By bradyphagia (eating too slowly) we understand a condition in which eating is performed abnormally slowly, so that the organism is thereby injured.

In general, we as physicians will more often have to battle against the above-described tachyphagia, advocating a properly slow or, more correctly, a rational mode of eating. This, however, may be, and is, indeed, overdone by some persons to their detriment. In such cases every morsel is masticated and remasticated, and before being swallowed is again chewed and everything carefully tested with the tongue, whether it has been thoroughly comminuted. An abnormal fear and suspicion develop in this manner, and for such a person eating is a difficult task. The enjoyment and pleasure of eating are transformed into a doleful process, and thus frequently a smaller quantity of food is taken than usual. Not rarely it happens that the bolus occasionally remains in the pharynx or oesophagus and refuses to budge. It is not an organic affection that causes this variety of dysphagia, but merely the excitement and fear of eating. In these cases, in course of time, a chronic inanition develops, owing to bradyphagia and the added temporary dysphagia, in consequence of which the patient gradually becomes weaker and occasionally dies, unless we combat the evil energetically at once.

Since bradyphagia is of comparatively rare occurrence, I do not hesitate to give a few examples.

Case I. April 2d, 1896

G. I. L., 32 years old, lawyer, has suffered for the last five or six years from digestive disturbances. He has lost considerable flesh, and has been unable for the last three years to attend to business. He complains of his inability to swallow food and of intense pains in the upper abdominal region, particularly after meals. He has lost in all about forty pounds, of which the smallest quantity in proportion was lost during the last six months. He adheres to a strict diet and eats very slowly, taking a half-hour to consume a glass of milk.

Status praesens: The whole body is emaciated; examination of the thoracic organs gives negative results; the stomach extends to about two fingers' width below the navel. The epigastrium is slightly sensitive to pressure. One hour after test breakfast the stomach contents showed the presence of free HCl and an acidity of 78. The swallowing sound occurred seven seconds after the drinking of water.

In the absence of any organic lesion the diagnosis of neurasthenia and hyperchlorhydria was made. The difficulty in eating was explained by the psychic excitement subsequent to the sitophobia and bradyphagia. The patient was put upon a more liberal diet and advised to eat more quickly. In three weeks he gained eleven pounds; he continued to gain in weight and recovered entirely.

Case II. March 23d, 1903

Mrs. E. F., about 35 years old, has been suffering from digestive disturbances for the last three years. She claims to have pains in the epigastrium after every meal, and suffers much from belching, constipation, and lack of sleep. She is much run down and has been unable for the last two years to look after her household duties. She says that she eats only the lightest foods (principally liquid diet) with the greatest.care, requiring twenty minutes for the ingestion of half a plate of soup and twenty-five minutes for a cup of milk. Owing to these extreme precautions, she is obliged to take her meals alone. She is surprised that in spite of all this she does not improve. The diagnosis of neurasthenia, hyperaesthesia of the stomach, and bradyphagia was made. The patient was told to eat a variety of plain and simple foods, and to eat and drink more rapidly. In two or three months she had completely recovered. She ate with the rest of the family and was again able to attend to her household duties.