Famine can be defined as a failure of food production or distribution resulting in dramatically increased mortality. This increase is attributable to two, and very often three, orders of disease. First, there is the disease of general starvation characterized by wasting and inanition. Second, there are behavioral disorders and social disruptions, some a direct consequence of energy deficiency, others linked to mental disturbance. These can be lethal in their own right while at the same time contributing to the general starvation and to the spread of contagious illness. Third, there is epidemic infection, which is not always seen in mass starvation but which is frequent enough to be considered a classic concomitant. Facilitated by impaired individual and community resistance to pathogenic agents, contagions tend to run an exceedingly rapid course through famished populations, contributing in large measure to overall mortality.

General Starvation

Starvation, a condition in which the body draws on its own internal reserves for energy, arises from normal processes essential to survival. These processes lead to the disease of general starvation, or undernutrition, only after progressing beyond a threshold where damage resulting in functional incompetencies is done to active tissue. If starvation is not acute, that is, not rapidly induced, dysfunctions incompatible with heavy work are not apparent in nonobese people before the loss of 10 percent of prestarvation weight.

Ordinary starvation may be said to begin some 4 or 5 hours after a meal. It is then that the liver begins to release as glucose its store of glycogen. It is then that the liver begins to release as glucose its store of glycogen. As this process continues, muscle and adipose (fatty) tissue, which otherwise rely on free glucose for fuel, gradually revert to the oxidation of fatty acids.