OF HUNGER AND THIRST. STARVATION. 395 



tions, 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 indicate ; namely, extreme general emaciation and 

 disappearance of fat, diminution in the bulk of the principal viscera, and almost 

 complete bloodlessness, save in the brain, which still receives its usual supply. 

 It is specially worthy of note, that the coats of the small intestines are peculiarly 

 thinned (Donovan, loc. cit.), so that they become almost transparent; and that 

 the gall-bladder is almost invariably turgid with bile, the cadaveric exudation 

 of which tinges the surrounding parts. And further, the body rapidly passes 

 into decomposition. 



418. 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 tendency 

 to putrescence, which is so remarkably manifested during life in the fetid ex- 

 halation and in the peculiar secretion from the skin, and which is shown after 

 death in the rapidity with which putrefaction supervenes. Moreover, 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 manifestation of the general disinte- 

 gration that is making progress even during life. Now referring to the condi- 

 tions formerly enumerated ( 210), as those which favor the operation of zymo- 

 tic 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 mat- 

 ter in the blood and general system, which forms the most favorable nidus pos- 

 sible for the reception and multiplication of such poisons. And thus it happens 

 that pestilential diseases most certainly follow in the wake of a famine, and 

 carry off a far greater number than perish from actual starvation. 



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

 alimentation as is not adequate to produce the results just described; provided 

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

 it be conjoined with other unfavorable conditions. Of this, a remarkable ex- 

 ample was presented at the Milbank Penitentiary in 1823. The prisoners con- 

 fined in this establishment, who had previously received an allowance of from 

 31 to 33 oz. of dry nutriment daily, had this allowance suddenly reduced to 

 21 oz., animal food being at the same time almost entirely excluded. They 

 were at the same time subjected to a low grade of temperature, and to consider- 

 able exertion; and were confined within the walls of a prison situated in the 

 midst of a marsh which is below the level of the adjoining river. The prison 

 had been previously considered healthy ; but in the course of a few months, the 

 health of a large proportion of the inmates began to give way. The first symp- 

 toms were loss of color, and diminution of flesh and strength; subsequently, 

 diarrhoea, dysentery, and scurvy; and lastly, adynamic fevers, or headache, ver- 

 tigo, convulsions, maniacal delirium, apoplexy, &c. The smallest loss of blood 

 produced syncope, which was frequently fatal ; and after death, ulceration of 

 the mucous lining of the alimentary canal was very commonly found. Out of 

 860 prisoners, no fewer than 437, or 52 per cent., were thus affected. The 

 influence of concurrent conditions, especially of previous confinement, was here 

 remarkably shown ; for those were found to be most liable to disease who had 

 been in prison the longest. That the reduction of the allowance of food, how- 

 ever, was the main source of the epidemic, was proved by the two following 



1 See Rostan in "Diction, de Medecine," art. "Abstinence;" and Dr. Donovan's ac- 

 count of the Irish famine in 1847 in the "Dublin Medical Press," Feb. 1848. 



