STARVATION OF VEGETABLE AND ANIMAL TISSUES. 
77 
to diminution of the fluid constituents of the blood ; but the 
phenomena occurring in the intestinal canal appear to be quite 
decisive. ^Yithout the experimental data it might have remained 
a more open question whether the conditions in the human 
subject were not rather secondary phenomena^ dependent on the 
fatal diarrhcea and dysentery^ or due to some occult cause 
inducing the latter ; but when taken along with the phenomena 
of uncomplicated starvation in the larvee they appear unequivo- 
cally traceable to the influence of defective nutrition. The 
clinical experience obtained in the conduct of relief camps also 
affords most conclusive evidence on the question. Had all the 
tissues retained their integrity and capability of performing their 
proper functions, the excessive mortality and the general futility 
of the most careful dietetic treatment among cases of advanced 
starvation would remain utterly inexplicable. 
When, however, we recognise the existence of destructive 
change in the tissues of the intestinal canal, these problems 
admit of ready solution, and all occasions to call in arbitrary 
explanations of the prevalence of fatal diarrhoea and dysentery 
among the subjects of starvation ceases. It has been usual to 
ascribe these symptoms to the influence of noxious materials in 
the blood derived from abnormal transformations of tissue, and 
such materials may, no doubt, be present, but the local effects 
produced on the intestinal tissues appear to be quite sufficient 
to account for. the symptoms. It has also been indicated, as a 
curious effect of starvation, that it should produce an incapacity 
for the assimilation of food when supplied.^ With the present 
anatomical data it would rather be a matter of wonder if it did 
not. With the degeneration and destruction of the epithelial 
and glandular elements of the mucous membrane of the digestive 
system, the digestion and assimilation of nutritive materials 
supplied in the food must necessarily be impaired or destroyed, 
according to the degree of morbid change. The food-elements, 
not being submitted to their normal transformations, become 
mere foreign bodies liable to undergo decomposition, and well 
adapted to cause irritation, especially on surfaces which have 
been more or less denuded of their normal protective coverings, 
as is the case with the intestinal mucous membrane after the 
destruction of its epithelium. 
That symptoms of intestinal irritation should set in under such 
circumstances is only what might be expected, aud that these 
symptoms should have been especially liable to occur in people 
shortly after admission into relief camps is readily ex})licable. 
AVliile they were outside and actually suffering from extreme 
privation, the primary destruction of tissue was no doubt 
* Carpenter; op. cit., p. 112. 
