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imagines that the blood and the vital or functioning tissues of the body begin to break down the moment food is withdrawn; that organic destruction sets in immediately and that every day the fast is prolonged means a greater destruction of the vital tissues.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."