396 OF FOOD, AND THE DIGESTIVE PROCESS. 



facts : the prisoners employed in the kitchen, who had 8 oz. of bread additional 

 per day, were not attacked, except three who had only been there a few days : 

 and after the epidemic had spread to a great extent, it was found that the addi- 

 tion of 8 oz. to the daily allowance of vegetable food, and J oz. to the animal, 

 greatly facilitated the operation of the remedies which were used for the resto- 

 ration of health. 1 Another very striking example of the effects of prolonged 

 insufficiency of diet has been furnished by the ft Maison Centrale" of Nimes; 

 which is a large penitentiary containing an average of 1200 prisoners. The 

 mortality in this prison, between the years 1829 and 1847, varied from 1 in 

 7.85 to 1 in 23.88, the average being 1 in 12.70; whilst the average mortality 

 among the inhabitants of the town of Nimes, of the same age and sex, was only 

 1 in 49.9; so that the mortality among the prisoners was from two to six times 

 as great as that among the townspeople, the average being nearly four times. 

 Several causes doubtless concurred to produce this terrible result; but whilst 

 over-crowding and deficient ventilation were constant, deficiency of food, amount 

 of labor exacted, and depression of temperature were variable; and the varia- 

 tions in the rate of mortality followed these last so uniformly, that there could 

 be no doubt of their dependence upon them. 3 



420. It is a curious effect of insufficient nutriment, as shown by the inqui- 

 ries of Chossat (op. cit.), that it produces an incapability of digesting even the 

 limited amount supplied. He found that, when turtle-doves were supplied with 

 limited quantities of corn, but with water at discretion, the whole amount of 

 food taken was scarcely ever actually digested; a part of it being rejected by 

 vomiting, or passing off by diarrhoea, or accumulating in the crop. It seems as 

 if the vital powers were not sufficient to furnish the requisite supply of gastric 

 fluid, when the body began to be enfeebled by insufficient nutrition; or per- 

 haps we might well say, the materials of the gastric fluid were wanting. Hence 

 the loathing of food, which is often manifested by those who have been sub- 

 jected to the influence of an insufficient diet-scale in our prisons and poor-houses, 

 and which has been set down to caprice or obstinacy, and punished accordingly, 

 may be actually a proof of the deficiency of the supply, which we might expect 

 to have been voraciously devoured, if really less than the wants of the system 

 require. 



421. It is extremely important that the Medical Practitioner should be aware, 

 that many of the phenomena above described may be induced by the adoption 

 of a system of too rigid abstinence in the treatment of various diseases ; and 

 that they have been frequently confounded with the symptoms of the malady 

 itself, and have led to an entirely erroneous method of treating it. " Many 

 cases," says Dr. Copland, 3 " have occurred to me in practice, where the anti- 

 phlogistic regimen, which had been too rigidly pursued, was itself the cause of 

 the very symptoms which it was employed to remove. Of these symptoms, the 

 affection of the head and delirium are the most remarkable, and the most readily 

 mistaken for an actual disease requiring abstinence for its removal." The ex- 

 perience of those, especially, who are largely engaged in consulting practice, 

 must have furnished numerous illustrations of the above statement. Dr. Cop- 

 land mentions the following: " A professional man had been seized with fever, 

 for which a too rigid abstinence was enforced, not only during its continuance, 

 but also during convalescence. Delirium had been present at the height of the 

 fever, and recurred when the patient was convalescent. A physician of emi- 

 nence in maniacal cases was called to him, and recommended that he should be 



1 See Dr. Latham "On the Diseases in the Milbank Penitentiary," 1824. 



2 See the highly-instructive account of this series of occurrences, by M. Boileau-Cas- 

 telnau, chief physician to the "Maison Centrale," in Ann. d' Hygiene Publ., Janv., 1849. 



3 " Dictionary of Practical Medicine," vol. i. p. 26. 



