But notwithstanding the indifference of physicians to appetite in
itself, many therapeutic measures are based on the promotion of it.
And in this the truth of empiricism makes itself irresistibly felt.
When the patient is enjoined to eat sparingly, or when he is restrained
from eating at all till the physician expressly permits, or again, when
he is (for instance, during convalescence) removed from his ordinary
surroundings and sent to an establishment where the whole life, and
particularly the eating, is regulated according to physiological
needs--in all these cases the physician seeks to awaken appetite, and
relies upon it as a factor in the cure. In the first case, where the
food is prescribed in small portions, in addition to preventing the
overfilling of a weak stomach, the oft-recurrence of appetite juice,
which is so rich in quantity and so strong in digestive power, is of
great importance. I ask you here to call to mind one of our experiments
in which food was given in small portions to a dog, and thus led to
a secretion of much stronger juice than if the whole ration had been
eaten at once. This was an exact experimental reproduction of the
customary treatment of a weak stomach. And such a regulation of diet
is all the more necessary, since, in the commonest disorders of the
stomach, only the surface layers of the mucous membrane are affected.
It may, consequently, happen that the sensory surface of the stomach,
which should take up the stimulus of the chemical excitant, is not
able to fulfil its duty, and the period of chemical secretion, which
ordinarily lasts for a long time, is for the most part disturbed, or
even wholly absent. A strong psychic excitation, a keen feeling of
appetite, may evoke the secretory impulse in the central nervous system
and send it unhindered to the glands which lie in the deeper as yet
unaffected layers of the mucous membrane.
Public-domain text, read in full here on John Shaqi.
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