DURATION OF THE SHAM FEEDING EFFECT. 85 



from the mere filling and distension of the stomach, must diminish 

 the desire for food, and, consequently, bring the secretory effect to an 

 end. 



It is, therefore, improbable that the whole secretory process in the 

 stomach, which, in the case of certain kinds and quantities of food, lasts 

 from ten to twelve hours, is dependent on the factors which we have up 

 to the present investigated. This is all the more obvious since a sham 

 feeding of five minutes, even under the most favourable circumstances, 

 does not call forth a secretion for longer than three to four hours. We 

 must, therefore, seek for other exciting agencies of the innervation 

 apparatus of the gastric glands. 



Why and wherefore is the secretion instituted by psychic influence 

 maintained? What would first occur to all your minds is naturally 

 the immediate influence which the food exerts upon the walls of the 

 stomach. And this is true, but it does not happen in the simple, direct 

 fashion current in the minds of many physiologists and physicians, When 

 I said that bread or boiled white of egg, introduced directly into the 

 stomach, may not for hours produce a trace of secretion, probably many 

 of my hearers may have asked themselves with natural astonishment, 

 " How, then, is the effect of the forced feeding of phthisical and insane 

 patients, and the artificial feeding of those with gastric fistula- (performed 

 on account of stricture of the oesophagus) to be explained ? " I will 

 introduce my answer by a very unexpected pronouncement relative to 

 the asseition, that mechanical stimulation of the stomach wall by 

 food constitutes a reliable and effective means of calling forth the 

 secretory work of the glands. This assertion, which is so categorically 

 set forth in many text-books of physiology, and which consequently has 

 gained hold of the mind of the physician, is nothing else than a sad 

 misconception degenerated into a stubborn prejudice. My own state- 

 ment, repeated in many published articles, and at the meetings of 

 various medical societies, that this dictum is only a picture of the 

 imagination, has met, for the moat part, either with an unbelieving 

 shake of the head or else with a direct avowal that " it cannot be so." 

 I regret exceedingly that these steadfast unbelievers are not here, so 

 that we might together bring the matter before the tribunal of fact, to 

 the demonstration of which we will now proceed. To this matter I 

 attribute very great importance. It is on this ground, according to 

 my opinion, that the whole battle must be fought out between the 

 generally accepted view, thac every agency is capable of exciting the 

 gasti-ic mucous membrane, and the theory that it is only excitable by 

 specific and selected stimuli. If once the defenders of the old opinion are 

 driven from their position, and obliged to admit the inefficiency of 

 mechanical stimulation, there would be nothing further left for them 



