Macon beacon. [volume] (Macon, Miss.) 1859-1995, 1897-05-08
FEEDING THE INSANE BY FORCE.
Habit of Refusing to Eat Is Common
Among Lunntics.


The persistent refusal of food among
the insane is a symptom of frequent
occurrence, which, when moral suasion
has failed, has to be treated by forcible
feeding.
OF the last 200 patients admitted to
a lunatic hospital for private patients,
among whom refusal of food is said
to be more common than among paul
pers, 81 required forcible feeding,
which | performed on them nearly 1900
times. Complete refusal of food for
"a hours in a strong, well-nourished
patient, Or the missing of two meals
by a feeble one, may be taken, us a
general rule to indicate the operations;
freshly-admitted eases with a history
of starvation, who are feeble, with weak
pulse, and who resist taking food,
should be fed at once. OF these 200 pa
tients SIS were males, lis females, and
of the q fed, 10 were males and Is fc-
males; this 81 does not include many
patients whom the attendants were
able to feed with a spoon, but only
those who successfully resisted this
method. OF these 81, four were in Il
state of acute mania, four in a s%tuporose
case, 10 were melancholiacs, four were
suffering from delusional insanity and
two were chronic dement's; 10 Of them
were at some period actively suicidal.
The effect of feeding was soon APP
parent in most cases; nutrition i'm
proving, some getting fat, and no doubt
the lives of many were saved by its
adoption; sometimes, but rarely, the
pharnyx, oesophagus, or stomach be-
came irritated by the tube, and then
feeding by the bowl had to be resorted
to. In I'M lady, a case of stupor, gas
tritis was set up, and, %curiously enough,
the pyrexia was coincident with the
commencement of her recovery.
Besides the improvement of nutri-
ton, feeding has a lasting moral eff
feet, in some cases a few feelings effect
ing a cure of the habit of refusal; it
occasionally cures a delusion, as one
case in a friends practice eXempliiies,
a EAST in which he was "commanded'
not to eat; after a few nasal feelings
with a tube smeared with asafetida he
was commanded no more. A mere eN-
hibition of the tubes will cure the
habit in some hysterical cases.
The method of feeding adopted was
the funnel and soft rubber oesophagcal
tube passed to the stomach by the
mouth or nose; the latter way | now
almost always use as generally prefera.
bic, its only danger being the passage
of the tube into the larynx, of which
the evidence, stridulous breathing and
loss of voice, is at once perceived and
remedied by withdrawing the tube to
the pharynx, pouring a little food down
the tube, and as the patient swallows
pushing it down; the passage of the
tube by the mouth is a more expeditions
procedure, as a large tube can be uset
so that n quart or more of food may
be used in a few seconds, and this is
advantageous in old people and Others
who secrete a large amount of mucus
about the throat which they cannot
swallow while the tube is in the oeso.
phagus, and which, collecting over the
CLOTHS, causes dyspnoea. The disad.
vantages of the passage through the
mouth are the need of a gag, which i,
apt to injure the lips or break the teetl,
of the patient, and the possibility oil
the gag slipping out. and so rendering
biting and swallowing the tube, OF
injuring the operators fingers, proba
ble.-British Medical Journal.