PICA, a perverted or morbid appetite for substances unfit for food, or incapable of diges tion. It is most common in chlorosis and in pregnant and hysterical women. Some insane persons and idiots are subject to it, introducing into the stomach such articles as string, paper and cocoanut fibre. The perverted appetite causes persons having it to eat, with apparent relish, chalk, slate-pencils, coal, plaster, earth, clay pipes, stones, and even filth. Dirt and clay eating (geophagia) exists not only among sav ages, hut also in certain sections of the civilized world, mainly among the lower classes, although sometimes educated people indulge in it. In the case of an appetite for articles of a repulsive nature the disease is called coprophagy, or dung eating. Physicians incline to regard the vitiated tendency of the appetite as a neurosis connected with the digestive system. It may in some in
stances be the outcome of habit resulting from the silly desire for notoriety; it may depend on a disordered condition of the brain; may be caused by had and insufficient diet and chloro anwmia; by inflammation of the mesentery or the presence in the duodenum of numerous nematoid parasites? It has been supposed that some of the substances eaten supply a deficiency in some of the ingredients of the ordinary food.
Horned cattle and sheep are also subject to pica. Prolonged eating of dirt, clay and other unusual substances usually produces emaciation, a protuberant abdomen and a sallow com plexion. Sometimes there are serous effusions and hypertrophied liver and spleen. The treat ment consists in removal of the causes and the substitution of proper diet. See BULIMIA.