In cases of complete abstinence, the phenomena—to several of which attention has already been called—are very striking. The respiration becomes slow until just before death, when, as Chossat observes, there is often a quickening of the respiratory movements. The exhaled breath has a peculiarly sickening and fetid odor. The pulse loses in force and frequency.
The blood becomes reduced in quantity to such an extent sometimes that, as observed by Collard and Martigny,[25] incisions may be made in various parts of the bodies of animals suffering from inanition without there being any hæmorrhage.
The animal temperature falls, according to Chossat, 8° per day until the day of death, when it reaches 14°; and at the moment life departs, the loss suddenly becomes 30°.
All the secretions are diminished in quantity. This is especially shown as regards the saliva and urine. Even open sores cease to secrete pus.
At first there is pain, the seat of which is referred to the stomach, and which pain in the beginning, being simply a feeling of emptiness, rapidly assumes a gnawing or tearing character. But before long this fades away and it does not appear that in the middle and final stages of inanition there is any suffering which can be called a pain, or which can be fixed in any definite part of the body.
The mental faculties are profoundly affected. A high state of delirium supervenes, and there are often hallucinations. These sometimes relate to food, which appears to the sufferer to be spread out before him in the most seducing manner. All nobility of character disappears, and selfishness and brutality govern. Finally the delirium becomes low and muttering, the bodily weakness becomes excessive, walking, or even standing, is impossible, the sufferer loses all sensation, and death ensues.
But probably no part of the subject is of more interest than that which relates to the association of inanition with hysteria. As is well known by physicians, the existence of this latter condition enables many to bear partial, or even complete deprivation of food longer and with less apparent suffering than would be possible with individuals in good health.
That Miss Fancher is subject to hysteria is very evident from a consideration of the clinical history of her case, and hence it is to be expected that she can endure long fasts without much inconvenience. It is just possible that she might, by remaining quietly in bed in a state of partial or complete trance—a hysterical condition in which the waste of the tissues is greatly reduced—exist for a month without either food or drink, and therefore the proposition which I made to her friends contains no exacting condition. But when it is gravely said that "for a period of nearly fourteen years she has lived absolutely without food or nourishment of any kind," we are forced to declare, in the interest of science, that the statement is necessarily absolutely devoid of truth. Subsequent statements, as we have seen, modify this fourteen years' claim very materially, and really leave it in doubt whether there was any abstinence at all.
But I think it may safely be believed that Miss Fancher has indulged in frequent long fasts. Hysteria is very frequently marked, not only by the ability to endure lengthened periods of abstinence, but by the abolition of all desire for food, to such an extent that the sight or even idea of aliment of any kind excites loathing and disgust. M. Lasègue,[26] in a very interesting memoir, has discussed this part of the subject with great precision, and has shown that though such patients take very little food they do take some, and that eventually they experience all the symptoms of inanition. He has never seen death result from the abstinence, for as soon as the condition becomes decidedly unpleasant the patient resumes gradually her normal alimentation.