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The word starvation is derived from the Old English steorfan, meaning to die. Today it is used almost wholly to designate death from lack of food. When we mention fasting to the average person and even the average physician, he immediately pictures to himself, the dire consequences that he thinks must inevitably result from going for even a few days without food. To him to fast is to starve--that is, die.
This fear of fasting is kept alive by the press, which, ever so often carries the story of somebody dying while fasting, and invariably death is attributed to starvation. These deaths are presented as "horrible examples" of the "evils of fasting." How rare are these deaths! But it would be enlightening if we could have all the details of each of these deaths. No doubt, we would find that most of them are not due to abstinence from food at all. Most of these deaths have been due to irreparable damage to some vital organ (organic disease), an occasional one may have been due to pushing the period of abstinence beyond the fasting period, a few have been due to injudicious breaking of the fast, some of them have been due to drugs. But every day people die from unnecessary and "unsuccessful" operations and the press keeps quiet. Everyday people die from drugging and the editors and newsmen ignore such deaths. Fasting is their target.
There is no sense in the panicky fear of missing a few meals that is so prevalent in both lay and professional circles today. The fear of starving, expressed on every hand, is a foolish fear. "I am not going to starve to death," says Mr. Average Man, when advised to fast. They warn others who are fasting that they will starve to death. Although we oppose letting people "starve to death," we make no decided stand against them stuffing themselves to death; instead, we rather encourage it.
In popular opinion fasting means starving. Physicians, physiologists and others of the "learned professions" habitually employ the two terms--fasting and starvation--synonymously. "I am not going to starve," says a long-suffering invalid, upon being advised to fast. Those who employ fasting are commonly referred to as "starve-to-death doctors."
The uninformed physician imagines that the blood and the vital or functioning tissues of the body begin to break down the moment food is withdrawn; that organic destruction sets in immediately and that every day the fast is prolonged means a greater destruction of the vital tissues. That this idea is false will become apparent presently.
In previous chapters it was shown that the body, at all times, has stored within itself reserves of food sufficient to last for considerable time in the event of scarcity of food, or of sickness, when food cannot be digested. We saw how the body feeds upon this food reserve and how the vital tissues of the body feed off the least essential, so that even if actual starvation occurs, there is almost no damage to the vital organs.
So long as the body's food reserves last, the individual abstaining from food is fasting. When this reserve has been consumed to the point where it is no longer able to sustain the functions of life, further abstinence becomes dangerous; starvation begins. It is only after this point is reached that any real damage is sustained by the vital organs and their functions. As a general rule, under proper conditions of environment, one may fast for weeks, and even months, before the starvation point is reached. "It is perfectly true," says Sinclair, "that men have died of starvation in three or four days; but the starvation existed in their minds--it was fright that killed them."
Laboratory workers describe destructive changes in the pancreas, supra-renal glands and other organs and glands of the body, as a result of starvation. But these changes occur after the period of fasting proper has been passed. The vital cells of the organs and glands--those doing the actual physical and chemical work of these organs--do not begin to break down until actual starvation begins.
Morgulis says: "Apart from the purely pathological phenomena occurring in the terminal stages (the starvation period) of fasting, it should be mentioned that the histological peculiarities appearing in the very beginning of inanition are associated with changes in the colloidal condition of the protoplasm and are not at all degenerative in kind. The progressive atrophic changes coincident with inanition are simply due to the gradual withdrawal of metaplasmic inclusions which represent the nutritive reserves of the cells. The atrophic diminution of both cells and nuclei does not, therefore, present a pathological phenomenon either. Moreover, the morphological processes in inanition are not invariably destructive, cell proliferation going on even when the organism has been deprived of nourishment for a long time."
This means that, except during the actual starvation period, the wasting of parts during a fast is the result of the using up of those portions of the protoplasm of the cells containing the products of their secretions and not of an actual destruction of the cell proper. The metaplasm is slowly used as the fast progresses, so that the size of the cells and, consequently, of the organ is gradually reduced, but there is no actual deterioration in structure of the cells, tissues and organ.
Dr. Morgulis makes the cautious, perhaps over-cautious, estimate that a fast which involves a body loss of ten to fifteen per cent is harmless and usually beneficial; and that the danger point in fasting begins when from twenty-five to thirty per cent has been lost. He has had animals recover normal health after a weight loss of sixty per cent. We have seen the same thing in more than one man and woman.
A number of people have died of serious organic "disease" while fasting, and autopsies have been performed in many of these. In every case there was still considerable subcutaneous fat, whereas, this is always entirely absent where death has been caused by starvation. Except in a case or two where the heart had never sufficiently developed or where there was previous heart "disease," the heart was found to be normal in all cases; while in actual starvation, the heart is always contracted or markedly atrophied. The pancreas is little, if at all affected, in death during the fast, whereas in death from starvation, this gland is almost entirely absent. In these cases the blood was normal in amount with no anemia present; while in starvation, the relative blood volume is reduced and there is usually marked anemia.
In starvation the tongue remains coated, the breath offensive, the pulse and temperature sub-normal and hunger may disappear for days at a time.
Death may result at any time, feeding or fasting, due to the failure of some particular vital organ, which is so far destroyed that a fatal ending cannot be prevented by any means, but death from abstinence from food cannot occur until all possible nutritive material has been exhausted. "True starvation begins," says Sinclair, "only when the body has been reduced to the skeleton and the viscera."
Fortunately we are not left unprotected and unwarned in this matter. Before the danger point is reached an imperious demand for food will be made. We say, then, that so long as hunger is lacking, the patient is fasting; but after hunger returns, if he continues to abstain from food, he is starving. Besides the return of hunger, there are other indications that the body is ready to take food, as stated elsewhere.
Carrington has well summed up the matter in these words: "Fasting is a scientific method of ridding the system of diseased tissue, and morbid matter, and is invariably accompanied by beneficial results. Starving is the deprivation of the tissues from nutriment which they require, and is invariably accompanied by disastrous consequences. The whole secret is this: fasting commences with the omission of the first meal and ends with the return of natural hunger, while starvation only begins with the return of natural hunger and terminates in death. Where the one ends the other begins. Whereas the latter process wastes the healthy tissues, emaciates the body, and depletes the vitality; the former process merely expels corrupt matter and useless fatty tissue, thereby elevating the energy, and eventually restoring the organism that just balance we term health."
Prof. Morgulis divides what he calls starvation, or inanition, into four periods--"each period comprising approximately one-fourth of the total loss in weight sustained at the time of death."
The first of these periods of "every complete inanition," (by "complete inanition" is meant abstinence from all food until death occurs) is a "transition from the condition of adequate feeding to the basal metabolism of fasting"--"the organism is readjusting itself from the prefasting metabolic level to the level of the true physiological minimum characteristic for the particular individual."
The division between the next two periods is not well marked or defined. They constitute one period divided into "early and late phases" and "are not very distinct but merge gradually one into the other." During these "two periods," physiological activities are at a minimum peculiar to this individual. The length of these two periods will be determined by the size of the animal or man or the surplus food reserves on hand.
The final or fourth stage of inanition "is characterized by the predominance of pathological phenomena caused by the prolonged stringency of nourishment and exhaustion of the tissues." This is the true starvation period and sets in when the body's nutritive stores are practically exhausted.
Prof. Morgulis refers to the whole period, from the omission of the first meal until death finally ends the scene, as starvation and as fasting. He uses the two words synonymously and does not distinguish between fasting and starvation as we do. It will be noted that all pathological phenomena, of which we are so frequently warned, belong to the fourth stage of inanition; or, to the period of starvation proper, as distinct from fasting, as we employ these terms.
Morgulis points out that "the morphological changes observable in advanced starvation are practically identical with those generally found in every pathological condition and present nothing peculiar" and suggests that perhaps all "pathological changes of tissues are primarily inanition effects."
Further applying his division of "starvation" into four periods, Prof. Morgulis says: "All the scientifically studied fasts of men have been of relatively short duration. In the longest fast of this kind lasting 40 days Succi lost only 25 per cent of his original weight. Judging by the loss of weight, therefore, the experiments on inanition with human subjects have not extended far beyond what may be regarded as the second stage of inanition and, regardless of the length of time of the abstinence, had no deleterious effect whatever upon the subjects because the fasts were invariably discontinued long before the exhaustion stage had been reached."
Taking up the study of Levanzin's fast for 31 days, undergone at Carnegie Institute, Morgulis says that this fast extended over the first two inanition periods. The first of these periods, lasting fifteen days saw a loss of ten per cent of Levanzin's weight and represents "the transition from the metabolism of the well nourished condition to that of the fasting condition."
By the end of his 31 days' fast, Levanzin lost about 20 per cent of his weight. "Assuming the maximum loss he could possibly have survived 40 per cent," says Morgulis, "it is clear that the fast could have extended another month before a fatal termination. In other words, the fast was broken at a relatively early stage." If we take into consideration the fact that the second 20 per cent of Levanzin's weight would not have been lost nearly so rapidly as the first 20 per cent, it is very certain that he could have fasted much more than another month before a fatal termination.
The rule that man or animal can sustain a loss of 40 per cent of his or its body weight before death results must not be taken too seriously in practice. Obviously an emaciated man or woman weighing only 90 or 100 pounds cannot afford to lose 40 per cent of his or her weight. On the other hand a man who ought to weigh about 150 pounds, but who actually weighs 350 pounds, can afford to lose much over 50 per cent of his weight. Exhibition fasters have survived a reduction of body weight of thirty per cent without anything like a total collapse of vital vigor.
Within recent years physiologists have tried to determine how long man can live without food by figuring on a basis of the period of time required for animals, particularly mammals, to starve to death. Their experiments indicate that the period in which death from starvation ensues is proportionate to the cube root of the body weight.
A mouse weighing 18.0 grams dies after five or six days without food. The corresponding "starvation period" in man would be 15.6 times as long or 96.5 to 109 days. A dog weighing twenty kilograms dies in sixty days; the corresponding period for man is eighty-nine days. A cat weighing twenty-one kilograms can live eighteen days without food; the corresponding period for man would be fifty-five days. A rabbit weighing 24.22 kilograms dies after twenty-six days; the corresponding period in man would be seventy-nine days.
From these figures, Dr. A. Putter, a German physician, who has made a study of fasting, concludes that there is nothing in comparative physiology to show that man cannot live from ninety to a hundred days without food, if he were kept under proper conditions of warmth, rest, fresh air, water and emotional poise.
Sylvester Graham denied that the fat man lives longer on prolonged abstinence from food than does a thin one. He says, "If the it be designed for the nourishment of the body during protracted fasts, etc., then if a very fat man, in the enjoyment of what is ordinarily considered good health, and a lean man in good health, be shut up together, and condemned to die of starvation, the fat man ought to diminish in weight much more slowly, and to live considerably longer than the lean man; but directly the contrary to this is true. The lean man will lose in weight much more slowly, and live several days longer than the fat man, in spite of all the nourishment which the latter may derive from his adipose deposits."--Science of Human Life, pp. 193-194.
Trall took a similar view, as does Carrington, who says of Graham's statement: "I may say that this has been my own experience, precisely." The explanation offered is that, while the fat person has a large store of fat on his frame, he is deficient in other food requisites. Fatty tissue, these men think, is invariably diseased and deficient tissue. Trall said, "Feed a dog on butter, starch, or sugar alone, and you will save in him the consumption of fat, but the dog will die of starvation. He will be plump, round, embonpoint, and yet die of inanition."--Alcoholic Controversy, pp. 148-149. This seems to be what they thought will take place in the fasting fat man.
This is an a priori conclusion, since the experiment has never been made, and it is not borne out by animal experimentation. There is, as I have emphasized elsewhere, a vast difference between a fast and a very deficient diet, such as the diets described by Trall. The ultimate results of the two types of nutrition are very different. Nevertheless, there may be cases of fat individuals who would actually starve to death before a thinner person would do so, for the reason that the nutritive reserves in the fat person may be so unbalanced that he cannot go long without food. I have, myself, cared for fat men and women who did not fast well and who did not hold up under fasting as well as do many who are actually skinny. But I have never been sure that in these patients, the trouble was not largely if not wholly mental. In view of the fat person's love of food and his worrying and fretting when deprived of it, he may actually kill himself while the thin man is still philosophizing about life and death.
If there can be such a thing as unbalanced reserves, and I presume that such may exist, there is as much reason why the thin man, eating the same type of diet as that eaten by the fat man, may have an unbalanced reserve as there is that the fat man may have this. The greatest losses in the fast, however, are in those very nutritive factors that are most abundant in the diet of most people, while the body clings to the factors that are commonly lacking. The tendency is for nutritive balance to be restored. The fact that the fat man who does not fast well, loses all of the difficulties that appear to have come from fasting, as soon as he gets his first half-a-glass of fruit juice, indicates that his troubles are mental.
Graham's statement that the fat man will lose weight much faster than the thin one is literally true, but what he overlooked is that this rapid loss of weight is not continued. Indeed, we often see fat women who undertake to fast to reduce, lose twenty to twenty-five pounds the first two weeks, but six pounds the third week and two pounds the fourth week. The rapid rate of loss does not continue. It should be observed at this point, also, that some thin people lose rapidly the first few days of their fast.
A fast of a hundred days or more can be survived even under the most favorable conditions, only by the individual who possesses sufficient food reserves to sustain his vital organs and vital functions for this period of time. The smaller the amount of food stores one has in reserve, all things else being equal, the earlier is the starvation period reached.
What Morgulis classes as the first three stages of starvation, we class as the period of fasting; while his fourth period of starvation is classed by us as the starvation period. Fasting begins with the omission of the first meal and ends with the return of natural hunger. Starvation begins with the return of hunger and terminates in death. Fasting is distinctly beneficial; starvation is distinctly harmful. It is precisely because the average medical man does not distinguish between these two major phases of abstinence from food, and because he imagines that the pathology developed during the starvation period belongs, also, to the fasting period, that he offers his false objections to fasting.
It was conclusively demonstrated in the laboratory, by Lasarev, that the changes in the various organs of the body are definitely related to particular stages of fasting and starvation. Vital organs do not begin to break down as soon as the first meal is omitted. Fasting belongs to that period during which there are ample food reserves to maintain vital integrity. The fasting period is, therefore, determined by the amount of reserves the body has on hand. Starvation sets in after the reserve stores have been sufficiently exhausted that they are no longer adequate to maintain functional and structural integrity.
Thousands of fasts, ranging from a few days to three months in duration, in men, old and young and both sexes, in all conditions of life, have demonstrated not only that man can go for long periods without food and not be harmed thereby, but also, that he will receive great benefit from a rationally conducted fast. To starve is to die; to fast is to live.
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