It is perhaps unnecessary to emphasize the truth that, in the physical distress suffered by this woman, medicine was unable to grant her relief. In fact, the time when she was most free from suffering was covered by the last several weeks of fasting before death occurred.

During the forty days of abstinence large quantities of blackish offensive fluid was discharged with each enema, and there was progressive relief from distress with lessened pain. However, no decrease in the amount of refuse evacuated was noted until the power of function of the eliminative organs diminished with lowering vitality.

Case 2 is that of a married woman, thirty-nine years of age, who for all of the adult period of life had suffered greatly from impaired digestion, variously diagnosed by many different physicians. For two years prior to death the patient had subsisted upon a diet of liquid food, the stomach refusing solids. This woman since girlhood had the distinction of consistently refusing medical remedies, but, nevertheless, her condition steadily grew worse, and, while no hope was offered that recovery could be had, her request that she be permitted to undergo a fast was granted. No food, excepting the slight amount of nourishment contained in the juice of oranges and lemons in small quantities was given for fifty-seven days, when she died. In fact, at no time from the beginning of the fast, which really was undertaken because the stomach repeatedly rejected the liquids ingested, could food have been introduced into the organ. This was absolutely determined by the results of the autopsy, which are now given.

In the duodenum, just below the pyloric opening of the stomach, there must at one time have been an ulcer or some acute inflammation. Nature in her efforts at repair had deposited tissue cells at this point to the degree that the lumen of the intestine had been almost occluded. As time went by this growth enlarged and involved the bile ducts, so that when death occurred the passage through the duodenum was entirely blocked. In composition the accumulation of tissue showed none of the characteristic cell formation of cancer, but was a mass of muscle and membrane, healthy in their components, but abnormal in deposition. The right kidney was in a state of complete degeneration, but the other organs of the body and the intestines, with the exception of the duodenal portion, were normal in size, position, and condition.

In view of the remarkable circumstances involving the physiology of this woman, a fuller description of her dietetic habit proves interesting. As stated, for two years previous to death only liquids were tolerated. Food substances obtained by boiling vegetables and by diluting fruit juices were the forms in which sustenance was furnished. In fact, so intolerant of solids was the stomach that the broths and juices were strained through cloths in order that no formed particles entered into them. Whenever the straining was defective, vomiting of sediment occurred, hence the utmost care was needed so that distress might not be caused.

This case, then, subsisted for two years upon only that sustenance which her body was able to appropriate through stomach absorption. Mineral salts and the vitamins may conceivably be conveyed in part to the centers of nutrition in this manner, but it could only have been in minute amounts that proteins, carbohydrates, and the starches were delivered, and then in forms not fully digested. While, until a year or so before her death, there might have been a small passage through and past the accumulation in the duodenum, thus permitting of some intestinal digestion, it is certain that months of existence had elapsed with no food ingested other than that described as strained to a watery consistency; and it is virtually certain that for this same period no intestinal digestion took place, for, when vomiting occurred, no bilious fluid ever appeared, and in the whole history of the case no formed feces were ever evacuated, the enemas in discharge being invariably fluid and never more than slightly discolored.

Case 3. A young married woman of twenty-four who, since maturity, had suffered from severe intestinal troubles and from acute bilious attacks. Four years before her death she had been medically treated for alleged appendicitis, and at this time an operation was advised to which she refused to submit. In this connection it is interesting to note that the autopsy on this body disclosed an appendix in normal condition with no signs of previous disease.

Eight months before death the patient had undergone a fast of twenty-eight days and had convalesced into the most satisfactory physical condition she had known since childhood. During this fast she cared for her young baby and continued to do so until acute hepatic hyperemia or congestion of the liver, with symptoms that denoted disease organic in nature, occurred. A fast was at once entered and continued for sixty days when the patient died. It was discovered then that the woman had been pregnant, and to this condition may be attributed some of the complications that arose. From the beginning of the fast copious foul discharges, black in color, were evacuated, and there was a slight daily rise in temperature, which, however, was invariably reduced to normal after the administration of the internal bath.

Post mortem examination discovered the liver in an advanced condition of degeneration; the stomach exhibited an extreme hour-glass contraction, and its pyloric opening would not permit the insertion of a probe the size of a lead pencil, while the walls of its lumen were cirrhosed or hardened; the small intestines and the colon throughout their lengths displayed a series of cartilaginous contractions. These structural defects were undoubtedly developed after arrival at maturity, since the unaffected portions of the organs were normal in size and in condition. The fetus was removed from the uterus at the autopsy, and was found to be in excellent state, exhibiting the normal development of an unborn child at four months.

Case 4. This was a married woman of thirty-five years, and the case is similar in many respects to the one preceding. The patient fasted fifty-nine days from the beginning of illness until death. The entire adult life of this woman had been made wretched by digestive impairment, bilious attacks, and menstrual difficulties. Drugs, including patent medicines, had done their worst until about two years before death, when, in hopeless apathy, the patient consented to undergo a fast, and completed one of thirty days with such success that she experienced full relief from menstrual pain thereafter, and there was but little digestive distress unless there had been carelessness in diet.