124 OF FOOD, AND THE DIGESTIVE PROCESS. 



79. The most prominent symptoms of Starvation, as they have been noted 

 in the Human subject, are as follows : In the first place, severe pain in the 

 epigastrium, which is relieved on pressure ; this subsides after a clay or two, 

 but is succeeded by a feeling of weakness and " sinking " in the same region ; 

 and an insatiable thirst supervenes, which, if water be withheld, thenceforth 

 becomes the most distressing symptom. The countenance becomes pale and 

 cadaverous ; the eyes acquire a peculiar wild and glistening stare ; and gen- 

 eral emaciation soon manifests itself. The body then exhales a peculiar 

 fetor, and the skin is covered with a brownish, dirty-looking, and offensive 

 secretion. The bodily strength rapidly declines ; the sufferer totters in 

 walking, his voice becomes weak, and he is incapable of the least exertion. 

 The mental powers exhibit a similar prostration ; at first there is usually a 

 state of stupidity, which gradually increases to imbecility, so that it is difficult 

 to induce the sufferer to make any effort for his own benefit ; and on this a 

 state of maniacal delirium frequently supervenes. Life terminates either in the 

 mode described in Chossat's observations, or, as occasionally happens, in a 

 convulsive paroxysm. 1 On post-mortem examination, the condition of the 

 body is found to be such as the results of Chossat's observations would indi- 

 cate; namely, extreme general emaciation and disappearance of fat, 2 dimin- 

 ution in the bulk of the principal viscera, and almost complete bloodlessness, 

 save in the brain, which still receives its usual supply. It is especially 

 worthy of note, that the coats of the small intestines are peculiarly thinned, 

 so that they become almost transparent ; and that the gall-bladder is almost 

 invariably turgid with bile, the cadaveric exudation of which tinges the sur- 

 rounding parts. And further, the body rapidly passes into decomposition. 



80. Now it is peculiarly worthy of note, that the deficient supply of new 

 histogenetic materials appears to check the elimination and removal of those 

 which have become effete ; for in no other way can we account for that ten- 

 dency to putrescence, which is so remarkably manifested during life in the 

 fetid exhalation and in the peculiar secretion from the skin, and which is 

 shown after death in the rapidity with which putrefaction supervenes. More- 

 over, towards the close of many exhausting diseases, the fatal termination 

 of which is really due to a chronic inanition, it frequently happens that a 

 " colliquative diarrhoea " comes on, which must be considered as a mani- 

 festation of the general disintegration that is making progress even during 

 life. Now, referring to the conditions hereafter to be enumerated, as those 

 which favor the operation of zymotic poisons in the body, it is obvious that 

 no state could be more liable to it than this; since we have not merely that 

 general depression of the vital powers, which is a predisposing cause of almost 

 any kind of malady, and pre-eminently so of zymotic diseases, but also the 

 presence of a large amount of disintegrating matter in the blood and gen- 

 eral system, which forms the most favorable nidus possible for the reception 

 and multiplication of such poisons. And thus it happens that pestilential 

 diseases must certainly follow in the wake of a famine, and carry off a far 

 greater number than perish from actual starvation. 



81. Another class of phenomena, however, results from such a deficiency 

 of alimentation as is not adequate to produce the results just described ; pro- 

 vided this deficiency be prolonged for a considerable length of time, and 

 especially if it be conjoined with other unfavorable conditions. Of this, a 



1 See Uo-tan in Die-lion. de Me"decine, art. Abstinence ; and Dr. Donovan's ac- 

 count of the Irish famine ..)' 1SJ7 in th<; Dublin Medical Press, Feb. 1848; also a 

 paper by Martin, Mi-d. T. and Ga/.., April, 1861. 



In cases of acute starvation, as Dr. Fowler has shown in reference, to the case of 

 the "Welsh fasting ejirl (Lancet, vol. ii, 1870, p. 150), a considerable amount of fat 

 may bo present in the body, and emaciation may not be marked. 



