HUNGER AND THIRST. 173 



of food, even in unusually large quantity, has but a momentary effect in appeasing the 

 appetite ; showing that, although the feeling of satiety which follows the introduction of a 

 sufficient quantity of food into the stomach is experienced, the system still feels the want 

 of nourishment, and this want is expressed by an almost immediate recurrence of the 

 appetite. 



If food be not taken in obedience to the demands of the system as expressed by the 

 appetite, the sensation of hunger becomes most distressing. It is then manifested by a 

 peculiar and indescribable sensation in the stomach, which soon becomes developed into 

 actual pain. This is generally accompanied by intense pain in the head and a feeling of 

 general distress, which soon render the satisfaction of this imperative demand on the 

 part of the system the absorbing idea of existence. Starvation overcomes, in many 

 instances, every moral and intellectual feeling and gives full play to the purely animal 

 instincts. Furious delirium frequently supervenes after a fe\v days of complete absti- 

 nence ; and this is generally the immediate precursor of death. It is unnecessary to cite 

 any of the numerous instances in which murder and cannibalism are resorted to when 

 starvation is imminent ; suffice it to say, that the extremity of hunger or of thirst, like 

 the sense of impending suffocation, is a demand on the part of the system so imperative, 

 that it must be satisfied if within the range of possibility. There have been instances of 

 sublime resignation in the face of this terrible agony, but these are rare in comparison 

 with the examples of frightful expedients to satisfy the demands of Nature. 



The question of the seat of the sense of hunger is one of considerable physiological 

 interest. When we say that it is instinctively referred to the stomach, it is simply 

 expressing the fact that the sensation is of a nature to demand the introduction of food 

 into the alimentary canal. The sense of the want of air demands the introduction of fresh 

 air into the lungs ; but, though air be inspired, if any thing interfere with its passage to 

 the system by the blood, the demand for oxygen is unsatisfied. It has been shown that the 

 real seat of the respiratory sense is in the general system, and that this is referred to the 

 lungs because it is necessarily by the introduction of air into these organs that the want 

 is met. The same principle is manifested, in a manner no less distinct, with regard to 

 the ingestion and assimilation of food. When the system is suffering from defective 

 nutrition, as after prolonged abstinence or during recovery from diseases which have 

 been accompanied by lack of assimilation, the mere filling of the stomach produces a 

 sensation of repletion of this organ, but the sense of hunger is not relieved ; but if, on the 

 other hand, the nutrition be active and sufficient, the stomach is frequently entirely 

 empty for a considerable time without the development of the sense of hunger. The 

 following observation bears strongly on this point : In a dog with a fistula into the gall- 

 bladder, the bile-duct having been tied and partly exsected, digestion was so much inter- 

 fered with that death from inanition took place in thirty-eight days ; and, although the 

 animal took food abundantly, the appetite was voracious and never satisfied. The same 

 phenomenon has sometimes been observed in cases of diabetes accompanied with great 

 deficiency of assimilation. The appetite is preserved and hunger is felt by persons who 

 suffer from extensive organic disease of the stomach, and the sensation has been occa- 

 sionally relieved by nutritious enemata or by injections into the veins. 



An interesting and curious case has been reported by Prof. Busch, of Bonn, which 

 points almost conclusively to a want of assimilation of nutritive matter by the gen- 

 eral system as the main cause of the sensation of hunger. In this case, which will be 

 more fully detailed hereafter, there existed a fistula into what appeared to be the upper 

 third of the small intestine. The patient was a woman, thirty-one years of age, who, 

 in the sixth month of her fourth pregnancy, received the injury which resulted in the 

 fistulous opening, by being tossed by a bull, one of the horns penetrating the abdomen. 

 She was seen by Prof. Busch six weeks after the injury, at which time every thing taken 

 into the stomach passed at the upper opening of the fistula. Although the patient took 

 food in large quantity, she became extremely emaciated and weak. " The patient at 



