The secretion of bile customarily continues during the early days of the fast. Indeed, it may be secreted in increased amounts. In some very foul conditions of the body, the secretion of bile is greatly increased, either during the first few days of the fast, or, at some period of its progress. This is likely to be regurgitated into the stomach where it causes nausea and vomiting. In such cases the bile is invariably evil-smelling and tainted. After a crisis of this kind, the patient's condition is seen to be much improved. The amount of bile secreted is then greatly decreased in amount.

A profuse cholerrhagia (flow of bile) through the bowels or by vomiting, is often seen in fasting. This produces drainage of bile through the bowels, instead of by cholecystotomy (the surgical way of draining the gall-bladder) in these cases and should convince the most skeptical of the superiority of this plan of care.

Normally bile is poured into the intestine only in response to a need for it in the work of digestion. It is poured out as the chyme from the stomach empties into the duodenum. If no food is eaten no bile is poured out. Physiologists are agreed that when an animal is fasting no bile enters the intestine. This is probably also true of a really healthy man; but it is certainly not true of the sick man.

The liver, among other things, is an organ of elimination. The products it takes from the blood are made into bile and poured out as such. When the sick man fasts the liver greatly increases the production of bile and this is poured into the intestine. The quantity and character of bile secreted during a fast as well as its degrees of alkalinity or possible acidity seem to be dependent upon the toxic overload under which the patient is struggling. Habitual hearty eaters, particularly those who consume large quantities of proteins and carbohydrates, produce the most bile and suffer most discomfort as a result.

Observations upon thousands of fasting cases have convinced me that the sooner the "over-production" of bile commences, after the cessation of eating, and the more bile is thrown off, the more rapidly the patient recovers his or her health. The patient is cleaning out. It is doubtful if such bile would have much value as a digestive fluid. In many cases, at least, its alkalinity is greatly reduced and it may even be slightly acid at times. When vomited it ranges in color from almost that of water, having but little bile pigment in it, to very dark. It often has a very offensive odor, not an odor of decay, and is commonly mixed with large amounts of mucus, this latter coming largely from the stomach, no doubt. Such bile must be considered as almost wholly a product of the excretory function of the liver. The secretory function is probably at rest like that of the glands which secrete digestive juices.

This is only one of the evidences of increased elimination during a fast and the cleaning out accomplished by this is of immense value in restoring health to those who have, through abuse or neglect, permitted their health to slip away.