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Fasting is not a toy to be played with by the ignorant nor should it be looked upon as a stunt. There have been stunt fasters, but we do not advise one to undertake stunt fasts. Nor do we advise indiscriminate fasting of any kind by anyone. Anyone undertaking an extended fast should either be fully acquainted with all the details of fasting, or he should be directly and immediately supervised by one who has had much experience in conducting fasts. In fasting, as elsewhere, but "a little knowledge is a dangerous thing."
Carrington has emphasized the fact that fasting is a great deal more complicated than is commonly supposed, or than is involved in the mere idea of "going without food." "There is a science of fasting," he says, "which we are just now (1909) beginning to realize." While expressing the view that the dangers of fasting are so slight as to be insignificant, and its benefits, when rightly applied, far-reaching and immeasurable, he says: "fasting should be applied by skilled hands; or rather, practiced only under the close supervision and observation of one skilled in" conducting the fast. He says: "the average physician is no more qualified to undertake the supervision of a protracted fast than is any other man who has a good working knowledge of physiology." He advises that the fast be undertaken under the supervision of a good reputable Hygienist.
When one undertakes to fast, one reasonably desires to obtain the greatest possible good in the shortest possible time. To accomplish this requires that the fast be conducted in strict accordance with a few simple and easily understood principles. These few principles must be known and observed in abstaining from food, by either the well or the sick. Tilden says: "Fasting as a remedy requires great knowledge and experience, and should not be assumed by laymen, nor by professional men who have given the subject no thought from a fundamental point of view." Fasting must be fully understood, rightly applied, it must be conducted with skilled hands, if full results are to be expected. There are many factors that must be considered while the patient is abstaining from food.
If the sick person's condition represents years of abuse by bad habits and treatment, great skill is required to take him through a fast to perfect health. Many of the evils ascribed to fasting have resulted from the attempts of unskilled and inexperienced men to conduct fasts.
No greater truth was ever uttered than that contained in Oswald's statement that, "Fasting is a great system-renovator. Ten fast-days a year will purify the blood and eradicate the poison-diathesis more effectively than a hundred bottles of expurgative bitters." But to achieve ideal results the fast must be properly conducted.
The Hygiene of the fast does not differ from the hygiene of "disease." Indeed, we must learn to regard fasting as a hygienic, not as a therapeutic measure. I do not like the terms "fasting cure" and "therapeutic fasting," or "curative fasting."
All of our care of the faster should be designed to conserve in every possible manner, his energies and reserves. Every method of care and every influence in the environment of the patient that occasions a dissipation of the patient's energies and reserves should be carefully avoided. Much harm results from the use of drugs and measures of treatment that are not conservative and there is everywhere, in the ranks of those who oppose fasting, a tendency to credit this harm to the fast, rather than to the enervating measures employed in mis-caring for the patient. Let conservation, rather than dissipation, be our watch-word. The instructions that follow, if carried out conscientiously, will prove conservative; hence, they will definitely shorten the period of time the patient will have to fast, and will leave him in better physical condition at the end of his fast.
The hibernating animal possesses sufficient reserves to maintain a minimum of physiological and little or no physical activity throughout a prolonged period of abstinence, but in the case of a fasting man, there is no hibernation and there is no reduction of physiological activity to such low levels. Rarely, even, does he discontinue all physical activity, even for short periods, to the same extent as does the hibernating animal. Usually, also, there is considerable mental and sensorial activity. Prof. Morgulis describes the winter sleep of Russian peasants in trying years of famine, when entire families are "massed closely together," on top of a wide stove. "Deprived practically of every means of subsistence," "they spend the dreary winters in an almost uninterrupted sleep," "well-protected against loss of heat by close contact as well as by their fur coats." He says "members of the entire household and frequently of entire villages remained, with occasional interruptions, in a state of winter sleep, preserving their energy by limiting its dissipation."
Nature does the same thing when she prostrates the patient and suspends all digestive activities. She preserves energy by limiting its dissipation. The energy thus saved is available for use in the temporarily more important work of healing.
If we are wise we will take our cue from nature and also conserve our energies, while fasting, by curbing their expenditures. I favor the plan of putting the fasting individual to bed. I am sure that better and quicker results are thus obtained. Nature puts her hibernating animal to bed and to sleep. Seals and salmon are, of course, very active during their months of fasting, but they are exhausted at the end. The salmon usually die and the seals sleep for weeks.
Observations made during the fasts of Succi and others show that the body wastes less rapidly when the patient is kept warm and at rest. Rest conserves the body's energies and substances and hastens the process of healing.
I agree with Purinton, who says in his Philosophy of Fasting: "Not an ounce of energy shall be dissipated during the extreme fast. This means loafing, resting, lazing along and not caring." The best place for the faster is in bed.
In hibernation, due to the extremely low degree of metabolic activity, the nutritive reserves are consumed very slowly, but fasting may be associated with vigorous physical activity--witness the fur seal bull and male salmon during their mating seasons.
It is quite obvious that, given the same amount of nutritive reserve, the active individual will consume his internal food stores sooner than the resting individual. For this reason, if for no other, the fasting patient who rests while fasting will emerge from the fast in better condition than the faster who is active during this period. At the same time, if a prolonged fast is essential, rest will enable the patient to conserve his reserves to the utmost and thus lengthen the period over which he can safely fast.
The nutritive materials stored in the tissues supply the minimum amount of substance indispensable to keep up the necessary activities of life until a more favorable condition of life is produced. The less physically active organism expends less of its reserves, not alone due to reduced physical work, but, also, due to decreased physiological activity.
The great value of rest in all pathological conditions is well established. Beyond a certain minimum of physical activity (and even this is profitably dispensed with in most acute and a few chronic conditions) the more rest the sick organism receives, the more rapidly is good health restored. This principle does not cease to be true when the sick organism is fasting. Rest (physical, mental and physiological) is equally important and beneficial during the fast. By physiological rest in this particular connection, I have reference to freedom from stimulation--excitation.
In insects the condition of perfect quiescence is accompanied by the most wonderful changes. The worm-like caterpillar becomes, within its cocoon, the butterfly with locomotive powers immensely greater and with a totally new and different organism. Growth and repair are most efficient in man when he rests and sleeps most. The nearer the faster can approach the quiescence of the pupa, the greater will be the conservation of his energies and the more rapid and efficient will be the repair of his damaged structures. Even reading, writing, talking, listening to the radio and similar forms of activity should be avoided as much as possible. The noisy radio with its jazz music, its emotionally exciting soap operas, exciting or depressing newscasts, etc., is especially bad.
Somewhere in the Bible is the statement that "a man's foes shall be they of his own household." How true this is may be discovered by anyone who undertakes a fast at home. Even missing one meal is often enough to cause a family alarm that results in a near-panic.
Every form of pressure will be brought to bear upon the faster to persuade, or even to coerce him to return to eating. Well-meaning though these members of the faster's family may be, they are actually the enemies in his own household. It is wise, therefore, to get away from family and friends when undertaking a fast.
Fasting is an unusual experience for most patients. The first fast, in particular, is likely to be filled with unfounded anxiety, uncertainty, mental perturbation, and even fear. The faster will experience new and formerly unknown feelings and sensations and these will disturb him. Nausea, faintness, pain, vomiting, headache, and other symptoms that occasionally arise may give rise to panic and result in injurious treatment or to a premature and hurtful breaking of the fast. The faster needs to be under the care and constant supervision of one who understands these developments and who can give him encouragement and explanation. He is even helped by being with other fasters, as these support him by their own experiences.
Levanzin says that at the start of the fast, if the patient concentrates his thinking upon his privation from his accustomed pleasures, he suffers mentally. He advises that the patient try to find a diversion so that he may have his mind on something else. He advises drinking a glass of water when the accustomed meal time arrives, but I do not advise this unless there is actual thirst. If the patient will not worry about his "deprivation" he will be less likely to experience any discomfort at all. The Bible advises: "When thou fastest, anoint thine head and wash thy face that thou appear not unto men to fast."
Fear of the fast, broodiness and other phases of mental depression are especially to be combatted. While fasting, as at other times, one's thoughts and emotions profoundly affect the organs and functions of the body. A cheerful attitude is especially important at this time.
Literally, millions of people have fasted and many thousands have fasted for long periods, and we know that there is no danger associated with prolonged abstinence from food. Disabuse the mind of all fear and apprehension. Do not imagine that you are going to grow weak or starve to death. Fear in particular is dangerous.
Prof. Morgulis says: "The practical value of inanition (emptiness) will never be fully utilized until both laymen and the medical profession lose their instinctive fear of fasting." I do not believe the fear of fasting is at all instinctive, but that it is due to misinformation and false training. An instinctive fear of fasting, it seems to me, would, of itself, be a strong reason for rejecting the measure altogether. Morgulis adds that "the experiences of recent years which through the medium of the press have reached a large audience will in course of time, alleviate the entirely unjustifiable fear of abstention from food for longer periods."
The hunger strikes and a few similar experiences which have been published are as nothing compared to the many thousands who have fasted for long periods under the care of those whom Morgulis refers to as "amateurs" and "enthusiasts." Nor has the daily press, in carrying such stories, done a hundredth part as much in breaking down this "entirely unjustifiable fear" of fasting as have the "enthusiasts," through their lectures, writings and successes in fasting the sick. For sectarian reasons, Morgulis, who belongs to the self-styled "regular" medical profession, would minimize the work of these men and refers to them as "crank reformers who see in inanition a panacea for all ills of the flesh."
Sinclair says: "There are two dangers to be feared in fasting. The first is that of fear. I do not say this as a jest." "The faster should not have about him terrified aunts and cousins who will tell him that he looks like a corpse, that his pulse is below forty and that his heart may stop beating in the night. I took a fast of three days out in California, on the third day I walked fifteen miles, off and on, and except that I was restless, I never felt better; and then in the evening I came home and read about the Messina earthquake, and how the relief ships arrived, and the wretched survivors crowded down to the water's edge and tore each other like wild beasts in their rage of hunger. The paper set forth, in horrified language, that some of them had been seventy-two hours without food. I, as I read, had also been seventy-two hours without food, and the difference was simply that they thought they were starving. And if at some crisis during a long fast, when you feel nervous and weak and doubting, some people with stronger wills than your own are able to arouse in you the terrors of the earthquake survivors, they can cause their most direful anticipations to be realized."
The fast should not be continued if the patient is in dread of it--living in fear. Fear may kill. It certainly inhibits elimination.
Scientific works on the mind and emotions are replete with well authenticated cases of death resulting from fear, anger, grief, shock, etc. Instantaneous death has resulted more than once from the reading of a telegram. In other cases, grief or fear has sent people to the grave in a few days. Only recently in this city, grief over the death of his father resulted in the death of a young boy in three months' time.
Physical and emotional activities cause a rapid expenditure of the stored reserves. The fasting man is more or less active--physically, mentally, emotionally, sensorially--and this activity consumes his reserves at a much more rapid rate than the reserves of the hibernating bat, for example, are consumed. This results in a more rapid exhaustion of reserves. For, while man's metabolic rate is greatly reduced, it is not lowered to the same extent as that of the hibernating or estivating animal.
The effort to keep warm should not cause one to exclude fresh air from the room. Fresh air is even more imperative during the fast than at other times. See that the room is well ventilated both day and night.
Hibernating animals manage to live despite the low temperatures of their bodies, but man and, perhaps, most other non-hibernating animals would freeze to death if subjected to such prolonged low temperatures without food. Resistance to cold is greatly reduced by the low metabolic rate of the faster, so that he feels cold at what may be, under ordinary circumstances, a comfortable temperature. This causes a more rapid using up of his reserves. Therefore, the faster should be kept warm in order that his reserves may be conserved to the greatest extent.
Chilling causes discomfort, prevents rest and sleep, and checks elimination. It may, in some cases, cause nausea, vomiting and pain. Warmth promotes comfort and elimination. The patient who is kept warm recovers more rapidly. A hot jug to the feet will usually be sufficient to insure comfort and prevent chilling. The faster should net be overburdened with bed clothing.
Fasting patients should not be permitted to remain cold. They are inclined to chill easily and if nurse or doctor is careless, such patients can freeze to death even in July or August; and they certainly will freeze to death in the winter time unless they are carefully attended to.
It is the rule that those persons who suffer constantly with cold hands and feet lose this complaint as a result of fasting. During the fast, however, the feet particularly, are likely to feel cold much of the time.
Fasters must he kept warm. It requires nerve force to warm the body, and the patient should not be permitted to waste his nervous energy in keeping warm, but should be kept warm by artificial heat. The fasting patient who throws off the covers and kicks his feet and legs out, declaring he is too hot, yet who has cold extremities, as revealed by feeling his feet, must be carefully warmed and kept warm. Such patients are actually in danger. Tilden says of such: "unless that patient is carefully warmed and kept warm, death will ensue within twenty-four to forty-eight hours. And if the case has advanced very far before receiving this attention, death will certainly take place." Again: "After fasting has gone beyond a certain point--after the patient has reached a point where the rectal temperature goes one or two degrees below normal--there will be great difficulty in resuscitation."
Where such a condition as he here describes has been permitted to develop, and it should be known that its development is due to ignorance or carelessness, artificial heat and much of it must be applied to the faster. Food will have to be given in very small quantities and at frequent intervals. Rest and quiet are very important in such a condition.
For a number of years I continued exercise through the fast of most chronic sufferers. My rule was: "Chronic sufferers, unless otherwise contra-indicated, should have daily exercise while fasting." I insisted that the exercise should be mild and carefully adapted to the strength of the patient and preferred those forms of exercise that could be taken while lying in bed. I employed the corrective exercises that may have been needed in most cases during the fast. My rule was that fatigue should be avoided.
I became convinced that this was not good practice in most cases. It is now my practice to require all sick fasters to rest. Only those vigorous individuals who are undergoing a fast of ten days to two weeks as a Spring house-cleaning, and fat individuals who are fasting for reduction of weight are now given exercise while fasting. While the fast is in progress, the emphasis is placed on rest. After eating is resumed, exercise is given.
On general principles working during a long fast is to be severely condemned. It has been done. It can often be done. But it should not be done. Perhaps the first fast of any length in which the faster worked was the twenty-eight days fast undergone by Mr. Milton Rathburn, a wealthy grain dealer, in 1899. Mr. Rathburn, who was a very fat man, took this fast to reduce upon the advice of Dr. Dewey and continued his daily work throughout the entire length thereof. According to the New York Press, of June 6, 1899, "he worked and worked hard. He came down earlier to his office and went away later than usual. He made no effort to save himself. On the contrary, he seemed determined to make his task as hard as possible."
Others have done this same thing and some of them were even more remarkable. In 1925, a weaver in Jersey City, N. J., fasted forty days and worked as a weaver throughout the time. On January 18, 1926, George Hassler Johnston, of New York City, a friend and co-worker of the author, began a fast which lasted thirty days, during which time he was unusually active. Mr. Johnston underwent this fast, under my supervision, purely as a publicity stunt and not because he was in need of a fast. He was an athlete of no mean ability and was in excellent physical condition at the beginning and at the end of the fast.
During the entire period of the fast, Mr. Johnston arose each morning at 5 o'clock and went to a radio broadcasting station, where he broadcasted three classes in exercises, each class lasting fifteen minutes. From here he usually walked a distance of twenty-five blocks to the offices of the Macfadden Publications, where he entered upon his editorial duties. At 11:30 A.M. each day he visited one or the other of the three Physical Culture Restaurants in New York, where he remained until 2 P.M., meeting the people and answering their questions and giving advice upon fasting, diet and exercise. From the restaurant he would return to the office where, at 3 P.M.,
he conducted two classes, composed of Macfadden employees, in calesthenics. After this he resumed his editorial duties, remaining at his desk until 5 P.M. During most of the fast he would walk home in the evening, a distance of 72 blocks, and spent his evenings at Madison Square Garden, watching the boxing and wrestling bouts. It was not until the end of the first week of the fast that he gave up his training at a down-town gymnasium and his track work--running.
This fast ended on the evening of Tuesday, Feb. 16, just 30 days after it had begun. On June 2, just three and one-half months thereafter, Mr. Johnston started from Chicago, in an effort to walk from there to New York without food. This stunt, I warned him against, but he made a brave effort and ended it June 20th at Bedford, Pa., having covered a distance of 577.8 miles in the 20 days.
This walk carried him over hills and valleys, through wind, rain, and the summer's heat and through crowds that flocked along the way. Handshaking, interviews, posing for pictures and making short health talks consumed almost as much of his energy as the walking. These often delayed him so that his walking on several days began late in the forenoon, although it often extended far into the night. I warned Mr. Johnston before he left to conserve his energies and predicted that he would go 20 days and no longer. He would have covered more miles in the same time he walked had he done more walking and less of other things, but he would still have ended on the 20th day.
This thing can be done, but it is damaging, even dangerous, and should never be undertaken. Gandhi, the Hindu Nationalist leader, who has probably fasted more than any other man in modern times, learned the necessity of conserving his energies while fasting. A painful mistake, which almost left him an invalid for life, taught him this lesson. It was while in South Africa that he took his second long fast, lasting fourteen days, that he foolishly imagined he could do as much work as while eating. On the second day after breaking the fast he began strenuous walking. This caused excruciating pains in the lower limbs, but he did the same the next day and for several days thereafter. The pains increased. His health was gravely injured by this and he was years in fully recovering from it. Of this he said: "From this very costly experiment I learned that perfect physical rest during the fast and for a time proportionate to the length of the fast, after the breaking of it, is a necessity, and if this simple rule can be observed no evil effects of fasting need be feared. Indeed, it is my conviction that the body gains by a well-regulated fast, for during fasting the body gets rid of many of its impurities."
This warning against working throughout a long fast does not apply to a short fast. I have on several occasions worked both at hard physical labor and at prolonged and exacting mental work for three or four days without food, and I have had hundreds of patients to do the same up to as high as nine days. But I do not think this should be prolonged beyond the tenth day, and where it is possible to absent oneself from work, it is best that all the time be spent in rest.
The practice pursued by many, of spending the whole day in activity, retards recovery from "disease." Conservation of energy should be the guiding principle.
Dr. Eales worked throughout his fast devoting eleven to twelve hours a day to the labors of his profession. He was very energetic during the whole time. Regular and frequent strength tests were made. The tests on the eleventh, sixteenth, twenty-first, twenty-third, twenty-fifth, twenty-ninth and thirty-first days of his fast showed his strength to be as great as at the beginning of the fast. The doctor reports that he could have competed in athletic work on the thirtieth day.
Bathing during the fast should follow the rules laid down for bathing in a preceding volume. The faster in particular should avoid extremes of temperature. Wash the body quickly and do not stay in the tub or under the shower for a prolonged period. A sponge bath should be used if the patient is too weak to take his or her own bath.
Sun bathing is as beneficial and useful during the fast as at other times. The chronic sufferer should have these throughout the course of the fast. Certain precautions are essential. As the fast progresses, the length of the exposure must be reduced, else an excess of sun will depress and weaken the patient. Nervous patients are especially prone to be depressed by over-exposure.
Dr. Gian-Cursio has objected to the sun bath during the fast on the grounds that the anabolic processes are at a standstill during this time. But this is a mistake as shown by the continuance of growth in fasting animals and by the healing of wounds and ulcers during this period. I advise and employ the sun bath in all chronic sufferers while the fast is in progress.
Certain precautions are essential. It is my practice to gradually increase the time of exposure up to the twentieth day of the fast, then gradually decrease it. This rule is not inflexible, for I find it necessary to decrease the time of exposure before the twentieth day in occasional cases, and I find it possible to wait until the thirtieth day before decreasing the time of exposure in some patients.
No patient should be permitted to stay in the sunbath until he is depressed, or feels "washed out," or is left nervous and irritable. Patients suffering from nervous diseases are especially likely to be depressed by a slight over-exposure. In asthmatics, a little too much sun may bring on a paroxysm of asthma. In sufferers from heart disease, a little over-exposure may depress the heart. Over-exposure of patients with tuberculosis of the lungs has been known to induce a hemorrhage. In this connection it should be understood that by over-exposure, I do not mean sufficient exposure to produce a burn. One may overexpose oneself after one has acquired a very deep, dark tan. Sunbathing may be overdone at any time and over sunning is definitely harmful.
Throughout most of the fast, the fasting individual is annoyed by a very bad taste in the mouth. This may be alleviated somewhat by a daily scrubbing of the tongue with a toothbrush. This should not be done, however, until after the tongue has been examined by. the doctor who is conducting the fast. Mouth washes, lemon juice, etc., are not to be recommended. Gargling the throat is certainly of no value. As the fast progresses and the tongue clears up, the taste becomes less and less offensive, until, when the fast should be broken, the taste in the mouth is very pleasant.
It has been determined experimentally, that the chewing of gum occasions an inhibition of gastric secretion. This, instead of enhancing digestion, as gum chewing is popularly and professionally supposed to do, actually retards the digestion of protein foods. As there is no digestion going on during a fast, it may seem unimportant if the faster chews gum, but this is far from true. I have permitted fasters to chew gum and I have noted a tendency to chew it in large quantities, the faster chewing three or four packages of gum a day. I am inclined to think that he chews it until he extracts all the sugar from it, then takes fresh gum, doing the same with this.
Gum chewing serves no useful purpose. It is an evidence of weakness, the foundation for which is laid in infancy and early childhood. Mothers give their babies bottles, nipples, crackers or cookies to keep them quiet. Later in life these perpetual sucklings trade their nipples or their cookies for chewing gum or the cigarette. Gum chewing is a mental habit that is needless and foolish, as well as a wasteful practice under any and all circumstances. It is not the innocent practice it is commonly regarded. There can be no doubt that it exhausts the salivary glands. It does not seem probable that any useless habit can be regularly indulged by anybody with impunity. Gum chewing is certainly wasteful of the patient's energy and the energy wasted in this useless practice may be, at least in very low states of health, just enough to mean the difference between recovery and death. It is particularly essential in all serious states of disease, and in fasting, that all nerve-leaks and all sources of enervation be discontinued. Energy must be conserved in every possible way. The faster should certainly refrain from chewing gum.
WATER DRINKING DURING THE FAST
Most fasting advocates advise drinking much water while fasting. This is done on the theory that water aids in eliminating toxins from the body. Levanzin expresses this theory as follows: "as a rule, it is certainly advisable to do a good deal of water drinking during a fast--since this serves to flush out the whole system and wash through the accumulated impurities." He also states that water "carries along with it many impurities from the blood."
Both Carrington and Macfadden advocate drinking more water than thirst calls for while fasting. Mr. Carrington advocates drinking water as a means of relieving morbid sensations in the stomach, that may arise during the early part of a fast. Water-drinking for this purpose is the use of water as a palliative and not to serve any need of the body. Water taken in excess of need must be thrown out speedily lest the excess result in harm, and it does not occasion any increase in the elimination of toxins.
This is a mistake that the early Hygienists--Graham, Jennings, Trall, Alcott, etc.--did not make. They frowned upon much water drinking. The fact is that there is neither need for so much water, nor benefit from taking it. Drinking water as a mere matter of routine is not advisable. One may rely upon the instinct of thirst to tell him when he should drink and how much. Drink when thirsty. Do not drink when not thirsty.
Prof. Levanzin seems to have been a bit confused on this matter of water-drinking during a fast. He says that generally the faster desires "very limited quantities of water." He tells us that in 1911 he fasted five days without taking any water; that he suffered no discomfort, and that he busied himself with his usual occupations throughout this period. He also tells us that during his experimental fast undergone in Carnegie Institute he was compelled to take a quart of water a day, which was too much for him. In spite of all this he advocates much water drinking by fasters.
Dewey, on the other hand, took a decided stand against water in the absence of thirst. Thirst, he said, should be the only guide to the amount of water to drink. He insisted on drinking only as much water as demanded by thirst and was convinced that much water drinking, except when indicated by thirst, is definitely harmful. During the first fourteen days of his second fast (taken in New York City) Tanner took no water and suffered no inconvenience. He became stronger when he took water and won a race with a young reporter who refused to believe that one could maintain one's strength while not eating. He tells us that after taking the water he "ran upstairs like a boy."
Fasting animals take but little water and some of them none at all. For example, the Alaskan fur-seal bull takes no water throughout the whole of his four or five months fast. Hibernating and estivating animals do not drink water during their period of dormancy. It is the rule that sick animals (this is especially true of the acutely sick and seriously wounded animals) will not drink much water. I have repeatedly seen sick animals take no water at all for days at a time, or take but a few sips once or twice a day. For the most part, they refuse to drink large amounts of water.
Thirst is seldom great during a fast. I have watched fasters go for two and three days at a time and take no water, simply because there was no demand for water, and they have not suffered as a consequence. Others take but little water; sometimes not more than half a glass a day. Then, there are those who drink much water. In some of these there may be thirst; in others it appears to be nothing more than a result of a desire to get something into the stomach. Others drink because they have been taught that they must. In occasional fasters, there will arise a great thirst that may last a day or two or three days, during which time they will drink so much water that their tissues become water-logged and they gain in weight as a result. The thirst subsides and they do not drink so much thereafter. Large quantities of water should be taken when thirst calls for much water, as it sometimes does; otherwise, there should be no effort made to take large amounts of water. Excesses of water are simply eliminated without increasing the elimination of waste--perhaps, on the contrary, with an actual decreased elimination of waste.
A frequent development while fasting is a dislike for water. This is particularly true if the water is "hard." "Hard water" that, while one is eating, tastes pleasant enough, is rejected by the sharpened sense of taste. In such cases we find the use of distilled water, to be satisfactory.
The loss of weight when no water is taken is about three times as rapid as when water is taken--the loss averaging about three pounds a day instead of the usual pound a day. This is especially helpful in dropsical cases and greatly shortens the duration of the fast in fat individuals who are fasting merely for reduction of weight. Tanner found that he lost but one and a half pounds a day while abstaining from water. He took water after the fourteenth day and lost a little less than half a pound a day.
Writing in This Week's Magazine, which is a Sunday supplement of the New York Tribune, under the title They Never Have to Drink, Roy Chapman Andrews, Director of the American Museum of Natural History, tells us that "many desert animals, particularly rodents," never drink after they are weaned. He mentions the "desert-living mice, rats, hares, and ground squirrels," that "not only do not drink but few, if any, perspire." He tells of installing a group of live desert pocket mice in the museum that "live among the vast dunes of nearly white gypsum in New Mexico" and tells of these, that they were "fed a diet of thoroughly dried seeds. They thrived on this unappetizing food and would never touch water." Each time liquid was offered they filled the dishes with sand. He adds: "In the Gobi Desert we found that even the wild ass rarely, if ever, drinks. On one vast stretch of the Gobi where there was no water for hundreds of miles, except for a few deep Mongol wells, there were literally thousands of wild ass and gazelle."
He recounts some experiences of the Central Asiatic Expedition, while at Wolf Camp in the middle of the Gobi Desert. A Mongol brought in a young gazelle which they nursed on a bottle for a time, after which it was adopted by a she-goat. He tells us that "When old Nanny finally weaned Skippy (the gazelle), he lived on camel sage and the leaves of thorny bushes scattered in clumps over the desert. I was particularly interested to see whether Skippy would drink water. During the six months he was with us he never touched a drop. He would sniff at the pan from which the goat was drinking and then turn away without even moistening his lips." Then, as if he might have been thinking of the creed of the physicians and dairymen, that we are never to be weaned, he adds: "We never offered him milk after he was weaned but I feel sure that no liquid would have tempted him."
Mr. Andrews thinks that "this is one of the marvellous adaptations of nature." He adds: "The ability to exist without water appears to be peculiar to rodents and other herbivorous mammals. As far as I know, all flesh eaters must drink."
It is, of course, true that all animals must have water. These desert animals obtain large quantities of carbohydrates from their vegetable fare and when these are broken down in the process of digestion, they yield enough water to supply their bodily needs, and, in the case of the nursing mammal, to supply enough extra water for milk production.
While man dissipates considerable water in sweating, he certainly does not have any need for the large quantities of water advised in many quarters for both fasters and those who are eating. Nor does the consumption of large quantities of water produce all the beneficial effects commonly claimed for the practice. Certainly nothing is to be gained from forced drinking or the practice of routine drinking. The taking of water for which there is no physiological demand, as expressed in thirst, is of no value. The practice may prove decidedly harmful.
Prof. Carlson says that "an adult man fasting can live fifteen to twenty days without water. If food is taken, death from water deprivation comes quicker. If there is body fever or great external heat leading to sweating, death from water deprivation is hastened. Foods require water for elimination of waste products."
It is not definitely known how long a fasting man may live without water. A few criminals have died in a few days to seventeen days when they denied themselves both food and water. But there were emotional and nervous factors in all such cases that hastened death.
Our aim is not, of course, to determine how long a patient can go without water. The aim is to provide for the patient the best possible conditions under which to carry forward the healing processes and to complete these in as short a time as possible. The death of a woman from dehydration in New York state in the early part of 1950 at the end of a thirty days fast, as a consequence of having gone for the whole period without water, is not only a lesson about the need for water, but also a warning to those who attempt a long fast without proper supervision. Had this woman been under experienced expert supervision, she would not have been permitted to make this grave mistake.
When food is not taken the need for water is lessened and there is a corresponding lessening of thirst. Although it is asserted by many fasting advocates that drinking large quantities of water, despite lack of desire for it, increases elimination, I have seen no proof of this, while, my own experience fails to substantiate the assertion.
Due to the bad taste in the mouth while one is fasting, the water is likely to appear to taste badly. At other times patients complain of the water being too sweet. They frequently request permission to add salt or lemon juice or other substances to the water to flavor it. The evils of salt using were discussed in the chapter devoted to "Objections to the Fast." The use of lemon juice means that the patient is taking food, and although he takes but minute quantities of the juice, it is enough to interfere with the fasting process and is often enough to cause a return of hunger and thus makes the fast much more difficult, or compels its premature breaking. It is never wise to add anything to the water. For the bad taste in the mouth one needs only cleanliness. The teeth, tongue and mouth must be cleansed. The tongue should not be brushed before it has been examined each day.
In the summer time patients are likely to demand ice-water to drink. Drinking very cold water is not a good practice under any circumstance; it is especially harmful during a fast. Indeed, giving very cold water to fasters seems to almost stop their progress. There can be no objection to giving them cool water to drink.
Tilden says: "A fast must not be continued when the patient is suffering greatly, it matters not in what way. * * *
"Some patients will start without food and within a week they are very sick--sick because of great enervation. They have been overstimulated so long that when the stimulating food is removed they soon evolve a severe prostration. Most intelligent people know how much the inebriate suffers when he is compelled to go through delirium tremens. Delirium tremens is the acme of prostration. People who are tremendously prostrate or enervated, from years of overstimulation from food, do not suffer just the same as the inebriate but they suffer, many of them, just as greatly. A good many will become very sick at the stomach and vomit almost unceasingly. This must be avoided. When such a patient starts on a fast, the physician must recognize the coming symptoms, and break the fast by giving a small amount of fruit. As soon as the symptoms of irritation have subsided, the fast will be resumed, until other symptoms indicate that the system is suffering too greatly from the effect of going without food, when a little fruit may be given for two or three days, and sometimes a week. The fast can then be resumed; but, as soon as the patient begins to show the appearance of suffering, and the haggard state begins to develop, feeding must be resumed."
He says that "little by little, such cases can be piloted into perfect health." I give Dr. Tilden's plan for what it is worth. It is my own plan not to break a fast while there is vomiting. I have broken fasts when there is great prostration and resumed the fast after strength has been recovered.
The remedy for delirium tremens is not more whiskey. Just so the remedy for the great prostration caused by long-continued food drunkenness is not more food. If we would not give a dose of morphine to the morphine addict who suffers when deprived of his morphine, or the coffee addict a cup of coffee to "relieve" her headache, why should we give the food drunkard more food to relieve his suffering? With all due respect to Dr. Tilden, whose experience with fasting was very great, I do not find this plan essential or helpful, except in a very few cases.
Tilden also urges daily enemas and lavages. He says: "the bowels should be looked after from the day the fast is started until it is ended. A retention of excretions will poison and make the patient very sick, and there is a possibility of his becoming so prostrated from the effect of the poison absorbed that he will die. Nausea and vomiting following fasting are a very good indication that there is too much absorption taking place. Then the bowels must be moved by enemas, or whatever is proper to do, until they are thoroughly cleaned out."
My experience does not bear this out. I have seen more vomiting and nausea in cases that received daily enemas than in those who have received no enemas at all. Nor have I seen prostration and death as a result of absorption of retained excretions. Indeed, it seems clear to me that absorption does not occur.
Tilden also says: "But fasting must not be continued if the patient begins to present a haggard appearance or if nausea and efforts at vomiting develop. When a patient under a fast begins to show a depressed state and haggard look and the tissues begin to droop down, and a decided discomfort begins to manifest, feeding must be resumed and the patient must be brought back to a reasonable state of comfort. Then fasting can be resumed; or if it is not thought best to go without food entirely, then the patient may be put on a small amount of fruit for a week or more. It requires a great deal of skill to assist nature back to a normal state when the health has been outraged almost to the point of dissolution. Fasting is not a remedy that should be trusted in the hands of laymen, nor in the hands of ignorant professional men. Putting such a remedy as fasting into the hands of laymen, to be applied to sick people, is equivalent to putting an insane man to work in a barber shop, especially if the barber's hallucinations are on the order of homicidal mania."
We are not convinced that laymen cannot make excellent use of fasting in minor troubles and the less advanced pathologies; but we are sure that Tilden's warning should be heeded by those who suffer with advanced stages of pathology.
Dr. Hazzard, Mr. Carrington, Mr. Sinclair and others, regard the enema as almost indispensible during the fast. This arises out of a distrust of the body's powers of self-adjustment. There is no more need for, nor benefit to be derived from the enema during the fast than at other times. What is more, if no enema is used, normal bowel action will be established much sooner after the fast than if the enema is employed.
Levanzin, who often advocated the frequent use of the enema during the fast, says that he uses the enema only when he desires to get faster results. If the enema really gives faster results, there would seem to be no reason, at least in the great majority of cases, why it should not be used in every fast. But Hygienists dispute that it gives faster results. We are convinced, on the contrary, that it retards recovery and impairs bowel function.
Mr. Carrington voices the same view in these words: "we can readily see that frequent flushing of the bowels--say one a day--will materially assist a return to health, and effectively shorten the fast. It is a most important hygienic auxiliary to the main treatment; and, though so essential, Dr. Dewey hardly mentions the enema in any of his books; but its omission seems to me a very great fault, since we can see that its use will both shorten and lighten the period of fasting." This is an a priori conclusion that is not borne out by actual test and experience. It is based on the mistaken assumption that bowel action is elimination, and the added assumption that poisons are absorbed from the colon. Dr. Hazzard, who should have known better, was so possessed with her fear of auto-intoxication from the re-absorption of waste from the colon that she conjured up such symptoms resulting therefrom as mild delirium, stupor, hiccoughs, etc. The fact is, as all may know who have given both plans a thorough test, that the enema neither shortens the fast nor makes it more comfortable.
While connected with the Macfadden Publications, I once had a controversy with a member of the staff of Physical Culture over a statement in an article of mine dealing with fasting, to the effect that no enema should be used after the fast, but that one may safely wait a week or more for a spontaneous movement. He said: "Surely steps must be taken to move the bowels at least once a day under any circumstances. If the movement is held up for several days or a week, or fourteen days, so much poison is produced in the organism that the advantage of the fast is counteracted and all its benefits lost. * * * It seems to me that the failure of the bowels to move for a week or more would be almost fatal. It certainly would lead to all sorts of complications dangerous to health."
These words voice the prevailing view of the matter, yet this view is wholly false. The fact that patients have gone for over thirty days without a bowel movement and have developed no complications, but have grown steadily better during these periods, proves positively that "failure of the bowels to move for a week or more" is not "almost fatal." One does not lose the slightest bit of the benefits of fasting nor does one develop "all sorts of complications dangerous to health." This is equally true when we wait upon the bowels after the fast is broken. The enema should not be employed when eating is resumed.
Dr. Hazzard claimed the dubious credit of having introduced the enema practice into the procedure of fasting. Dewey rejected the enema up to the time of his death. Dr. Tanner also rejected it. So did Jennings and Page, Dr. Claunch did not employ it. I have not employed it for over twenty-five years and find this more satisfactory than its use. Dr. Page observed: "Tanner had no movement during his fast; Griscomb's experience was similar, and Connolly, the consumptive, who fasted for forty-three days, had no movement for three weeks, and then the temporary looseness was occasioned by profuse water drinking, which in his case, proved curative"--The Natural Cure, p. 112.
It is rare that the colon ever fully empties itself of the water ingested. Carrington says of the retained water, that, since it is perfectly harmless, and will be absorbed and eliminated by the system in exactly the same manner as water that is drunk, is eliminated, no alarm should be felt over its retention. But one case I observed that retained water for twenty-four hours did not absorb it and eliminate it through the skin and kidneys. On the other hand, if the fear of toxic absorption from the colon is based on fact, such absorption of water would certainly result in far greater absorption of toxins than could ever occur without the water. Carrington mentions cases in which there was considerable difficulty in expelling the water (enema) and says that "retention beyond even a few minutes is impossible." In this connection, he is mistaken. Retention for considerable periods, even twenty-four hours, is possible, and we see it often.
Prof. Levanzin says that when enemas are not used during the fast, a "plug of hard feces is formed in the rectum, and another one at the duodenum (upper part of the bowels) is formed by the newly ingested food. The intestines are empty and full of air." To avoid the rectal plug, he advises the enema. The rectal plug is no myth. Were there an upper-bowel plug, the enema would never reach it.
Although a strong advocate of the use of the enema in the fast, Mr. Macfadden says: "enemas are somewhat enervating, and when the patient is already weak, he may find it a drain upon his vitality to take these."--Encyclopedia of Physical Culture, Vol. III, p. 1374. It does not seem to me necessary to resort to enervating practices in our conduct of the fast and for more than twenty-five years I have refrained from the use of the enema. The enema is at all times a drain upon the patient's powers and its use during the fast not only weakens the patient and thus prolongs his illness, but it impairs his colon and he is often weeks and months getting over the effects. The employment of laxatives, as advocated and practiced by some, has the same weakening and debilitating effects upon the colon and they exert their irritating influence upon the stomach and small intestine, also.
Major Austin conducted an experiment upon himself to determine the relative values of the enema and purgation during the fast. He fasted for sixteen days taking nothing but water and half-an-ounce to an ounce of Epsom salts every morning. He was energetic and carried out his ordinary duties, even engaging in and winning a walking match of two miles, most of the distance uphill, on the sixteenth day. He felt a little faint and giddy in the mornings upon arising and had the same sensations at times during the day upon arising after he had been sitting for some time.
Some months after this fast he underwent a second fast of ten days, taking nothing but water and employing a three-pint enema of water each morning instead of the saline purge. He again carried out his regular duties, as before, but had less energy, his tongue was more heavily coated and he did not sleep as well as during the previous fast.
Some weeks later he took a third fast, this one also ten days long. He again used the saline purge each morning instead of the enema. His experience during the third fast was the same as that during the first. He says: "Thus I proved to my own satisfaction, that the use of saline purgatives during a fast makes the ordeal a very much less trying one than is the case when only the enema is used." He advocates as do others (Dr. Wm. H. Hay, for example, in this country), the use of both the enema and the purge and also advocates drinking large quantities of water.
I realize that the foregoing experiment is not sufficient to establish Major Austin's contention; that the experiment would have to be repeated many times on many patients with uniform results, to prove what he claims to have proven. I have repeatedly seen the same excellent results, that he records for his fast during which the purge was employed, in patients who received neither purge nor enema. Patients who have previously fasted under the care of others and who were purged during the fast, have described to me their experience during this time and often they have had more discomfort and weakness than Major Austin had during his second fast when he employed the enema.
Individual actions vary so much during the fast and in the same individual at different times, that the apparent "effects" of purging and the use of the enema in one case cannot prove anything. Let those who perform these experiments now conduct an extensive series of experiments without the use of either enema or purge.
I know the evils of the enema as well as those of the purge. I know that the enema does not reach the small intestine, as the purge does. If we grant the need for either, the purge may be preferable, but I do not grant their need.
Major Austin says: "I may here explain that during a fast waste products and toxins are being continually deposited in the stomach and intestines, and unless these are washed away by large drinks of water and enemas or a saline purge, some of the morbid material is re-absorbed; this causes auto-intoxication and its attendant discomforts, weakness, headaches, etc."
It has never been explained how the re-absorption of a small amount of the large amounts of toxins thrown out will cause symptoms that the whole amount of the toxins failed to produce before they were eliminated. Re-absorption is assumed and symptoms are arbitrarily referred to this. I agree that if re-absorption occurs, it would occur in the intestine and not in the colon and the waste matter could easily be reached by a purge and not by the enema. But does re-absorption actually occur? If so, why does it occur?
I suggest that the practice of drinking large quantities of water, to "wash away" toxins, to "flush the system," may cause re-absorption of toxins. The water is absorbed. It does not pass out through the colon; but through the lungs, skin and kidneys. It will "pick up" and hold in solution, the waste and toxic matter in the stomach and intestine (it does not reach the colon) and it doubtless carries some of this into the body with it when it is absorbed. Drinking only when nature demands water and only so much as she demands will reduce this absorption to a minimum. Until my plan is thoroughly tested all argument to the contrary is wasted words.
Major Austin advises cold abdominal packs and cold sitz-baths to "tone up and improve the condition of the colon, which is left in a more or less flabby state after the warm-water wash-outs."
Reverse peristalsis, starting in the middle portion of the transverse colon and passing backward to the cecum, first noted by Prof. Cannon and now known to be constant in both man and animals, is normally confined to the colon; but in constipation, particularly in colitis, with spastic contraction of the descending colon, these reverse peristaltic movements are greatly exaggerated and, when the ileocecal valve is incompetent, these reverse movements push the contents of the cecum into the small intestine. Water, feces, toxins, waste matter--the whole foul collection--may be forced into the intestine and from here be absorbed and poison the body.
The daily enemas and the purges and laxatives employed by many during the fast, undoubtedly contribute to the nervous depletion against which they often warn us. The fast certainly does not. The claim is made that fasting patients recover more quickly from their ailments if they are given enemas than if their bowels are left to their own resources. This claim is not made by those who have thoroughly tested both methods. For five years I employed the enema in all fasting cases, giving from one to two and occasionally three enemas a day. For twenty-six years I have left the colon alone. If anything, patients who do not have the enema make the quickest recoveries and it is certain that their bowel function is a hundred per cent more efficient after the fast, if the colon has been permitted to attend to its own function in its own way.
Mr. Pearson, who thinks "enemas comprise 60 per cent of the treatment in fasting" and who, himself, took as many as three to four enemas a day during his own fasts, says: "The large quantity of water introduced into the bowels will cause a rapid infusion of the toxic poisons from the bowels to the surrounding tissues, thus inducing headaches" and that "it is advisable to use an antiseptic in the water to reduce these poisonous substances as far as possible." He says he "probably took two to four teaspoonfuls a day" of baking soda, "for about five years in enemas." With Pearson, as with Hazzard and Sinclair, the enema is a fetish. Dr. Hazzard, Mr. Pearson and others advise the use of two, or three and more enemas a day.
Fasting animals do not employ enemas nor anything that may be regarded as serving the same purpose. Fasting seals and salmon, hibernating bears and snakes, fasting sick and wounded animals, regardless of the length of their fasts, employ no measures to force bowel action. Since this thing has been tried out on the plane of instinct for unnumbered thousands of years, and has been approved by nature, we need have no fear of fasting without the employment of enemas.
Certain advocates of fasting employ the lavage as a routine practice. Dr. Tilden formerly employed it as a daily measure. This proved to be too great a tax upon his patients so he reduced its use to three times a week. From my own experience with the measure, I consider even this too great a tax upon the energies of the patient.
Others employ the lavage only when there is actual nausea and gastric distress. They wash out the stomach to relieve the faster of discomfort. This measure often brings considerable relief, but at a big price. The insertion of the stomach tube is a severe enough tax on most patients. Pouring a gallon or more of water, with or without soda or other drug, into the stomach, also taxes them. The retching and vomiting occasioned by this procedure leaves the patient weak and nervous for hours. The relief afforded by the lavage is short-lived and the cost in nerve force is too great to justify it.
Many who employ the fast have the patient drink large quantities of water and then induce vomiting, where vomiting does not occur from the use of the water alone. I do not employ and do not approve of forcing measures. Vomiting can and does occur when a real need for it exists without resorting to forcing measures. Nausea and gastric distress are most often due to lowered or increased gastric tone and there is, in such cases, nothing to be expelled.
Fasters who have false teeth should keep their teeth in during the fast and should bite on them sufficiently often to keep the gums tough. The gums will shrink somewhat in the general loss of weight so that the plates will not fit after the fast, until the gums have filled out again. This makes chewing, especially of uncooked foods, rather difficult, unless the gums have been kept tough.
The lingering faith in forcing measures is a hold-over from the time we still had faith in the drugs of the physician. When we lost our faith in his poisons, we adopted a heterogeneous array of drugless measures that are intended to force the body to do what we, in our almost infallible wisdom, think it should do under the circumstances. Hence, we find many advocates of fasting employing in conjunction with it, many measures that are intended to force the body to disgorge.
The one great "need" that is so frequently stressed is that of increased elimination. For example, Prof. Levanzin says that "it is important to remember that all avenues of elimination should be constantly open during a long fast--that the system may have a chance to cleanse and invigorate itself by throwing out a mass of impurities. Enemas, deep breathing exercises, frequent baths, proper water-drinking, etc.--all these are essential and greatly assist in the cleansing of the organism and the shortening of the fast." He advocated the use of the Turkish bath while fasting because of the mistaken assumption that sweating, thus induced, constitutes an eliminating process.
Dr. Hazzard had the thought that in "organic disease of more than ordinary degree," it is "virtually certain that the avenues of elimination will prove inadequate to exacted demands" in a long fast. The thought is inherent in this statement that fasting overburdens the eliminating organs, if they are weak. Yet she says that "autointoxication takes place more often when feeding than when fasting."
The chief fault I find with Mr. Carrington's monumental work on fasting is the fact that he strongly urges forcing measures--enemas, sweatings, excessive water-drinking, exercise, hydrotherapy, etc. He thinks that by the use of these forcing measures the fast may be shortened and recovery may be effected in cases in which it may otherwise be impossible. His insistence upon exercise while fasting is based on the thought that exercise stimulates the excretory organs. He thinks that those who take more exercise while fasting will be able to totally eliminate bodily impurities more rapidly. This was also Macfadden's view. Carrington said that those who exercise most will terminate their fast soonest. I would say that they will be forced to terminate their fast soonest, and often prematurely, because of the more rapid exhaustion of their reserves.
All of these forcing measures are not only unnecessary and futile, but they constitute a heavy drain upon the energies and substances of the fasting organism. All forms of stimulation are enervating and the more they are used the more enervation they produce. The activities of the organs of elimination are in keeping with the amount of functional energy with which they are supplied and all efforts to keep them "constantly active" in spite of a lack of energy, only renders them less able to act. For, everything that we appear to gain in the increased activity occasioned by the forcing measures, we lose in the inevitable reaction. Every new source of enervation becomes an actual check to elimination. Our efforts should all be directed to the end of conserving the energies and reserves of the patient in every possible way, and not to dissipating them as rapidly as possible. Rest, quiet, poise, warmth--these are far more important than any method of treatment ever devised.
Mr. Carrington, himself, in dealing with drug stimulants, urged the necessity of refraining from them and pointed out that the weaker the organism, the greater the necessity of doing nothing. It is strange that he should abandon this principle in dealing with the drugless stimulants. These various drugless stimulants may be as wasteful of the body's energies as drugs. The sweat bath, the hot bath, the cold bath, the alternate hot and cold bath, the salt rub, massage, etc., are all very wasteful of the patient's precious energies. The same is true of the enema and the gastric lavage.
The reader is well aware that I do not approve of the chaotic mass of nonsense that is called drugless medicine. The methods of treatment employed by drugless practitioners are especially to be avoided during the fast. I could hardly do better at this place than to quote the following from Purinton: "The Conquest Fast doesn't harmonize with the Kneipp Water Cure, or the Macfadden School of Physical Culture, or any other regime that demands large expenditure of energy and vitality. These methods may be ever so good--they are not timely.
"I knew a man that had chronic rheumatism. He consulted a Fasting specialist, and stopped eating, began to feel better, wondered if he couldn't be improving faster--consulted a Turkish Bath specialist; and began bathing. Presently he died. Then each specialist declared the other had killed the patient."
The fasting individual should conserve his or her energies and not permit them to be dissipated by depleting--stimulating and depressing--treatments. Too often fasting has been held responsible for the results of the Blitzguss, frequent massage, spinal manipulation and other forms of drugless hocus pocus.
The actions of the body in relation to drugs are more prompt and vigorous when fasting than when eating. Due to this fact, fasting usually compels one to abandon his accustomed drug habits. The nervous system of the faster becomes more acute and also relatively larger than when eating. For these reasons the resistance to drugs is more prompt and vigorous. It is always more dangerous to use drugs when fasting than at other times. Drugs are bad at all times; the faster especially should avoid them.
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