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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.
When one considers the proportion of tissue that is composed of lymph vessels and glands, it is then obvious that inflammation of these structures should cause a painful affection of members, when so affected, and that marked lameness and, in some instances, general constitutional disturbance such as anorexia, hyperthermia and general circulatory disorder are to follow.
"The lips were dry, the tongue markedly coated; foetor ex ore was present; painful eructations were frequent, also singultus, complete anorexia and extreme thirst.
The quantity of aliment may be reduced either by imposing an always uniform regimen, which soon begets anorexia and disgust, or by withholding from the food a considerable quantity of fat, or, finally, by forbidding beverage during meals.
I went to see a stomach specialist who looked me over and gravely informed me that I had psychasthenia anorexia. This was a new one on me. For all I knew about the term, it may have been obsolete swearing. I did not realize then that a little medical learning to a layman is a dangerous thing. This doctor prescribed exercise, as had all the others whom I had ever consulted.
Thus, for example, there exists in adult life a disturbance of the nervous system which is called "anorexia nervosa." A boy of nineteen was brought to the Out-patient Department of Guy's Hospital suffering from this complaint. He was little more than a skeleton, unable to stand, hardly able to sit, and weighing only four and a half stones.
Nadia, whom Janet was able to study during five years, was a young woman of twenty-seven, healthy and intelligent, not suffering from hysteria nor from anorexia, for she had a normal appetite. But she had an idea; she was anxious to be slim and to attain this end she cut down her meals to the smallest size, merely a little soup and a few eggs.
A piece of bread and two apples satisfied her as her day's nourishment, which is typical for the hysteric anorexia and perhaps merely signifies the unconscious wish to cost the father as little as possible. Just one single characteristic was wanting for her perfection, the soft, clinging, typically feminine characteristic.
He exhibited entire loss of motion in the lower extremities, with the exception of very slight movement in the toes of the left foot; sensation was almost nil up to the hips, above which it was normal; he had complete retention of urine, with a severe cystitis. His tongue was heavily coated, the bowels constipated, and there was marked anorexia, with considerable anemia.
The symptoms which result from the ingestion of poisonous meat are often very severe. In some cases their appearance is delayed from twenty-four to forty-eight hours. They may resemble those of an infectious disease or those of acute enteritis. Usually there are headache, anorexia, rigors, intestinal disturbance, pains in the back and limbs, and delirium.
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