Morris tribune. [volume] (Morris, Minn.) 1880-2000, 1897-05-12
FEEDING IDIOTS BY FORCE.
Habit OF Refusing to Eat Ia Common
Among Lunatics.

habit OF Refusing Co Eat ~ common
Among Lunatics.
The persistent refusal of food
among the insane is symptom OF
frequent occurrence, which, when
moral suasion has failed. has to be
treated by forciblt feeding.
OF the last 200 patients admitted
to lunatic hospital for private pa
tients, among whom refusal of food
Is said to be more common than
among paupers, 81 required forcible
feeding, which performed on them
nearly 5000 times, Complete refusal
of food for "a hours in a strong,
well nourished patient, or the miss
ing of two meals by a feeble one,
may be taken, as a general rule, to
indicate the operation. Freshly adj
mitted cases with a history of stary-
alton who are feeble, with weak
pulse, and who resist taking food,
should be fed at once. OF these 200
patients So were males, lis females,
and of the % fed 10 were males and
15 females. This 27does not include
many patients whom the attendants
were able to feed with spoon, but
only those who successfully resisted
this method. OF these % there we're
4 in state of acute mania, A in a
stuporose condition, 10 were melan-
choliacs, 4were suffering from de
lusional insanity and 2were chronic
dement's; IL of them were at some
period actively suicidal.
The effect of feeding was soon ap
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 pharynx, esophagus
or stomach became irritated by the
tube, and then feeding by the bowl
had to be resorted to. In one lady,
a case Of stupor, gastritis was set
up, and, curiollsly enough, the py-
rexia was coincident with the com
mencement of her recovery.
Besides the Improvement of nutri
ton, feeding has a lasting moral
effect, in some cases a few feelings
effecting a cure of the habit of re-
fusal. 1t occasionally cures delu-
sion, as one case in a friends prac-
tice exemplifes, a case in which he
was commanded not to eat. After a
few nasal feelings with a tube
smeared with asafetida he was COM
manded no more. A mere exhibit
ton of the tube will cure the habit
in some hysterical cases.
The method of feeding adopted
was the funnel and soft rubber
esophageal tube passed to the stom-
ach by the mouth or nose. The lat
ter way now almost always use as
generally preferable, its only danger
being the passage of the tube into
the larynx, of which the evidence,
striduIous breathing and loss of
EVO1GC. 10 Ok OlNC GCINC1NSd4 uI1u4 Gil
edied by withdrawing the tube to-
the pharynx, pouring a little food
down the tube, and as the patient
swallows pushing it down. The pas
sage of the tube by the mouth is
more expeditions procedure, as a
large tube can be used so that a
quart or more of food may be given
in a few seconds, and this is advan-
tageous in old people and others
who secrete large amount of mu-
Gus about the throat which they
cannot swallow while the tube is in
the esophagus, and which, collect
ing over the glottis, causes dysp-
nea The disadvantages Of the pas
sage through q rsouth are the
need OF a gag !. -leh is apt to injure
the lips or break the teeth of the "a
tent, and the possibility of the gag
slipping out, and SO rendering biting
and swallowing thetube or .injuring
the operators fingers probable.
British Medical Journal.