There are several causes which may induce refusal of food, and these have to be carefully considered before attempting to forcibly feed an insane patient.

Anorexia is one of the earliest and most common symptoms of general bodily disease. It is always present in anæmic conditions and severe affections of the stomach. It may arise from nausea, the food not being properly digested, fœtid eruc–tations are produced, and so the patient loathes the idea of food.