This may-seem to be a very exceptional kind of evil, but I am informed by one whose experience makes him an authority on the ways of the British soldier that it is by no means uncommon for soldiers in barracks to die from this cause. Usually it is when they are under the influence of alcohol that fatal results occur, post-mortem examination disclosing large undigested masses of food in the stomach. A like experience is also frequently met with in the case of men killed by accident.

The presence of masses of imperfectly masticated food in the stomach may cause disturbance either mechanically or by reason of their impervi-ousness to the gastric juices. - We have already seen that the digestibility of a food is largely determined by its consistence, and that many articles of diet, such as cheese, hard-boiled egg, cocoa-nut, lobster, and new bread, which have the reputation of being very indigestible, can, if finely comminuted by chewing or otherwise, be rendered quite digestible. Such articles are indigestible essentially by reason of their compactness; the compact lumps, but little pervious to the gastric juice, tend to undergo abnormal chemical change in the stomach, and may in this way cause violent local irritation, even to the extent of setting up acute gastritis; or they may paralyse the nerves of the stomach and check gastric secretion and movement, and thus remain in loco wholly undigested for hours or even days; or, again, more distant nervous effects may be produced, such as frontal headache, which may be felt almost immediately after ingestion of the peccant substance, being of reflex rather than toxic origin, and presumably in some cases, at least, due to the mere mechanical irritation of the stomach.

The passage of imperfectly digested food into the bowel may still further aggravate matters. It does not seem improbable that the habitual bolting of food, by the prolonged local irritation to which it gives rise, may predispose to cancer of the stomach: Napoleon was a notorious fast eater and it is well known that he died from this disease.

While, however, the bolting of food readily sets up disturbance in some, it must be conceded that in many it seems to cause little or no inconvenience; especially is this the case in the young with vigorous muscular stomachs capable of triturating the food, and thus doing duty for the teeth. The human stomach is, indeed, a long-suffering organ, and wonderfully tolerant of ill-treatment, sometimes almost rivalling in its hardiness the gizzard of the bird. Nor is this surprising when we reflect that it is, in the ordinary course of nature, constantly exposed to the entrance of noxious substances. In this respect it stands in marked contrast to the intestines, for not only are highly irritant substances often vomited rather than passed onwards, but in ordinary circumstances the gastric contents are not allowed to pass the pylorus, until they have been duly prepared by the stomach; the pylorus, in fact, stands guard over the entrance to the bowel and is jealous of anything passing it which is likely to injure that canal.

And just as the pylorus protects the bowel so, in exceptional cases, may the oesophagus protect the stomach, regurgitating, after the fashion of the ruminants, insufficiently masticated bits of food, in order that they may be re-masticated. I have myself met with cases in point. Sometimes, in cases of this kind, the oesophagus may be dilated into a sort of proventriculus, which is capable of temporarily lodging a large quantity of food. Such a proventriculus is said to have developed in an apprentice who, not being allowed sufficient time for his dinner, rapidly bolted it, to regurgitate it after working hours and to chew the cud at leisure. Whether in these cases the food is ever returned from the stomach itself I am unable to say.

While the stomach is the organ especially liable to be injured by the swallowing of lumps of unmasticated food, the bowel may also suffer, especially the caecum and vermiform appendix. And here we come to one of the most serious indictments against the bolting of food; though man has doubtless always suffered from appendicitis, there can be little doubt that this malady is more common now than it used to be; and there is equally little doubt, in my own mind at least, that the cause of its greater frequency is related to his food. I do not propose to discuss here in detail how food is capable of causing appendicitis, but will merely refer to one of the ways in which it may do so. I had already come to the conclusion that the habit of bolting food is a potent cause, when I read Sir Frederick Treves's Cavendish Lecture in which he makes that contention. Sir Frederick Treves points out that in this rushing age people, especially business men, are apt to hurry over their meals and to take them at irregular times and often while standing at a bar; even when there is more leisure, food is rarely masticated nowadays in the same thorough way that it was in the old time, when it was of a coarser nature: hence solid lumps, especially in the case of such articles as pine-apple, preserved ginger, nuts, tough meat, and lobster, are apt to pass beyond the pylorus and, escaping intestinal digestion, to lodge in the caecum and precipitate an attack of appendicitis, the most common predisposing cause of which is a loaded caecum, often preceded by constipation.

Sir Frederick Treves contends that this distended state of the caecum encourages catarrh of the appendix by dragging upon it and blocking its orifice, as well as by twisting it and thus interfering with its blood-supply.1