It is not unusual, in certain cases, of indigestion, to have food remain in the stomach two or three days. Beaumont found that food taken in certain morbid states "remains undigested for twenty-four or forty-eight hours, or even more, increasing the derangement of the whole alimentary canal, and aggravating the general symptoms of the disease." He points out that all of this prolonged retention of undigested food in the stomach is often without discomfort or pain of some sort and without the patient's knowledge that it is present. Many hygienists have observed this same phenomenon. For example, Carrington says that he has seen cases where food was ejected from the stomach three days after it was eaten. The food was thus lying in the stomach for seventy-two hours without being digested. He says of one of these cases that the man was not conscious that there was anything wrong with his stomach. An amazing amount of pathology often exists in the stomach of those who regard themselves as healthy and as possessing good digestion. These patients habitually mistake the morbid sensations of their stomach for hunger.

Carrington says that "the fact that food frequently remains in the stomach of quite light eaters when they are indisposed, and 'out of condition,' is certain." It should also be noted that emotional upsets will suspend the process of digestion and cause food to be retained for prolonged periods in the stomach. Rabagliati says: "Indeed, food is occasionally, or even not infrequently, still in the stomach twenty-four, thirty-six, and even forty-eight hours after it has been taken." Carrington tells us that he has known of cases in which large quantities of food were vomited at the end of three days of fasting. I have seen a number of such cases in my own practice.

I think that it must be admitted, to use Carrington's words that it "would be a common sense procedure to wait until this mass of rubbish was removed before again adding food." It is quite obvious that stomach digestion is not going on in these instances and that the food is rotting rather than digesting.

A young man once visited me who complained of headaches, catarrh of the stomach, and nose and throat, hyperacidity of the stomach, constipation and nervousness. He was extremely ravenous, but could digest nothing he ate. A few days before coming to see me he had arrived home from work with an almost irresistible desire for food. He ate a hearty supper and started for the Y.M.C.A., where he was to play in a basketball game. About six blocks from his home he suddenly became dizzy; everything became black and he fainted. This was followed by vomiting, which brought up not only his supper, but food he had consumed at noon the day before. It had not been digested. I placed this man on a short fast, then taught him how to live, with the result that his catarrh, hyperacidity, indigestion, constipation, headache, nervousness and morbid appetite all ended.

Physiologists say that an ordinary meal is digested (in the stomach) in from two to five hours. That this is the normal digestion time may be nearly true, but it is no unusual thing for food to remain in the stomach for a much longer period. This is especially true if there is some slight indisposition. Physiologists have assumed that if the food has passed out of the stomach into the intestine it has been digested--that is, it is assumed that gastric digestion is completed. That this is often not true is shown by the great amounts of undigested food that is found in the stools of thousands of patients. The stomach may empty itself of undigested and unwanted food, either by vomiting or by passing it on to the intestine.

I wish here to revert to the contention of Dr. Hazzard that while "appetite" may be present in disease, genuine hunger never is. While such patients often insist that they are ravenous, it seems more likely that in every instance, they have mistaken their morbid symptoms for a demand for food.