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Merycism or Rumination Disorder: Review Article

This historical review article examines rumination disorder, which involves regurgitating and rechewing food, in humans. The term derives from Latin and Greek roots referring to animals bringing food back up to chew again. While known in animals, rumination was not described in humans until the 17th century. The author conducted an extensive literature review of historical sources on rumination from Latin, English, and French texts from classical times to the present, as well as a computer search. Case reports from the 17th century onward were analyzed to understand patterns in incidence, demographics, treatment, outcomes, and theories of causation. The findings were considered in relation to current diagnostic classifications of rumination disorder.

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59 views

Merycism or Rumination Disorder: Review Article

This historical review article examines rumination disorder, which involves regurgitating and rechewing food, in humans. The term derives from Latin and Greek roots referring to animals bringing food back up to chew again. While known in animals, rumination was not described in humans until the 17th century. The author conducted an extensive literature review of historical sources on rumination from Latin, English, and French texts from classical times to the present, as well as a computer search. Case reports from the 17th century onward were analyzed to understand patterns in incidence, demographics, treatment, outcomes, and theories of causation. The findings were considered in relation to current diagnostic classifications of rumination disorder.

Uploaded by

Artemis Thyng
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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British Journal of Psychiatry (1994), 165, 303—3

14 Review Article

Merycism or Rumination Disorder


A Historical Investigation and Current Assessment
BRENDA PARRY-JONES

Background.
In the ‘¿ fashionable'
fieldof eatingdisorders,therehasbeena notablegapin
the historiographyof rumination,allowingconsiderablescopefor constructinga comprehensive
historicalprofileof this disorder.
Method.A wide-rangingexaminationof printedmaterial,bothetymologicalandmedical,backed
by a Medline computersearch, uncoveredextensivesources,some of considerablerarity,
includingcase reports from the early 17th century onwards. Extracted data focused on
incidence,sexdistribution,age range,outcomeandcausation,andthe findingsarediscussed
in relationto diagnosticcriteria in DSM—lll—R
and ICD—10.
Results.While confirmingthe frequencyof ruminationin infantsand the mentallyretarded,
the study demonstrated,particularly,the needto recogniseits occurrencein normaladults,
occasionallyas a collateralbehaviourin anorexiaand bulimianervosa,and suggestedthat
its prevalence,distortedby secrecy, exceededestimated levels.
Conclusions.In future reviews of classification,existinganomaliesand inadequaciesin the
status and descriptionof ruminationwould benefit from integratingsome of the historical
conclusions.

The term rumination, applicable to both man and analysed to assess incidence, sex distribution, age
animals, derives from the Latin ruminor, to bring range, treatment, outcome and causation. These
up from the throat, or chew the cud, while merycism, findings were considered in relation to current
applicable only to human behaviour, comes from divergencies and perceived inadequacies in the
the Greek mërukismos, implying abnormal re classification of rumination disorder in DSM—III—R
gurgitation. Although classical writers, including (American Psychiatric Association, 1987)and ICD-10
Aristotle, the first to describe the stomach of (World Health Organization, 1992).
ruminants (Smith & Ross, 1910), were aware of
animal rumination, there is no record that they knew
Historical profile
of it in man (Riesman, 1895). In Greek and Latin,
the earliest references allude to allegedly ruminating Earliest clinical descriptions: the 17th century
fish, the meryx and the scarus (Goldsmith, 1864).
The Old Testament Mosaic code, in its definition of Rumination is arelatively rare disturbance of gastric
‘¿ kosher'
animals, more accurately applied the term and oesophageal function in man. Surprisingly, it
to cloven-footed, cud-chewing herbivores (Brim, was not described during Antiquity or the Middle
1936). The dual strands of physical and mental Ages. A possible explanation is that it was not
rumination (the latter implying excessive pondering) regarded as abnormal behaviour at these periods, any
were identifiable in Latin works from classical times more than the vomiting of feasting Romans between
(Lewis & Short, 1879) and in English sources from courses was perceived as pathological (Petronius,
the late 16th century. Rumination, therefore, was 1965). In rumination, a bolus of food is regurgitated,
addressed from three angles, veterinary medicine, without nausea, shortly after a meal for re-chewing.
human physiology and human psychology. The remasticated substance is generally re-swallowed,
but sometimes ejected, the latter resulting, particularly
in infants or the mentally defective, in moderate to
Method severe nutritional deficits. Tarbés(1813) observed
A comprehensive examination of printed sources, in that rumination was indulged in with “¿ sorta of
Latin, English and French, was conducted and a sensuality―and that food was said to taste pleasanter
Medline computer search, utilising the key words than on its first ingestion, differentiating it from
merycism, rumination or regurgitation, was employed acidic regurgitation or eructation. It has to be
to locate more recent literature. Published case distinguished, physiologically and clinically, from
reports from the early 17th to the 20th century were vomiting, and seen as a physiological act and not

303

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