain, with all this surplus activity, to prey upon itself: sleeplessness and madness naturally result.
Respecting the agonies endured by starving men, we have little accurate information. When those who have undergone the horrors of starvation are preserved, and attempt to recount them, they cannot do more than give vague indications; for there is nothing more difficult to describe than the sensations of the alimentary canal, even during the continuance of the sensation; and how difficult it is to describe them when past, may be conceived by any one who attempts to do so in his own case. Most of the narratives we have, are recorded by men little accustomed to analyse their sensations, and we must be content to fix our attention on the general characteristics of these narratives. From these cases two may be selected.
Goldsmith says that the captain of a wrecked vessel told him that "he was the only person who had not lost his senses when they received accidental relief. He assured me his pains at first were so great as to be often tempted to eat a part of the men who died, and which the rest of his crew actually lived upon. He said that, during the continuance of this paroxysm, he found his pains insupportable, and was desirous at one time of anticipating that death which he thought inevitable. But his pains gradually ceased after the sixth day (for they had water in the ship, which kept them alive so long), and then he was in a state rather of languor than desire; nor did he much wish for food except when he saw others eating. The latter part of the time when his health was almost destroyed, a thousand strange images rose upon his mind, and every one of his senses began to bring him wrong information. When he was presented with food by the ship's company that took him up, he could not help looking at it with loathing instead of desire;
* CANSTATT: Jahresbericht, 1854, p. 119.
and it was not till after four days that his stomach was brought to its natural tone, when the violence of his appetite returned with a sort of canine eagerness."
The next case is peculiarly valuable, as being the daily record of a man who voluntarily starved himself. He was a merchant, whose losses so preyed upon his mind that he resolved on suicide; and after roaming about the country from the 12th to the 15th of September 1818, dug himself a grave in the wood, and remained there till the 3d of October, when he was found, still living, by an innkeeper. Hufeland, who records the case, says that, after an abstinence of eighteen days, the man still breathed, but expired immediately after a little bouillon had been forced down his throat. On his person they found a diary, written in pencil, from which the following are extracts :—
Sept. 17.-What a night I have passed! It has rained; I am wet through. I have been so cold.
Sept. 18.-The cold and rain forced me to get up and walk; my walk was very feeble. Thirst made me lick up the water which still rested on the mushrooms. How nasty that water was !
Sept. 19.-The cold, the length of the nights, the slightness of my clothing,
which makes me feel the cold more keenly, have given me great suffering.
Sept. 20.-In my stomach there is terrible commotion; hunger, and, above all, thirst, become more and more fright ful. For three days there has been no rain. Would that I could lick up the
water from the mushrooms now!
Sept. 21.-Unable to endure the tortures of thirst, I crawled with great labour to an inn, where I bought a bottle of beer, which did not quench my thirst. In the evening I drank some water from the pump, near the inn where I bought
"Sept. 23.-Yesterday I could scarcely move, much less write. To-day thirst made me go to the pump; the water was icy cold, and made me sick. I had convulsions until evening; nevertheless, I returned to the pump.
Sept. 26.-My legs seem dead. For three days I have been unable to go to the pump. Thirst increases. My weakness is such that I could scarcely trace these lines to-day.
"Sept. 29.-I have been unable to move. It has rained. My clothes are not dry. No one would believe how much I suffer. During the rain some drops fell into my mouth, which did not quench my thirst. Yesterday I saw a peasant about ten yards from me. bowed to him. He returned my salutation. It is with great regret I die. Weakness and convulsions prevent my
writing more. I feel this is the last time
indeed all other cases do, the truth This pathetic case illustrates, as
that Thirst is far more terrible than Hunger. His resolution was not drink, yet he never seems to have strong enough to resist the desire for faltered in his determination to refrain from food. It will be further noticed that he ceases to complain of the cold when thirst sets in fiercely, because then fever had also supervened.
The sensation of Hunger is at first rather agreeable, but it quickly becomes unpleasant if prolonged. The sense of keen appetite is delightful, but that "sinking in the stomach which ensues, soon passes from an uneasy sensation into positive pain. The pain soon becomes acute; and if food be still withheld, we feel as if the stomach were being torn by pincers. A state of general exhaustion, feverishness, headache, lightheadedness, often flaming into madness, follows. The whole being seems possessed by one desire, before which even the energetic instinct of maternity has been known to give way, and mothers have disputed with their companions for the flesh of their dead children.
But let us avert our eyes from such scenes, and turn them on that of the eight colliers, who were shut up in a pit for one hundred and
* History of the Earth, vol. ii. p. 126.
thirty-six hours.* The first day they shared between them half a pound of bread, a morsel of cheese, and two mugs of wine, which one of them had brought into the mine, and refused to keep for himself alone. Two of the men had eaten before descending into the mine, and they generously declared that they should not die sooner than the others, and would not share the small supply of food. It is very remarkable that these men, who for five days had no nourishment whatever, declared, when they were rescued, that their abstinence had not greatly inconvenienced them. If we knew more of the circumstances we might explain this now inexplicable fact.
Having considered the subject of Hunger under these general aspects, we may now endeavour to answer the question-What causes the sensation of Hunger?
It has been seen that the absence of food needed to repair the waste of tissue is the primary cause; but it has also been seen that this primary cause may exist without the existence of that sensation known to us as Hunger. All animals need food, but we have no ground for supposing that polypes, jelly-fish, and other simpler animals destitute of a nervous system, feel the sensation of Hunger; we must therefore seek for some more proximate cause of this sensation. The popular notion is that Hunger arises from emptiness of the stomach, which, according to some physiologists, allows the walls of the stomach to rub against each other, and the friction causes the sensation. It is easy to show the inaccuracy of this hypothesis, but two facts will suffice here: first, the stomach is always empty some time before Hunger is felt; secondly, it may be empty for days together-in illness-without the slightest sensation of Hunger being felt.
Another notion is that the gastric juice accumulates in the stomach, and attacks its walls. Such a cause would certainly be ample for the effect, and I know but of one objection
to our accepting it, namely, that the fact on which the explanation rests is unfortunately a fiction; the gastric juice does not accumulate in the empty stomach, but is only secreted after the stimulus of food.
A more ingenious explanation has been propounded by Dr Beaumont, whose name is always cited when Digestion is under discussion, because he was enabled to enrich science with many valuable observations, made on a patient who had a hole in his stomach, produced by a gunshot wound. During the hours of fasting," says Dr Beaumont, “ the gastric juice is slowly being secreted in the follicles and retained in their tubes, thereby distending them; this distension, when moderate, produces the sensation of Appetite, when more powerful, of Hunger." There are several analogies which give colour to this explanation. Thus, milk is slowly accumulated in the breast, and the sense of fulness, if unrelieved, soon passes into that of pain. ingenious as the explanation is, a closer scrutiny causes us to reject it. Out of many arguments which might be urged, I will mention only twoone anatomical, and one physiological. If the gastric juice were accumulated in the tubes, there is no anatomical obstruction to its immediate passage into the stomach, and the distension would be obviated. Nor have we any good ground for supposing that an accumulation does take place; for Dr Beaumont's argument that it must take place, because it flows so abundantly on the introduction of food into the stomach, would equally prove that tears must be accumulated in advance, because they gush forth so copiously on the first stimulus of grief, and that saliva must be accumulated, because it flows so freely whenever a stimulus is presented. While, therefore, Dr Beaumont's explanation wants an anatomical basis, it is still more directly at variance with the physiological fact, that when food is injected into the veins or the intestines, the sensation of Hunger disappears,
* This case is quoted by LONGET in his Traité de Physiologie, 1857.
although the stomach is as empty as it was before, and the tubes as distended as they were before.
The fact last named would dispose us to believe that want of food was, after all, the proximate as well as the primary cause of Hunger, did we not know that tobacco, opium, and even inorganic substances, introduced into the stomach will remove the sensation. Humboldt tells us of savages who eat clay to allay their hunger; and we all know how the first mouthful of food takes away the sharpness of the sensation, although two or three hours must elapse before the food will really have entered the body. For we must remember that food in the stomach is as much outside the organism as if it were in the hand. The alimentary canal is nothing but a folding-in of the general envelope, like the inverted finger of a glove; and until the absorbent vessels carry the food from the stomach into the circulating system, the food remains outside.
Here, then, are two noticeable facts: we may relieve the sensation of Hunger without directly acting on the stomach, the mere supply of food to the blood sufficing; and we may relieve the sensation simply by acting on the stomach, the want of food being as great as before. Do not these facts indicate that Hunger must be related to the general state of the system, and to the particular state of the stomach? If we once regard the subject in this light, we shall be easily led to perceive that although the general state of the system, under deficiency of food, is the primary cause of Hunger, it is only the cause of it in as far as it produces a certain condition of the stomach; and this condition of the stomach is the proximate cause of the sensation. I think this mode of viewing it will extricate us from the difficulties which have been brought forward in the many discussions as to whether the stomach, or one part of the nervous system, is the seat of Hunger. The stomach is the seat of the sensation, just as the eyes are the seat of the sensation of sleepiness; the general state of exhaustion which causes the eyes to droop heavily, and the general state
of the system which causes the stomach to produce the sensation of hunger, are equally the origins of the two: and as in sleepiness we may relieve the sensation by bathing the eyes with cold water, yet this will not relieve the general exhaustion; so in hunger, we may relieve the sensation by opium, or even clay, but this will not relieve the general state of the system which produced the sensation.
Although it is evident that the general state of the system must be felt, and to it we owe those daily variations in comfort which we express in the terms "vigour," "gladness," "lassitude,' depression," &c., physiologists have not assigned a name to such sensations. The time will come when it will be found necessary to distinguish the Systemic Sensations (or those arising in the system in general), from the Organic Sensations (or those arising in the separate organs), as these latter are distinguished from those of the five special Senses of Hearing, Sight, &c. In a popular exposition, such as I am now employed on, the current terms must be accepted; and although, therefore, strict accuracy would lead us to say that Hunger, as a Systemic Sensation, is caused by want of food to repair the waste of tissue, and as an Organic Sensation, it is caused by a specific condition of the stomach; yet, following popular language, we must say that Hunger is a sensation having its seat in the stomach; and all the arguments or experiments which attempt to prove that its seat must be elsewhere, have reference to the general state of the system, but not to the specific sensation known to us as Hunger.
If we examine the stomach of a fasting animal, we shall find it pale, and in a condition of obvious atony. The blood has retreated from the smaller vessels, and circulates only in the larger channels. But no sooner is the organ stimulated by the introduction of food, or any irritant substance, than this pale surface becomes visibly congested, turgescent, and its secretions pour forth abundantly. With this rush