Of course such persons, if under the observation of a physician, could be fed forcibly, but through the ignorance of friends or relatives it not unfrequently happens that medical aid is not invoked in time, and serious symptoms, or even death itself, may result. The time at which this last termination ensues varies according to the kind of insanity with which the patient is affected. A general paralytic 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. Lépine[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 œsophagus 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 œsophagus 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 conjunctivæ 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.