Merycism Regarded in the Light of Atavie Tendency. 521 
bread less often, crackers when ingested in pieces of 
considerable size; the casein of the milk is regurgitated in 
lumps whenever milk is swallowed in large draughts. Pep- 
tonized milk, beef-peptones and fluids of any kind are never 
regurgitated. The taste of the regurgitated food assumes 
but rarely a disagreeable character ; it is quite unaltered when 
regurgitation occurs soon after the meal, and becomes of an 
acid nature of varying intensity, whenever the process takes 
place some time after, the patient not being able to define 
the exact time. On March 2Ist he visited me at 3:30 p. m., 
after having partaken of a dinner at 2:20 p.m. The fish 
eaten at the latter was regurgitated and remasticated during 
our conversation. Upon questioning I found that it had not 
lost any of its original flavor. The act of rumination occurs 
nearly always without the patient’s consciousness being aroused 
to asense of an effort. Nausea never precedes it. Whenever 
the patient goes to sleep after having partaken of a heavy 
meal, he usually awakens with a sensation of great discom- 
fort, and the regurgitations, on these occasions, are apt to be 
of a very distasteful nature. For this reason he avoids sleep 
on a full stomach. Past experience has taught him that he is 
at his best when he spends about three-quarters of an hour 
after eating in restful conversation, during which time the 
rumination is at its height; after that, a long walk seems 
to add greatly to the feeling of general well-being. 
As a peculiar feature I may mention the following observa- 
tion made by the patient on repeated occasions: whenever 
the ruminating act failed him, for some occult rt he 
invariably suffered with regurgitation of bile into the 
stomach. I had an opportunity of verifying the truth of his 
observation, on, at least, one occasion. At our first meeting, 
he stated that the regurgitation had been deficient for some 
days. I expressed the stomach, using a soft rubber tube, 
and found the expressa intermixed with bile, the presence of 
which was clearly demonstrated by Gmelin’s test for bile 
Pigments. This fact would almost point to a remarkable 
interrelation existing between the insufficiency of the cardiac 
and that of the pyloric end of the stomach, appearing perhaps 
less remarkable if we consider the wonderful play of nerve in- 
