The blood diminishes in volume in proportion to the decrease in the size of the body so that the relative blood-volume remains practically unchanged during a fast. The quality of the blood is not impaired; indeed, an actual rejuvenation of the blood may occur.

Dr. Rabagliati pointed out that the first effect of the fast is to increase the number of red blood corpuscles, but if persisted in sufficiently long, decrease them. The increase of erethrocytes, during the early part of the fast, he regarded as due to improved nutrition resulting from a cessation of overeating. This increase in red blood cells has been repeatedly noted in anemia. The decrease is seen only after the starvation period is reached.

Prof. Benedict says: "Senator and Mueller in reporting the results of their examinations of the blood of Celti and Briethaupt, noted an increase in the red blood corpuscles with both subjects. In a later examination of Succi's blood, by Tauszk, the conclusions reached were (1) that after a short period of diminution in the number of red blood corpuscles there is a slight increase: (2) that the number of white blood corpuscles decreases as the fast progresses; (3) the number of mononuclear corpuscles decreases: (4) the number of eosinophiles and polynuclear cells increases; and finally (5) that the alkalinescence of the blood diminishes."

Later experiments agree almost entirely with these results. The Carnegie Institute Bulletin, 203, pages 156-157 says: "The results of the above studies (of fasting) are conspicuous rather from the absence than the presence of striking alterations in the blood picture," and adds, "The final conclusions as to the effects of uncomplicated starvation on the blood to be drawn from the results of examination of Levanzin, are: In an otherwise normal individual, whose mental and physical activities are restricted, the blood as a whole is able to withstand the effects of complete abstinence from food for a period of at least 31 days (the length of Levanzin's fast), without displaying any essentially pathological change." Structural and morphological changes do not occur in normal blood cells during a fast.

Pashutin records the case of a man who died after four months and twelve days (132 days) without food and says that two days before death the blood contained 4,849,400 red and 7,852 white corpuscles in one cu. mm. Prof. Stengel says: "The blood in starvation preserves its corpuscular richness surprisingly, even after prolonged abstinence."

Fasting for only one week will increase the number of red cells in an anemic person. Medical and laboratory experimenters have conducted all their experiments on healthy men and animals, hence they have not been permitted to observe the regenerating effects of fasting upon the blood. Their statement that "human blood is relatively resistant during fasting" is true, but it does not tell the whole truth. Their statement that "there is a tendency to increase in the red cell count" is also true, but even this does not tell the whole truth.

Jackson says: "During human inanition, the erythrocyte (red cell) count is often within normal limits, but sometimes increased (especially in total inanition and earlier stages), or decreased (especially in chronic and late stages). In animals, the red cell count appears more frequently increased in the earlier stages of total inanition, often decreasing later. In hibernation, the erythrocyte count is variable."--Inanition and Malnutrition--p. 239.

Normal blood contains from 4,500,000 to 5,000,000 and as high as 6,000,000 in healthy young men, red cells per cu. mm. and 3,000 to 10,500, with a probable average of 5,000 to 7,000 white cells per cu. mm.

Dr. Eales' blood was examined June 20, 1907, the first day of his fast, by Dr. P. G. Hurford, House Physician to Washington University Hospital, St. Louis. It showed the following:

Leucocytes 5,300 per cubic millimeter.
Erethrocytes 4,900,000 per cubic millimeter.
Hemoglobin 90%.

A blood test was again made on July 3, the 14th day of his fast, by Dr. S. B. Strong, House Physician, Cook Gouty Hospital, which showed:

Leucocytes 7,000 per cu. mm.
Erethrocytes 5,528,000 per cu. mm.
Hemoglobin 90%.

It will be noted that the blood has materially improved on the fast.

A third examination of Dr. Eale's blood made by Dr. R. A. Jettis, of Centralia, Ill., on August 2, showed:

Leucocytes 7,328 per cu. mm.
Erethrocytes 5,870,000 per cu. mm.
Hemoglobin 90%.

A further improvement in the condition of his blood is here seen.

Laboratory investigators have reported an increase in the red cells of healthy fasters with a decrease in white cells. In anemia, fasting often results in an increase in the number of red blood corpuscles to more than twice their former number, with a concomitant decrease in the number of white blood cells. In a talk in Chicago a few years ago, Dr. Tilden said: "Cases of pernicious anemia taken off their food will double their blood count in one week." Dr. Weger reports a case of anemia in which a 12 days' fast resulted in an increase of the number of red cells from 1,500,000, to 3,000,000; hemoglobin increased fifty percent, and white cells were reduced from 37,000 to 14,000.

Wm. H. Hay, M.D., in his Health Via Diet tells of caring for 101 cases of progressive pernicious anemia, during twenty-one years by fasting, correct diet and colonic irrigation. Of these 101 cases he says that 8 failed of initial recovery. Part of the recoveries were made permanent by right living. Some of those who relapsed resorted once more to the fast and again recovered.

The first 13 cases of progressive pernicious anemia which Dr. Hay placed upon a fast recovered in from two weeks to longer. The fourteenth case, being in a dying condition when she arrived, did not recover. Dr. Hay says: "The blood during a fast undergoes no visible changes as to cell count unless markedly abnormal when the fast is begun in which case there is a return to normal." * * * "For most of two weeks (in progressive pernicious anemia) the red, erethrocyte, count continues to fall before there is a regeneration in the blood-making organs; then gradually the microscopic picture begins to show round erethrocytes with regular edges, no crenations or irregularities, and soon there is noticeable increase in number of these with gradual disappearance of the adventitious cells present in the beginning.

"Not unusually there is a gain during the succeeding two weeks that brings the total back to the normal five million erethrocyte count, even though this may have been at, or below, one million in the beginning.

Von Norden says: "The blood atrophies." This is true of the starvation period, not of fasting proper. Much confusion will be avoided if the student will keep clearly in mind the fact that destructive changes occur only after the exhaustion of the body's reserves. Von Norden, Kellogg and others never tired of detailing the destructive changes that occur in the body during "starvation." Indeed, they were right in their details if they had used the term starvation properly. But they believed that the changes seen in starvation belong, also, to the fasting period. They made no distinction between the two processes. Later, investigators have corrected this old mistake, although few writers on the subject in our encyclopedias and standard works seem to have heard of this fact.

The decreased alkalinity due to prolonged fasting is often urged against it. It is contended that fasting produces acidosis. Fasting does not produce acidosis and the decreased alkalinity is never great enough, even in the most protracted fasts, to result in any deficiency "disease," unless the frequent cases of impotency are to be regarded as due to a loss of vitamins or mineral salts. The blood rapidly regains its normal alkalinity after feeding is resumed and no damage is done.

Mr. Macfadden says: "It has been said that an acid condition of the blood, fluids and tissues (acidosis) is sometimes brought about by fasting. I cannot concede that this is ever the case, in true fasting. As a matter of fact, all the evidence seems to prove that as Dr. Haig expressed it, 'fasting acts like a dose of alkali.' If there is acidity in the system, fasting will remove it and restore the chemical balance of the system. Therapeutic fasting never created acidity, but on the contrary, removes that state when existing. Of course protracted starvation may do so, but then, who ever advised starvation.

"The medical as well as the general idea is that starvation begins practically immediately when meals are discontinued. The impression is that at once the blood and solid structures of the body begin to break down, that organic destruction has begun. Such is far from the case, as results have proved in scores (thousands) of cases. The vital cells of the organs and glands--those doing the active physical and chemical work of these parts--do not begin to disintegrate until actual starvation begins."

During a fast the body lives on its reserves. Starvation does not begin until these reserves are exhausted. What is more, these reserves contain sufficient alkaline reserves to prevent the development of so-called acidosis.

Dr. Weger says: "Varying degrees of acidosis were often in evidence during fasting. These we consider physiological. Except in very rare instances, the active symptoms are of short duration and easily overcome without interfering with or curtailing the fast." He describes the "symptoms of acidosis during a fast" as "lassitude, headache, leg and back ache, irritability, restlessness, redness of the buccal (mouth) mucous membrane and tongue, sometimes drowsiness, and also a fruity odor to the breath."

These symptoms develop at the beginning of the fast and grow less and less as the fast continues, until they cease altogether. If fasting produces acidosis the evidence should increase as the fast progresses. I believe that all of these symptoms may be explained without regarding them as evidences of acidosis. They result, I believe, from the withdrawal of the accustomed stimulation--coffee, tea, chocolate, cocoa, alcohol, tobacco, meat, pepper, spices, salt, etc., etc.--and are identical with these same symptoms when they develop in the man or woman who gives up coffee or tobacco, but who does not cease to eat. I do not think the "fruity odor" of the breath can be explained in this manner. However, in thousands of fasts I have conducted, I have never met with such a phenomenon--the breath in all cases being very foul and much like that of the fever patient or like the bad breath most people have, only much intensified.

Dr. Weger, himself, says: "Fasting is not and cannot be the cause of acidosis, for the symptom-complex of acidosis is quite common in full-fed plethoric individuals, in whom the makings of acidosis exist as a result of an over-crowded nutrition. It is true that symptoms of acidosis frequently occur and make patients decidedly uncomfortable during the early stages of the fast. However, these symptoms are due to excessively rapid consumption of the body fat--a catalytic action--and the checking of elimination because of sub-oxidation. In less than ten per cent of such cases do these discomforts last more than three or four days. This indicates to us that the acidosis, as such, was a latent condition that would be excited into activity by any other equally potent provocative. This condition is analogous to a crisis which might occur in the form of an acute disease. The sicker one is made by a fast, the greater the need for it."

In general I agree with these words of Dr. Weger, but I have noted these supposed symptoms of acidosis in cases where there was no rapid breaking down of tissue, and in cases in which physical activity was sufficient to keep up normal oxidation and in which elimination was normal or super-normal. I do regard these symptoms as being part of a crisis and as beneficial in outcome. I have noted repeatedly that the more severe are these symptoms, the more benefit the patient receives from the fast and the sooner do these benefits manifest.