VOMITING. 627 



ascend into the pharynx, and ultimately into the mouth. Generally, 

 regurgitation takes place in an involuntary manner; but there are 

 some who are capable of effecting it at will ; and can discharge the con- 

 tents of their stomachs at pleasure. To accomplish this, a deep inspi- 

 ration is taken, by which the diaphragm is forcibly depressed upon the 

 stomach ; the abdominal muscles are then contracted so as to compress 

 the organ ; and this effect is occasionally aided by pressing strongly 

 with the hands on the epigastric region. When these efforts are simul- 

 taneous with the relaxation of the lower third of the oesophagus, the 

 alimentary matters pass into the oesophagus. This voluntary regurgi- 

 tation seems to be what is called vomiting at pleasure. 



c. Rumination. Some individuals have taken advantage of this 

 power to chew the food over again, and subject it to a second deglu- 

 tition. The function of rumination is peculiar to certain animals; yet 

 man has occasionally possessed it. Peyer, 1 as well as Percy and Lau- 

 rent, 2 has given numerous examples. The wife of &frotteur or rubber 

 of the floors, in the establishment of the then Duke of Orleans, after- 

 wards King Louis Philippe could bring up a glassful of water into her 

 mouth immediately after she had swallowed it. Dr. Copland 3 appears 

 to have seen more than one instance of human rumination, and he de- 

 scribes it as an affection rather to be courted than shunned, so far as 

 regards the sensations of the individual. Under usual circumstances, 

 according to him, rumination commences from a quarter of an hour to 

 an hour and a half after a meal. The process is never accompanied 

 with the smallest degree of nausea, pain, or disagreeable sensation. 

 The returned alimentary bolus is attended with no unpleasant flavour; 

 is in no degree acidulous [ ?] ; is agreeable ; and masticated with addi- 

 tional pleasure, and greater deliberation than at first. The whole of 

 the food swallowed at a meal is not returned in order to undergo the 

 process ; but chiefly the part that has been insufficiently masticated. 

 The more fluid portions are sometimes, however, regurgitated along 

 with the more solid ; and when the stomach is distended by a copious 

 meal the fluid contents are frequently passed up to be again swallowed. 4 



d. Vomiting. This inverted action of the stomach, preceded as it 

 always is by manifest local and general disturbance, cannot properly 

 be regarded as within the domain of physiology. In the language of 

 Haller, vomitus totus morbosus est. It is, however, so nearly allied to 

 the phenomena we have just considered, and has engaged so much of 

 the time of the physiologist, as well as pathologist, that it requires 

 mention here. From regurgitation it differs essentially, in the sensa- 

 tion that precedes ; the retching that accompanies ; and the fatigue that 

 generally succeeds it ; in short, whilst in regurgitation no indisposition 

 may be felt, in vomiting it is always present to a greater or less extent. 



The sensation of the desire to vomit is termed nausea. It is an in- 



1 Merycologia, &c., Basil, 1685. 



2 Art. Merycisme, in Diet, des Sciences Medicales; Berard, Cours de Pbysiologie, 13te 

 livraison, p. 274, Paris, 1849. 



3 Edition ofDe Lys's translation of Richerand's Physiology. 



4 An interesting case of rumination is cited from the London Lancet, in the Philadelphia 

 Med. Examiner, p. 315, for May, 1845. 



