138 THE WORK OF THE DIGESTIVE GLANDS. 



grown-up individuals towards food, a matter with which the commenc- 

 ing phase of digestion is closely linked, it would seem undesirable to 

 habituate children solely to a nicety and uniformity of gustatory sen- 

 sations. Such might affect their capabilities of adapting themselves to 

 other conditions in after life. 



The question of the therapeutic influence of the so-called bitters, it 

 appears to me, bears the closest connection with that of appetite. After 

 a long period of high repute these substances have been almost expelled 

 from the list of pharmaceutic remedies. When tested in the laboratory, 

 they were unable to justify their old and valued reputation ; when 

 directly introduced into the stomach, many of them were unable to 

 produce a flow of gastric juice. Consequently, in the eyes of the 

 clinician, they became greatly discredited, so that many were quite ready 

 to discard their use altogether. Obviously, the simple conclusion was 

 drawn, that a weak digestion could only be assisted by a remedy which 

 directly excites secretory activity. In this, however, it was forgotten 

 that the conditions of the experiment possibly had not corresponded 

 with the actual state of affairs. The whole question of the therapeutic 

 importance of the bitters, however, acquires a different significance 

 when we link it with another question, such, for instance, as how do 

 bitters affect the appetite ? It is the universal opinion of the earlier 

 and later physicians that bitters increase the appetite, and if this be so 

 everything is said. They are, in consequence, real secretory stimu- 

 lants, since the appetite, as has many times been repeated in these 

 lectures, is the strongest of all stimuli to the digestive glands. It is, 

 however, not by any means strange that this had not previously been 

 observed in the laboratory. The substances were either introduced directly 

 into the stomachs of normal dogs or else injected into the circulation. 

 But their action is chiefly bound up with their effect upon the gustatory 

 nerves, and it was not, therefore, without some reason that this large 

 group of remedies, consisting of substances of the most varied chemical 

 composition, were grouped together mainly on account of a certain 

 bitter taste common to them all. A person who suffers from digestive 

 disturbance has, moreover, a blunted taste, a certain degree of gustatory 

 indifference. The ordinary foods, which are agreeable to other people, 

 and also to himself when in health, now appear tasteless. They not 

 only arouse no desire for eating, but may even cause a feeling of 

 dislike ; there is no sense of taste, or at best a perverse one. It is 

 necessary, therefore, that the gustatory apparatus should receive a 

 strong stimulus in order to restore a normal sensation. As experience 

 teaches, this object is most quickly attained by exciting sharp, un- 

 pleasant gustatory impressions, which by contrast awaken the idea of 

 pleasant ones. In either case there is no longer indifference, and this 



