THE IMPORTANCE OF APPETITE. 135 



tonics," and whose action is to promote appetite. Unfortunately medical 

 science has latterly deviated from this, the correct treatment of the 

 appetite, and that which corresponds to the real conditions. If one 

 reads current text-books on disorders of digestion, it is remarkable how 

 little attention is paid to appetite as a symptom or to its special therapy. 

 Only in a few of them is its importance indicated, and then merely in 

 short parenthetic phrases. On the other hand, one may meet statements 

 in which the physician is recommended to adopt no special means for 

 counteracting so unimportant a subjective symptom as a bad appetite ! 

 After what I have said and demonstrated to you in these lectures, one 

 can only designate such views as gross misconceptions. If anywhere, it 

 is precisely here that symptomatic treatment is essential. When the 

 physician finds it necessary, in disorders of digestion, to promote secre- 

 tory activity by different remedies, this object can most certainly and 

 completely be achieved by endeavouring to restore the appetite. We 

 have already seen that no other excitant of gastric secretion, so far as 

 quantity and quality of the juice are concerned, can compare with the 

 passionate craving for food. 



To a certain degree we can understand and this contributes to an 

 explanation of matters how medical science of our time has come to 

 regard so lightly the loss of appetite as a special object for treatment. 

 Now, however, the experimental method has penetrated more and more 

 into medical science, with the result that many pathological factors and 

 therapeutic agents are judged of according to whether they hold good 

 in the laboratory or not that is to say, they are valued only in so far as 

 they can be verified by laboratory experiments. Naturally we do not 

 doubt that a movement in this direction indicates a great advance, but 

 even here, as with every undertaking of mankind, things do not proceed 

 without mistakes and exaggerations. We must not consider an event 

 to be a mere picture of the imagination because it is not realisable 

 under given experimental conditions. We often do not know all the 

 essential conditions for the production of the phenomenon in question, 

 nor are we yet able to grasp the connection between all the separate 

 functions of life as fully as may be desired. Thus in the clinical treat- 

 ment and pathology of digestion assistance was sought for in the 

 laboratory, but nothing was there met with which had a relation to 

 appetite, and consequently this factor was overlooked in medical prac- 

 tice. As stated above, the psychic gastric juice obtained only cursory 

 mention in physiology, and this not even by all authors ; and when it 

 was noticed it was related more as a curiosity. Great importance was, 

 on the other hand, assigned to the mechanical stimulus, the efficiency of 

 which, now that our knowledge is more complete, has been shown to be 

 purely imaginary. Each of the contending factors has at length been 



