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Extremes and Perplexities of Appetite in Clinical Medicine

Extremes and Perplexities of Appetite in Clinical Medicine

(p.111) Six Extremes and Perplexities of Appetite in Clinical Medicine
Appetite and Its Discontents
Elizabeth A. Williams
University of Chicago Press

Chapter 6 explores medical approaches to appetite from 1800 to 1850, the “golden age” of physiology. Many physicians were hostile to physiology in its experimental form, especially vitalists who argued that organic beings adhered to unique laws of vitality and that medicine alone could comprehend the physico-moral complexities of disturbed appetite. Representations of appetite and hunger in medical theses, textbooks, and journals often upheld Hippocrates as the premier authority and recounted tales of extreme under- and over-eaters including “fasting maids” and entertainers famed for grotesque eating. Seeking to refine Enlightenment era nosologies, physicians gave new attention to ills such as gastralgia and dyspepsia but did little to resolve conflicts over the primacy of psychic or bodily symptoms in different forms of those diseases. In emergent mental medicine, Philippe Pinel upheld the vitalist tenet that psychic illness was linked to ills of the epigastrium and stomach rather than the brain, but others insisted that mental illness was seated in the cerebro-nervous system, despite failures to locate responsible lesions in autopsy. Overall, appetite proved impervious to methods that represented medical progress, especially those of pathological anatomy, and conflicts continued over its nature and the causes of its disturbance.

Keywords:   Hippocrates, fasting maids, over-eaters, gastralgia, dyspepsia, mental medicine, Philippe Pinel, pathological anatomy

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