i EXCHANGE OF MATEEIAL 21 



fakirs of India, who are supposed to throw themselves into a 

 state <>t' profound lethargy by hypnotic means. Similar phenomena 

 have been noted in certain- hysterical or psychopathic persons, 

 liiehet found in the case of hysterical patients at the Salpetriere 

 that pulmonary ventilation and the discharge of carbon dioxide 

 -r.ulually diminished during the lethargic state. Lethargy is 

 therefore a genuine hibernation, which enables the patient to 

 maintain a fast for a time proportional to the depression of the 

 respiratory processes. The case of Anna Garbero, described by 

 Dr. Asella (182*7), and to which I referred in my monograph on 

 fasting (1889), is one of very great interest. This woman lived in 

 a state of lethargy, during which she was unable to take any food 

 or drink for thirty-two months, eleven days ! After this case the 

 many marvellous stories of fasts collected from ancient literature 

 and quoted by Fortunio Liceto, a lecturer at Padua early in the 

 seventeenth century, in his book, De his qui diu mvunt sine 

 alimrnto, will cease to appear so astounding as to make us class 

 them one and all as fabulous and legendary. 



We thus find that both animals and man can endure a long 

 fast in two different ways : inanition, when all the functional 

 activities are maintained at a level but little below the physio- 

 logical, and the materials available for combustion are gradually 

 consumed, so long as this is compatible with life ; and hibernation, 

 during which the liberation of energy is diminished, and thus the 

 daily loss or combustion of material is reduced to a minimum. 

 We can readily conceive of processes occupying a position between 

 the extremes, inanition and hibernation, and partaking of the 

 characteristics of either the one or the other. 



Hibernation as a natural condition in hibernating animals is 

 not associated with any noticeable suffering or morbid condition. 

 Inanition, on the other hand, is not a natural state, and is associ- 

 ated with the sensation of hunger, and also of thirst, if there be 

 abstinence from drink as well as from food. Hunger, however, 

 only lasts three or four days and then disappears. This has 

 been noticed in dogs, and was observed by myself in Succi, by 

 Senator in Cetti and Breithaupt, and by Tigerstedt in the student 

 on whom he tried the experiment of a short fast. 



Analysing the condition, as observed in dogs, we can recognise 

 three phases or periods in the process of inanition: the brief 

 initial period of hunger ; the long period of physiological inanition, 

 characterised merely by a gradual diminution in the daily com- 

 bustion and a corresponding diminution in the production of 

 heat; finally, the period of morbid inanition or crisis, which 

 precedes death, and during which there is a slight rise of 

 temperature, vomiting, diarrhoea, and collapse. 



Xo special change is found in the bodies of dogs which have 

 died of inanition, with the exception of emaciation, wasting of the 



