140 THE WORK OF THE DIGESTIVE GLANDS. 



served in various ways, or, in the case of poorer people, stews made 

 with vegetables, and therefore rich in carbohydrate material. This 

 sequence of foods, from the standpoint of physiology, is quite 

 rational. Meat broth, as we have already seen, is an important 

 chemical excitant of gastric secretion. An attempt is therefore made 

 in two ways to secure a free secretion of gastric juice to act on the 

 chief food ; first in the excitement of the appetite juice by the 

 hors d'oeuvre, and secondly in the promotion of the flow by the action of 

 the meat broth. It is in this way that human instinct has made pro- 

 visions for the digestion of the chief meal. A good meat broth can 

 only be afforded by well-to-do people, and consequently with the poorer 

 classes a less expensive, and, indeed, also a less effective, chemical 

 excitant is used for awakening the early secretion. For example, kwas * 

 serves in this way with the Russian population, while in Germany, 

 where the price of meat is high, different kinds of soups are used, 

 consisting of water mixed with flour, bread, &c. It is further to be 

 borne in mind that the quantity of the digestive juices in general 

 stands in close connection with the content of water in the organism. 

 This has been shown by the experiments of Dr. Walther for the 

 pancreatic juice and by my own for the gastric juice. If this sequence 

 of foods, therefore, holds good for healthy people, it must be even more 

 strictly adhered to in pathological conditions. Thus, when a person 

 has no appetite, or only a weak one, he has no psychic juice or only 

 very little ; consequently, the meal must in every case be begun with 

 a strong chemical excitant for example, with a solution of the extrac- 

 tives of flesh. Otherwise solid foods, particularly if they do not 

 consist of meat, would remain long in the stomach without any digestion 

 whatever. It is, therefore, in every way desirable to prescribe meat 

 juice, strong broth, or meat extract to people who have no appetite. 

 The same applies also to forced feeding, for instance, of the insane. 

 It is true that the method of introduction in this case necessarily 

 secures the presence of a chemical excitant, since the food can only be 

 introduced in a fluid form. In any case the addition of meat extract 

 would be very useful. If one arranged the ordinary fluid foods in 

 descending order, according to the influence of the chemical excitants, 

 the following would be the series : first, the preparations of the flesh, 

 such as meat juice and the like ; secondly, milk ; thirdly, water. 



The usual termination of the repast is also, from the physio- 

 logical standpoint, easy to be understood. The chief meal is generally 

 ended with something sweet, and everybody knows that sweets are 



* Jtioas is a favourite Russian drink, prepared from water, bread or meal, with 

 malt and yeast. It contains a considerable quantity of lactic acid, some acetic acid, 

 and other products of fermentation. 



