(American Gynaecological and Obstetrical Journal, January, 1900), who attributes primary importance to the undoubtedly active factor of the irritation set up by the uterus, more especially the rhythmic uterine contractions; stimulation of the breasts produces active uterine contractions, and Evans found that examination of the breasts sufficed to bring on a severe attack of vomiting, while on another occasion this was produced by a vaginal examination.  Evans believes that the purpose of these contractions is to facilitate the circulation of the blood through the large venous sinuses, the surcharging of the relatively stagnant pools with effete blood producing the irritation which leads to rhythmic contractions.

It is on the basis of the increased vascular and glandular activity and the heightened nervous tension that the special psychic phenomena of pregnancy develop.  The best known, and perhaps the most characteristic of these manifestations, is that known as “longings.”  By this term is meant more or less irresistible desires for some special food or drink, which may be digestible or indigestible, sometimes a substance which the woman ordinarily likes, such as fruit, and occasionally one which, under ordinary circumstances, she dislikes, as in one case known to me of a young country woman who, when bearing her child, was always longing for tobacco and never happy except when she could get a pipe to smoke, although under ordinary circumstances, like other young women of her class, she was without any desire to smoke.  Occasionally the longings lead to actions which are more unscrupulous than is common in the case of the same person at other times; thus in one case known to me a young woman, pregnant with her first child, insisted to her sister’s horror on entering a strawberry field and eating a quantity of fruit.  These “longings” in their extreme form may properly be considered as neurasthenic obsessions, but in their simple and less pronounced forms they may well be normal and healthy.

The old medical authors abound in narratives describing the longings of pregnant women for natural and unnatural foods.  This affection was commonly called pica, sometimes citra or malatia.  Schurig, whose works are a comprehensive treasure house of ancient medical lore, devotes a long chapter (cap.  II) of his Chylologia, published in 1725, to pica as manifested mainly, though not exclusively, in pregnant women.  Some women, he tells us, have been compelled to eat all sorts of earthy substances, of which sand seems the most common, and one Italian woman when pregnant ate several pounds of sand with much satisfaction, following it up with a draught of her own urine.  Lime, mud, chalk, charcoal, cinders, pitch are also the desired substances in other cases detailed.  One pregnant woman must eat bread fresh from the oven in very large quantities, and a certain noble matron ate 140 sweet cakes