THE NATURE OF HUNGER 295 



his body of food and drink. During the eighteen days that he lived 

 he kept careful notes. On the third day the sensation of hunger de- 

 parted, and although thereafter thirst came and went, hunger never 

 returned. 11 Still further evidence of the same character could be cited, 

 but enough has already been given to show that after the first few days 

 of fasting the hunger feelings cease. On the theory that hunger is a 

 manifestation of bodily need, are we to suppose that, in the course of 

 starvation, the body is mysteriously not in need after the third day, 

 and that therefore the sensation of hunger disappears? The absurdity 

 of such a view is obvious. 



2. "Hunger may be Felt though the Stomach be Full" — a Selected 

 Alternative. — Instances of duodenal fistula in man have been carefully 

 studied, which have shown that a modified sensation of hunger may be 

 felt when the stomach is full. A famous case described by Busch has 

 been repeatedly used as evidence. His patient, who lost nutriment 

 through the fistula, was hungry soon after eating, and felt satisfied 

 only when the chyme was restored to the intestine through the distal 

 fistulous opening. 12 As food is absorbed mainly through the intestinal 

 wall, the inference is direct that the general bodily state, and not the 

 local conditions of the alimentary canal, must account for the patient's 

 feelings. 



A full consideration of the evidence from cases of duodenal fistula 

 can not so effectively be presented now as later. That in Busch' s case 

 hunger disappeared while food was being taken is, as we shall see, quite 

 significant. It may be that the restoration of chyme to the intestine 

 quieted hunger, not because nutriment was thus introduced into the 

 body, but because the presence of material altered the nature of intes- 

 tinal activity. The basis for this suggestion will be given in due course. 



3. "Animals may Eat Eagerly after Section of their Vagus and 

 Splanchnic Nerves" — a Fallacious Argument. — The third support for 

 the view that hunger has a general origin in the body is derived from 

 observations on experimental animals. By severance of the vagus and 

 splanchnic nerves, the lower oesophagus, the stomach and the small 

 intestine can be wholly separated from the central nervous system. 

 Animals thus operated upon nevertheless eat food placed before them, 

 and may indeed manifest some eagerness for it. 13 How is this behavior 

 to be accounted for — when the possibility of local stimulation has been 

 eliminated — save by assuming a central origin of the impulse to eat? 



The fallacy of this evidence, though repeatedly overlooked, is easily 



11 Viterbi, quoted by Bardier, loc. cit., p. 7. 



u Busch, ArcJiiv fur pathologische Anatomie und Physiologie und fur 

 klinische Medicin, 1858, XIV., p. 147. 



13 See Schiff, loc. cit., p. 37; also Duceeschi, Archivio di fisiologia, 1910, 

 VIIL, p. 579. 



