After the digestion of the last meal prior to the fast, the bowels practically cease to function. They take a rest. Dr. Oswald says: "The colon contracts, and the smaller intestines retain all but the most irritating ingesta." Sometimes they will continue to move regularly for the first three or four days of the fast. In rare cases a diarrhea will develop even after fifteen or more days of fasting. Mark Twain describes cases of starving shipwrecked men whose bowels had not moved for twenty and thirty days. For this reason most advocates of fasting insist upon the daily use of the enema. I think that the enema is a distinct evil and should not be employed.

Kellogg quotes Von Noorden as saying: "in fasting, the stools were highly putrid and 'similar in appearance to the feces passed when the diet is mainly composed of meat'." Kellogg and Von Noorden should both conduct a few hundred fasts and then write about the matter. This mistake is based on the notion that the fasting patient is on a meat diet and should have the stools of a meat eater. It is an assumption, not a fact. They have merely read into the matter false facts which conform to their mistaken theories even though they are at variance with the real facts.

The stomach, intestines and colon are given a complete rest by the fast and are enabled to repair damaged structures. Piles, proctitis, colitis, appendicitis, enteritis, enteric fever (typhoid), gastritis, etc., speedily recover under the fast. The alimentary tract becomes practically free of bacteria during a fast. The small intestines become sterile. But a week of fasting is required to result in a complete disappearance of all germs from the stomach. The quickest means of remedying bacterial decomposition in the digestive tract is fasting. Dr. Tilden says: "The fact that the hibernating bear loses its colon bacilli is not acted upon, and a fast recommended when disease results from overeating, bacterial decomposition and toxin poisoning."

Bowel action is necessarily more or less absent during a fast. There may be two or three actions during the course of a comparatively short fast, or no action at all during a most prolonged fast. The use of the enema during the fast, so much advocated in many quarters, is both unnecessary and pernicious. How unnecessary it is will be shown by the following cases:

Dr. Dewey tells of placing a dyspeptic, with feeble body and very low mental state, who had been under the care of physicians for ten years, on one meal a day. He says, (The Fasting Cure, p. 196) "The constipated bowels were permitted their own time for action." Further on he adds (page 107): "My patient's bowels gave no hint of their locality until the eighteenth day, when they acted with little effort; on the twenty-fourth day again in a perfect way, and daily thereafter."

It has been said that Dr. Dewey's fasting cases would have recovered more promptly had he employed the enema. But I find no satisfactory evidence that his cases, as a whole, were any longer recovering than the cases of those who employ the enema. Where they do appear to be longer in recovering, I think this may be accounted for more satisfactorily by the fact that in many of his cases he employed certain drugs, especially drugs to deaden sensation (relieve pain), and by the further fact that his limited knowledge of diet and his prejudices against fruit, which he had brought over with him from his medical training, did not give his patients the best after-care. Many of the fasts conducted by Dewey were under fifteen days. His records do not indicate that his fasts lasted longer or that his results were less satisfactory than those of Hazzard who employed the enema more, perhaps, than any other advocate of fasting His fasts were not unduly long. But I think the best answer to this charge against Dewey's practice is the fact that patients who are placed on a fast today and who are not given the enema recover sooner and more satisfactorily than those who do get enemas. The enervating effect of the enema is indisputable and no one of experience will deny that it is a trying ordeal for most patients to go through. In many cases it leaves an immediate weakness which lasts, often, for hours.

Dr. Eales' bowels moved at least once a day during the first week of his fast; with a slight movement about once a week thereafter. He records movements on the eleventh, and seventeenth days. He employed one enema a week and had both an enema and a spontaneous movement on the seventeenth day. His bowels began moving within twelve hours after breaking the fast and moved twice a day thereafter.

I cared for a case in my institution in February and March, 1929, in which the patient had a small bowel movement on the second day of an absolute fast, another on the fourth day, a copious movement on the ninth day and medium sized movements on the eleventh and thirteenth days. No enema was employed at any time during the fast, which lasted sixteen days.

I had another case of a young man who had a bowel movement on the second day of his fast, a small movement on the morning of the sixth day and a large movement on the evening of the same day. Again on the ninth day he had a small evacuation and a very copious movement in the evening of the same day. This man had suffered with acne vulgaris for several years and his face was thickly covered with eruptions when he began the fast. There was nothing of these except the discoloration by the end of the tenth day. Recently a lady fasted nine days under my direction, and had a good bowel movement on each of the seventh and eighth days.

Two ladies fasted here in the institution at the same time; one for eight days, the other for nine days. In both cases regular bowel action began on the third day after breaking the fast and has since continued. Both of these women made rapid progress and did not suffer during or after the fast. There was not at any time any evidence of poisoning in either case.

A patient took enemas contrary to my instructions, for the first three days of the fast, but abandoned them thereafter because of the discomfort and sickness which they produced. On the twenty-third day of the fast she had two spontaneous movements of the bowels--one at 5 A.M., the other at 11 A.M. On the morning of the twenty-fourth day there was another movement.

A lady arrived at my place on January 4, 1932, after having fasted since the morning of December 12, 1931. During the whole of her fast before reaching my place she had had a daily enema. I stopped the use of the enema and her bowels acted spontaneously on January 8th. There were no more bowel actions during the rest of the fast. The fast was broken on January 21, and the bowels acted immediately.

Another lady whose bowel action had not been good was placed upon a fast as a means of overcoming arthritis. Her bowels moved twice on the fifth day, once on the eighth day and again on the twelfth day of her fast. Another case, that of a man, with a brain tumor, had bowel actions on the fourth and ninth days and two actions on the eighteenth day of his fast. A woman who fasted under my direction in February, 1932, had a bowel movement on each of the fourth, tenth and fifteenth days of her fast. Another woman's bowels acted on the fourth, fifth and seventh days of her fast.