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d sometimes devoured an entire sheep。 He swallowed dirt； clay； pebbles； and glass； and was addicted to intoxication by brandy。 He lived sixty years in this manner and then he became abstemious； he died at seventy…nine。 His omentum was very lean； but the liver covered all his abdominal viscera。 His stomach was very large and thick； but the intestines were very narrow。
Ely had a patient who was addicted to chalk…eating； this ha said invariably relieved his gastric irritation。 In the twenty…five years of the habit he had used over 1/2 ton of chalk； but notwithstanding this he always enjoyed good health。 The Ephemerides contains a similar instance； and Verzascha mentions a lime…eater。 Adams mentions a child of three who had an instinctive desire to eat mortar。 This baby was rickety and had carious teeth。 It would pick its preferred diet out of the wall； and if prevented would cry loudly。 When deprived of the mortar it would vomit its food until this substance was given to it again。 At the time of report part of the routine duties of the sisters of this boy was to supply him with mortar containing a little sand。 Lime…water was substituted； but he insisted so vigorously on the solid form of food that it had to be replaced in his diet。 He suffered from small…pox； on waking up in the night with a fever； he always cried for a piece of mortar。 The quantity consumed in twenty…four hours was about 1/2 teacupful。 The child had never been weaned。
Arsenic Eaters。It has been frequently stated that the peasants of Styria are in the habit of taking from two to five grains of arsenious acid daily for the purpose of improving the health； avoiding infection； and raising the whole tone of the body。 It is a well…substantiated fact that the quantities taken habitually are quite sufficient to produce immediate death ordinarily。 But the same might be easily said of those addicted to opium and chloral； a subject that will be considered later。 Perverted appetites during pregnancy have been discussed on pages 80 and 81。
Glass…eaters； penknife…swallowers； and sword…swallowers； being exhibitionists and jugglers； and not individuals with perverted appetites； will be considered in Chapter XII。
Fasting。The length of time which a person can live with complete abstinence from food is quite variable。 Hippocrates admits the possibility of fasting more than six days without a fatal issue； but Pliny and others allow a much longer time； and both the ancient and modern literature of medicine are replete with examples of abstinence to almost incredible lengths of time。 Formerly； and particularly in the Middle Ages when religious frenzy was at its highest pitch； prolonged abstinence was prompted by a desire to do penance and to gain the approbation of Heaven。
In many religions fasting has become a part of worship or religions ceremony； and from the earliest times certain sects have carried this custom to extremes。 It is well known that some of the priests and anchorites of the East now subsist on the minimum amount of food； and from the earliest times before the advent of Christianity we find instances of prolonged fasting associated with religious worship。 The Assyrians； the Hebrews； the Egyptians； and other Eastern nations； and also the Greeks and Romans； as well as feasting days； had their times of fasting； and some of these were quite prolonged。
At the present day religious fervor accounts for but few of our remarkable instances of abstinence； most of them being due to some form of nervous disorder； varying from hysteria and melancholia to absolute insanity。 The ability seen in the Middle Ages to live on the Holy Sacrament and to resist starvation may possibly have its analogy in some of the fasting girls of the present day。 In the older times these persons were said to have been nourished by angels or devils； but according to Hammond many cases both of diabolical abstinence from food and of holy fasting exhibited manifest signs of hysteric symptoms。 Hammond； in his exhaustive treatise on the subject of 〃Fasting Girls；〃 also remarks that some of the chronicles detail the exact symptoms of hysteria and without hesitation ascribe them to a devilish agency。 For instance； he speaks of a young girl in the valley of Calepino who had all her limbs twisted and contracted and had a sensation in her esophagus as if a ball was sometimes rising in her throat or falling into the stomacha rather lay description of the characteristic hysteric 〃lump in the throat；〃 a frequent sign of nervous abstinence。
Abstinence； or rather anorexia； is naturally associated with numerous diseases； particularly of the febrile type； but in all of these the patient is maintained by the use of nutrient enemata or by other means； and the abstinence is never complete。
A peculiar type of anorexia is that striking and remarkable digestive disturbance of hysteria which Sir William Gull has called anorexia nervosa。 In this malady there is such annihilation of the appetite that in some cases it seems impossible ever to eat again。 Out of it grows an antagonism to food which results at last； and in its worst forms； in spasm on the approach of food； and this in its turn gives rise to some of those remarkable cases of survival for long periods without food。 As this goes on there may be an extreme degree of muscular restlessness； so that the patients wander about until exhausted。 According to Osler； who reports a fatal case in a girl who； at her death； only weighed 49 pounds； nothing more pitiable is to be seen in medical practice than an advanced case of this malady。 The emaciation and exhaustion are extreme； and the patient is as miserable as one with carcinoma of the esophagus； food either not being taken at all or only upon urgent compulsion。
Gull mentions a girl of fourteen； of healthy； plump appearance； who in the beginning of February； 1887； without apparent cause evinced a great repugnance to food and soon afterward declined to take anything but a half cup of tea or coffee。 Gull saw her in April； when she was much emaciated； she persisted in walking through the streets； where she was the object of remark of passers…by。 At this time her height was five feet four inches； her weight 63 pounds； her temperature 97 degrees F。； her pulse 46； and her respiration from 12 to 14。 She had a persistent wish to be moving all the time； despite her emaciation and the exhaustion of the nutritive functions。
There is another class of abstainers from food exemplified in the exhibitionists who either for notoriety or for wages demonstrate their ability to forego eating； and sometimes drinking； for long periods。 Some have been clever frauds； who by means of artifices have carried on skilful deceptions； others have been really interesting physiologic anomalies。
Older Instances。Democritus in 323 B。C。 is said to have lived forty days by simply smelling honey and hot bread。 Hippocrates remarks that most of those who endeavored to abstain five days died within that period； and even if they were prevailed upon to eat and drink before the termination of their fast they still perished。 There is a possibility that some of these cases of Hippocrates were instances of pyloric carcinoma or of stenosis of the p