The refusal of food by an insane patient is a troublesome and frequently a serious matter, partly because, from the absence of symptoms in most cases, it is difficult to arrive at a diagnosis of its cause. In many instances it may reasonably be supposed that subjective feelings of pain or discomfort in the stomach, leading to the refusal of food, arise from organic disease or functional disorder of that organ. That there is a centre in the brain, disorder of which causes a distaste for food, has been suggested, but is scarcely worthy of serious consideration. The cause is more likely to be some local affection, such as malignant disease, gastric ulcer, or simple gastritis, giving rise to pain on the ingestion of food; the refusal of food is then the translation of a protest from a stomach in an unfit state to receive any but the lightest food.
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