THE RATIONALE OF THE MENU. 139 



is the foundation upon which an appetite for this or that kind of food 

 may be awakened, and here a general physiological law is illustrated. 

 The light appears brighter after darkness, a sound louder after silence, 

 the enjoyment of blithesome health more intense after illness, and so 

 on. This explanation of the appetising effects of bitters proceeding 

 from the mouth does not exclude the possibility of some such similar 

 influence coming also from the stomach. As has been already stated in 

 the fifth lecture, there is some reason for believing that certain 

 impulses from the cavity of the stomach are likewise necessary for the 

 excitation of appetite. It is possible that bitters not only act directly on 

 the gustatory nerves in the mouth, but that they also act on the mucous 

 membrane of the stomach in such a way that sensations are generated 

 which contribute to the passionate craving for food. As a matter of 

 fact, it has been confirmed by many clinicians that after the administra- 

 tion of bitters some such special sensations do arise in the stomach. The 

 effect of these remedies consists, therefore, not merely in the generation 

 of a simple reflex, but in the production of a certain psychic effect, which 

 indirectly excites a physiological secretory activity. The same probably 

 applies to other substances, such as condiments. In any case, whether 

 our explanation corresponds to the actuality or not, the question of the 

 therapeutic effect of bitters is settled in the affirmative the moment we 

 acknowledge that these substances awaken appetite. The problem, 

 therefore, of an experimental investigation of bitters consists in estab- 

 lishing the fact that they have an effect upon the appetite. The 

 question is a difficult one, and has not hitherto been attempted in the 

 laboratory. lo is not sufficient to hand over clinical observations to the 

 laboratory as experimental proofs. One must have, in addition, the 

 assurance that the investigation has been correctly carried out ; that is 

 to say, that it dealt exactly with the point under consideration. It is 

 interesting to observe that the connection between appetite and gastric 

 juice is by many physicians, and in many text-books of medicine, 

 exactly reversed. Thus it is represented that some medicinal remedy 

 calls forth a secretion of gastric juice, and this, by its presence in the 

 stomach, awakens an appetite. Here we have to deal with a false 

 explanation of a true fact, and that because it was not recognised that 

 a psychic effect could by any possibility be a powerful excitant of 

 secretory nerves. The customs of the chief meal of the day also corre- 

 spond with our physiological results. After this or that hors d'ceuvre, 

 perhaps also with a liqueur of brandy (especially customary in Russia), 

 both of which are designed to awakea the appetite, the repast 

 proper begins, and, in the majority of cases, with something hot, 

 consisting mostly of meat broth (bouillon, different soups, and so on). 

 After this comes the really nourishing food meat of different kinds 



