deprived of all
food dies sooner than a healthy person. An insane person suffering from
acute mania also resists inanition badly, but one the subject of
melancholia often endures the total deprivation of aliment for a long
time. Esquirol[20] cites the case of a melancholic who did not succumb
till after eighteen days of complete abstinence, and Desbarreaux-Bernard
another in which life was prolonged for sixty-one days, but in this case
a little broth was taken once. Desportes[21] refers to the case of a
woman subject to melancholia who continued to exist during two months of
abstinence, during which she took nothing into the stomach but a little
water.

It would be easy to go on and quote other instances occurring among
prisoners, shipwrecked persons, those suffering from diseases which
prevented food entering the stomach, others lost in deserts, forests,
etc., in which life has been prolonged for considerable periods. Such
cases are, however, quite exceptional. An interesting instance occurring
under one of these heads may, however, be cited as an example.

M. Lepine[22] reports the case of a young girl nineteen years of age who
swallowed a quantity of sulphuric acid. As a consequence a stricture of
the [oe]sophagus was produced. Three months after the act, liquids alone
passed into the stomach; emaciation was extreme and the countenance
pallid. Four months subsequently, that is, seven months after swallowing
the acid, the obliteration of the [oe]sophagus was complete, and
nothing whatever could be swallowed. The patient lived for sixteen days
after all food or drink was prevented reaching the stomach. During the
last days of her starvation she complained only of thirst and not of
hunger. The prostration was extreme and the temperature greatly
lessened. A tendency to sleep was present, and there was a subdued
delirium. On the last day of life there was more excitement; the
conjunctivae were red, the pulse thread-like, and the skin cold. It is
not stated whether or not attempts were made to feed this patient by
injections into the rectum of nutritious substances, or by the use of
baths containing such matters in solution. It may, however, safely be
taken for granted that efforts of these kinds were made, and if so, the
unusually long period during which life was sustained is explained.

In all the cases in which life was extraordinarily prolonged there was
either not a total deprivation of food and drink, or there wa