an uneasy sensation occasioned by long abstinence from food when the body is in a healthy state.—See ABSTINENCE; FASTING; and ANATOMY, No 103.
The following useful observations upon hunger or famine are extracted from a paper by Dr Percival in the second volume of the Manchester Transactions.
In famine, life may be protracted (the doctor observes) with less pain and misery, by a moderate allowance of water. For the acrimony and putrefaction of the humours are obviated by such dilution, the small vessels are kept permeable, and the lungs are furnished with that moisture which is essential  fential to the performance of their functions. Fontanus, a writer of respectable authority in the estimation of Morgagni, relates the history of a woman who obstinately refused to take any sustenance, except twice, during the space of 50 days, at the end of which period she died. But he adds, that she used water by way of drink, though in small quantity. Redi, who made many experiments (cruel and unjustifiable in my opinion), to ascertain the effects of fasting on fowls, observed, that none were able to support life beyond the ninth day to whom drink was denied; whereas one indulged with water lived more than 20 days.
Hippocrates has observed, that children are more affected by abstinence than young persons; these, more than the middle-aged; and the middle-aged, more than old men. The power to endure famine, however, must depend no less upon the state of health and strength than on the age of the sufferer. There are also particular constitutions which do not suffer much pain from the calls of hunger. Dr Percival was informed by a young physician from Geneva, that when he was a student at Montpelier, he fasted three nights and four days, with no other refreshment than a pint of water daily. His hunger was keen, but never painful, during the first and second days of his abstinence; and the two following days, he perceived only a faintness when he attempted either bodily or mental exertion: A sense of coldness was diffused over his whole frame, but more particularly affected the extremities. His mind was in a very unusual state of puffilanimity; and he experienced a great tendency to tears whenever he recollected the circumstance which had been the occasion of his fasting. During the whole period, the alvine excretions were suppressed, but not those by the kidneys: and at the close of it, his skin became tinged with a shade of yellow. The first food he took was veal broth; which had something of an intoxicating effect, producing a glow of warmth, and raising his spirits, so as to render him ashamed of his despondency. Perhaps in the case of Sextius Baculus, as recorded in the commentaries of Caesar*, the extraordinary courage and prowess which he suddenly exerted, might be aided by the exhilarating effect of sustenance, which, under such circumstances, it is probable he would no longer decline. The fact, however, evinces, that neither his sickness nor the sensations of hunger had been so violent as much to impair his strength of body or vigour of mind. Pomponius Atticus, the celebrated friend of Cicero, who put a voluntary end to his life in the 77th year of his age by refusing all food, appears to have experienced ease from his disorder, rather than any acute sufferings by famine. "Sic cum biduo cibo se abstinentisset, subito febris decestit, leviorque morbus esse coepit: tamen propositum nilio fecius perigit. Itaque die quinto, postquam id confinium inerat, decestit." (Corn. Nepos in Vit. Pomp. Attic.) From the former circumstance it has been conjectured, that he did not wholly deny himself the use of water, or of some other diluent. But though a few examples of this kind may be adduced, we have the evidence of numerous melancholy facts to show, that the prelude of want is agonizing to the human frame. "I have talked (lays an ingenious writer†) with a captain of a ship, who was one of six that endured it in its extremity, and who was the only person that had not lost his senses when they received accidental relief. He assured me his pains at first were so great, as to be often tempted to eat a part of one of the men who died, and which the rest of his crew actually for some time lived upon. He said, that during the continuance of this paroxysm, he found his pains insupportable, and was dejected at one time of anticipating that death which he thought inevitable: But his pains, he said, gradually decreased after the sixth day (for they had water in the ship, which kept them alive so long), and then he was in a state rather of languor than desire; nor did he much wish for food, except when he saw others eating; and that for a while revived his appetite, though with diminished importunity. The latter part of the time, when his health was almost destroyed, a thousand strange images rose upon his mind; and every one of his senses began to bring him wrong information. The most fragrant perfumes appeared to him to have a fetid smell; and every thing he looked at took a greenish hue, and sometimes a yellow. When he was presented with food by the ship's company that took him and his men up, four of whom died shortly after, he could not help looking upon it with loathing instead of desire; and it was not till after four days that his stomach was brought to its natural tone; when the violence of his appetite returned with a sort of canine eagerness."
To those who by their occupations are exposed to such dreadful calamities, it is of serious importance to be instructed in the means of alleviating them. The American Indians are said to use a composition of the juice of tobacco, and the shells of snails, cockles, and oysters calcined, whenever they undertake a long journey, and are likely to be destitute of provisions. It is probable the shells are not burnt into quicklime, but only so as to destroy their tenacity, and to render them fit for levigation.* The mass is dried, and formed into pills, of a proper size to be held between the gum and lip, which, being gradually dissolved and swallowed, obtund the sensations both of hunger and of thirst. Tobacco, by its narcotic quality, seems well adapted to counteract the uneasy impressions which the gastric juice makes on the nerves of the stomach when it is empty; and the combination of tefaceous powder with it may tend to correct the secretion that is supposed to be the chief agent in digestion, and which, if not acid, is always united with acidity. Certain at least it is, that their operation is both grateful and salutary; for we find the luxurious inhabitants of the East Indies mix them with the betel nut, to the chewing of which they are universally and immoderately addicted. Perhaps such absorbents may be usefully applied, both to divide the doses and to moderate the virulence of the tobacco. For, in the internal exhibition of this plant, much caution is required, as it produces sickness, vertigo, cold clammy sweats, and a train of other formidable symptoms, when taken in too large a quantity. During the time of war, the impressed sailors frequently bring on these maladies, that they may be admitted into the hospitals, and released from servitude. It would be an easy and safe experiment to ascertain the efficacy, and to adjust the ingredients, of the Indian composition mentioned. And there is reason to believe, that the trial would be in some degree successful; for it is known that smoking tobacco gives relief to those habitual pains of the stomach which appear to arise from the irritation of the gastric secretions. The like effect is sometimes produced by increasing the flow of saliva, and swallowing what is thus discharged. And Dr Percival has related the case of a gentleman, who used to masticate, many hours daily, a piece of lead, which being neither hard, friable, nor offensive to the palate, suited his purpose, as he thought, better than any other substance. He continued the custom many years, deriving great ease from it, and suffering no sensible injury from the poisonous quality of the metal. On mentioning this fact to a navy surgeon, the doctor was told, that the sailors, when in hot climates, are wont to mitigate thirst by rolling a bullet in their mouths. A more innocent mean, the doctor observes, might be devised; but the efficacy of this evinces, that the salivary glands are for a while capable of furnishing a substitute for drink. When a scarcity of water occurs at sea, Dr Franklin has advised, that the mariners should bathe themselves in tubs of salt-water: For, in pursuing the amusement of swimming, he observed, that, however thirsty he was before immersion, he never continued so afterwards; and that, though he soaked himself several hours in the day, and several days successively in salt-water, he perceived not, in consequence of it, the least taste of saltiness in his mouth. He also further suggests, that the same good effect might perhaps be derived from dipping the sailor's apparel in the sea; and expresses a confidence that no danger of catching cold would ensue.
To prevent the calamity of famine at sea, it has been propounded by Dr Lind, that the powder of falep should constitute part of the provisions of every ship's company. This powder and portable soup, dissolved in boiling water, form a rich thick jelly; and an ounce of each of these articles furnishes one day's subsistence to a healthy full grown man. Indeed, from Dr Percival's experiments it appears, that falep contains more nutritious matter, in proportion to its bulk, than any other vegetable production now used as food. It has the property also of concealing the nauseous taste of salt-water; and consequently may be of great advantage at sea, when the stock of fresh water is so far consumed, that the mariners are put upon short allowance. By the same mucilaginous quality, it covers the offensiveness, and even in some measure, corrects the acrimony of salted and putrefied meats. But, as a preservative against hunger, falep would be most efficacious combined with an equal weight of beef suet. By swallowing little balls of this lubricating compound at proper intervals, the coats of the stomach would be defended from irritation: and as oils and mucilages are highly nutritive, of slow digestion, and indisposed to pass off by perspiration, they are peculiarly well adapted to support life in small quantities. This composition is superior in simplicity, and perhaps equal in efficacy, to the following one, so much extolled by Avicenna the celebrated Arabian physician; to whom we are indebted for the introduction of rhubarb, cassia, tamarinds, and lenna, into the materia medica. "Take sweet almonds and beef suet, of each one pound; of the oil of violets two ounces; and of the roots of marshmallows one ounce: bray these ingredients together in a mortar, and form the mass into boluses, about the size of a common nut." Animal fat is singularly powerful in allaying the most acute sensations of thirst, as appears from the narrative of the sufferings experienced by those who were confined in the black hole at Calcutta. A hundred and forty-fix persons, exhausted by fatigue and military duty, were there thrust together into a chamber of 18 cubic feet, having only two windows, strongly barred with iron, from which, in a clothy fultry night, and in such a climate as that of Bengal, little or no circulation of fresh air could be enjoyed. In a few minutes, these unhappy wretches fell into so profuse a perspiration, that an idea can hardly be formed of it; and this was succeeded by a raging thirst, which increased in proportion as the body was drained of its moisture. Water! Water! became the universal cry; and an old soldier on the outside, through pity, furnished them with a few skinfuls of it. But these scanty supplies, like sprinklings on the fire, served only to feed and increase the flame. From this experience of its effects, Mr Holwell, their chief, determined to drink no more; and kept his mouth moist by sucking the perspiration out of his shirt sleeves, and catching the drops as they fell from his head and face. "You cannot imagine (says he) how unhappy I was if any of them escaped me." He came into the prison without his coat, the season being too hot to bear it; and one of his miserable companions, observing the expedient he had hit upon of allaying his thirst, robbed him from time to time of a considerable part of his store. This plunderer, whom he found to be a young gentleman in the service of the East India Company, afterwards acknowledged, that he owed his life to the many comfortable draughts which he derived from him. Before Mr Holwell adopted this mode of relief, he had attempted, in an ungovernable fit of thirst, to drink his own urine: but it was so intensely bitter, that a second taste could not be endured; whereas, he assures us, no Bristol water could be more soft and pleasant than his perspiration. And this, we may presume, consisted chiefly of animal fat, melted by excessive heat, and exuding from the cellular membrane through the pores of the skin.
Persons who have been accustomed to animal food, are soon reduced when supplied only with the farinacea. Several years ago, to determine the comparative nutritive powers of different substances, an ingenious young physician, as Dr Percival informs us, made a variety of experiments on himself, to which he unfortunately fell a sacrifice. He lived a month upon bread and water; and under this regimen of diet he every day diminished much in his weight. But in 1784, a student of physic at Edinburgh confined himself for a longer space of time to a pint of milk and half a pound of white bread daily: And he assured our author, that he passed through the usual labours of study and exercise without feeling any decay of health or strength, and without any sensible loss of bulk. The cutaneous, urinary, and alvine excretions, were very scanty during the whole period; and the discharge of faeces occurred only once in a week. In this case the oily and coagulable parts of the milk probably furnished a larger proportion of aliment, and at the same time contributed to check the waste by perspiration and other discharges; for oleaginous substances are retained long in the body by their viscosity. Dr Ruffel, Ruffel, in his Natural History of Aleppo, relates, that in those seasons when oil abounds, the inhabitants, by indulgence in it, are disposed to fever, and affected with infarctions of the lungs; maladies which indicate both retention and obstruction. Milk has been suspected by some of producing similar effects, though in a slighter degree; and the free use of it has been on this account forbidden to asthmatics.
Gum arabic might be a good substitute for sago in the composition already recommended; and as it will give such firmness to the mass, as to require manduca tion, the saliva, by this means separated and carried into the stomach, would further contribute to allay the sensations both of hunger and of thirst. See GUM-ARABIC. This gum, combined with sugar and the whites of eggs, has been lately extolled in France, under the name of patigume, as a remedy for catarrhal defluxions. Dr Percival has seen cakes made of these ingredients, and thinks they might very well be applied to the purpose of obviating hunger. They are not perishable in the hottest climates, may be carried about the person with convenience, and though very tough are pleasant to the taste. In the formula by which they are made, the proportion of sugar is too large, and that of gum arabic too small, if the mass be intended to allay the cravings of appetite. According to our author's information, the receipt is as follows. "Take of fine sugar four ounces, and of gum-arabic one ounce: Levigate them well together; and add half an ounce of rose water, and of the white of eggs a sufficient quantity."
In our attempts to recover those who have suffered under the calamities of famine, great circumspection is required. Warmth, cordials, and food, are the means to be employed; and it is evident that these may prove too powerful in their operation, if not administered with caution and judgment. For the body, by long fasting, is reduced to a state of more than infantile debility; the minute vessels of the brain, and of the other organs, collapse for want of fluids to defend them; the stomach and intestines shrink in their capacity; and the heart languidly vibrates, having scarcely sufficient energy to propel the scanty current of blood. Under such circumstances, a proper application of heat seems an essential measure, and may be effected by placing on each side a healthy man in contact with the patient. Pediluvia or fomentations may also be used with advantage. The temperature of these should be lower than that of the human body, and gradually increased according to the effects of their stimulus. New milk, weak broth, or water gruel, ought to be employed both for the one and the other; as nutriment may be conveyed into the system this way, by passages probably the most pervious in a state of fasting, if not too long protracted. "A lad at Newmarket*, a few years ago, having been almost starved in order that he might be reduced to a proper weight for riding a match, was weighed at nine o'clock in the morning, and again at ten; and he was found to have gained near 30 ounces in weight in the course of an hour, though he had only drank half a glass of wine in the interval. The wine probably stimulated the action of the nervous system, and incited nature, exhausted by abstinence, to open the absorbent pores of the whole body, in order to suck in some nourishment from the air." But no such ab-
fortion as this can be expected in a state of extreme weakness and emaciation gradually induced; because the lymphatics must partake of the general want of tone and energy. And notwithstanding the salutary effects of wine in the cafe of the jockey, who, it is likely, had been reduced by sweating as well as by abstinence, such a stimulant might prove dangerous, and even fatal in other cases. It appears safer therefore to advise the exhibition of cordials in very small doses, and at first considerably diluted. Slender wine-whey will perhaps best answer this purpose; and afford, at the same time, an easy and pleasant nourishment. When the stomach has been a little strengthened, an egg may be mixed with the whey, or administered under some other agreeable form. The yolk of one was, to Cornaro, sufficient for a meal; and the narrative of this noble Venetian, in whom a fever was excited by the addition of only two ounces of food to his daily allowance, shows, that the return to a full diet should be conducted with great caution, and by very slow gradations.