Nausea: This seems to be an expression of a sudden decrease of the normal tension of the stomach. It may be induced by a foul odor, a bad taste, a disgusting sight, or an emotional shock. Severe pain, illness, fatigue, rapid descent in an elevator, etc., may produce nausea by lowering the tension of the stomach. These things bring about a loss of tension through a complicated "reflex" mechanism.

Continual emotional disturbances, such as prolonged worries, anguish, grief and repeated shocks, may result in a persistent loss of tone in the stomach and produce the "all gone" sensation or vague nausea often complained of.

In many cases there is no doubt that the sudden withdrawing of all food, as in fasting, results in a temporary lowering of tone or tension in the stomach and this produces nausea. On the other hand, tall, thin, undernourished people are likely to suffer with a chronic lack of tension in the stomach and this becomes more noticeable when they fast. The presence of bile in the stomach also causes nausea. Its presence is very likely to lead to vomiting.

Vomiting: I had one case to vomit almost continuously for six days and nights, although such vomiting usually lasts not more than a day or two. Much mucus and bile are thrown out. It is a cleaning-out process. The aforementioned case developed persistent hiccoughs when the six days of vomiting ceased, and this persisted for seven days before it ceased. The cessation of these two crises was the end of her suffering which had persisted for seven years. Another case, an old lady, vomited four days and nights, but made an excellent recovery. I do not regard vomiting as a danger signal, but as a cleansing process.

Mr. B, who underwent a 31 days fast in my institution in 1932-33, began vomiting on the 23rd day of his fast and vomited day and night for 7 days, or through the 29th day of fasting. Large quantities of mucus and bile were brought up. He was very weak while vomiting, but became strong again as soon as the vomiting ceased. This, however, is the usual experience.

Efforts to break a fast while the patient is vomiting are futile, even harmful. "Only God could break a fast," wrote Dr. Dewey, in a personal letter to Hereward Carrington, dated March 26, 1903, "where there is a sick stomach and there is no time to let nature perform the task. Taking food in such a stomach would be death-dealing. There is nothing to do but make the body and mind as comfortable as possible, and Nature will cure, if the seal of death is not set."

Speaking of the occurrence of vomiting during a fast, Mr. Macfadden says: "It is certainly inadvisable to break a fast at such a time. If food be administered at such a time, it most certainly will be ejected, and it may aggravate the vomiting all the more." Dr. Dewey records a case in which vomiting began after fasting fifty days. Food was tried, but promptly ejected. There was nothing to do but wait, with the result that one day after the last vomiting spell, there was a natural call for food--and this on the sixtieth day of the fast.

Much mucus is often (usually) expelled in the vomiting process. I have seen no pus so ejected but Carrington tells of such. I have seen vomiting last for as long as two weeks after forty or more days of fasting and, while it leaves the patient very weak, there has in no case been any danger of death.

Sometimes vomiting, headache and eruption will all come together. With a little experience in handling cases, one can judge fairly accurately in advance who is and who is not going to develop a severe crisis. Long standing cases of digestive troubles, particularly those accompanied with nervous disorders, are most prone to develop these.

As vomiting is merely part of the elimination that fasting encourages, most often due to overactivity of the liver with regurgitation of bile into the stomach, it needs only to be let alone. It may develop early or late in the fast, but it constitutes no danger, so far as my own experience and observations go. Carrington says that such vomiting spells occurring at the end of a prolonged fast have been known to terminate fatally. I have seen no such fatalities and naturally wonder if death in such cases may not have resulted from the heroic treatment designed to stop the vomiting.

Cramps: These may occur in the bowels of both sexes, or in the womb of females. In the bowels they may be due to gas, to bowel action, or to "psychic" interference with sympathetic control of peristalsis. Uterine cramps are rare, occurring chiefly in those patients who bleed from the uterus. More rarely the cramps result from efforts to disgorge the womb of an accumulation of mucus.

Gas: Many patients have considerable intestinal gas while fasting. Those who suffer with digestive troubles, visceroptosis, colitis, enteritis, etc., and "nervous" patients are most likely to be troubled with gas. In not a few cases there is sufficient gas to cause distress, even sleeplessness. Most of these cases experience difficulty in expelling the gas.

In most cases, distress is probably not due to the presence of a large amount of gas, for this is seldom present in large amounts. It seems rather to be due to increased internal tension. A constant internal tension or pressure is maintained in the digestive tube. This is regulated by the sympathetic nervous system. Increased tension is felt, reflexly, as pain or discomfort in the muscles of the abdomen.

"Nervousness," shock, strong emotions, etc., may cause increased tension in the tube and the faster will experience some kind of discomfort. Subconscious fears also may cause the so-called gas pains. Those who have long suffered with digestive derangements are especially prone to changes in the internal tension of the tube.

Functional irregularities in the stomach and intestine may cause pain because of increased peristaltic contractions that often exist in these. Marked visceroptosis, with sharp angulations, may increase the internal tension and cause discomfort or pain.

Increased peristaltic activity of the stomach walls, due to "nervousness," may also result in discomfort that is mistaken for "gas pains." Increased tension may occur in any section of the tube and thus pain or discomfort may be either general over the abdomen or may be more or less localized.

Fasters who so suffer generally complain that the "gas" makes them nervous and keeps them awake at night. It seems that the opposite of this is the truth--the nervousness causes the increased tension and resulting discomfort. Where these patients are able to completely relax, their "gas pains" cease. Although I no longer employ any of these: suggestion, abdominal massage, hot water applications to the abdomen, a drink of warm water and other measures, will usually relieve this distress, at least temporarily without actually lessening the amount of gas.

Gas rumblings in the intestine mean unstable nerve control of this organ. Cathartic drugs will almost always produce these rumblings. This is due to excitement produced by the irritating drugs.

The gurgling and rumbling often heard in the abdomen is due to the movement of gas from one section of the intestine to another. It may often be due to emotional interference with the normal sympathetic control of the gut. A nervous patient may exhibit such rumbling on the slightest provocation. Enemas, due to the excitement they occasion, often produce these symptoms.

Diarrhea: This is a rare development, although it is more common in fasting than some advocates of fasting know about. This is due to the fact that their use of the enema hides the actual development. It comes, when it does, only as a house-cleaning process, and only because there is an imperative need for it.

Dizziness: This is a very frequent symptom and manifests chiefly in the early part of the fast, or when one arises suddenly. It lasts but a few seconds and may be prevented by rising slowly. It is a common development during the fast and arises out of the sudden withdrawal of blood from the brain. If the faster will "take it easy," he will rarely experience any dizziness.

Fainting: This may occur in the early days of a fast. It should occasion no alarm or apprehension, and the patient should be cared for merely by stretching him, or her out and loosening all tight clothing and admitting plenty of fresh air to the patient.

Although relatively few fasters faint, many of them do at some time or other during a fast. Often this may occur on the first or second day and not again thereafter. Carrington mentions a case in which "a practical suspension of all consciousness resulted from the ingestion of the first meal, after the breaking of the fast, and lasted some hours." He emphasizes the fact that such occurrences are merely rare curiosities rather than "pathological phenomena likely to occur." He says that "it is doubtful if precisely the same effects will ever again be observed in fasting patients--being due, in every case, to a peculiar combination of causes, all but impossible to duplicate again."

When a fasting patient faints he should be cared for precisely as if he fainted while eating three square meals a day. All he needs is fresh air and time. He should not be set up, but should be left in a prone position. No stimulants or smelling salts need be given. Let him alone and he will soon open his eyes and look around, then get up and go about his business. Dashing cold water in his face is equally unnecessary. Rest, not shock, is the need of the person who has fainted.

Sore Throat: Although sore throat is most often seen following immediately upon breaking the fast, it occasionally develops during the fast. The soreness is never great, lasts but a day or two, at most, and need occasion no concern.

Palpitation: "Pain in the heart" and palpitation of this organ are due to gases in the digestive organs. These symptoms are of rare development and are not dangerous, although they are usually the source of much needless apprehension on the part of the patient. Palpitation may be the result of "nervousness," fear or exertion.

Pain felt in the heart is rarely actual pain in the heart. It is usually pain in the chest. It may be due to gas, it may be of "psychic" origin, it may be of toxic origin. Unless it is accompanied with other symptoms that indicate heart trouble, it should be ignored. It is not serious and soon passes.

Insomnia: This is most often due to a lack of need of sleep. Little sleep is required by the average fasting individual. In a few instances sleeplessness is due to nervous tension or to discomfort. Sleeplessness should cause no worry.

While few fasters sleep as much as when eating, all of them sleep much more than they realize. This is also true of all patients who suffer with insomnia. Ten hours of sleep seem like fifteen minutes because we are not conscious of the passage of time while we are unconscious; an hour of wakefulness seems like a whole night, because time drags so slowly when we are waiting to go to sleep.

Visual defects: While it is no uncommon thing to see great and lasting improvement in vision develop during a fast, particularly during a long fast, there are somewhat rare instances in which there develops temporary weakness of vision. Carrington mentions what he regards as a "curious development" which he says may never be seen again. A patient saw double for a time just prior to breaking the fast. Two visual images were perceived instead of one. I have seen one or two such developments myself at the end of a very long fast. What is seen more often, but still only rarely, is weakness of vision, so that the faster can see but little. He is forced to discontinue reading, or his vision may become weaker, even, then this would indicate. Much of this seems to be due to a temporary loss of coordination between the two eyes, as they do not focus upon the object viewed. That no real injury to the nerves or mechanism of vision occurs is shown by the fact that the weakness and defect soon disappear after the fast is broken and vision is soon better than it was before the fast. I had one case in which this development occurred, in a man who had worn heavy lenses for years prior to the fast. After the fast was broken he was able to discard his glasses and got along without them. Another case is that of a woman who wore glasses but who saw double (without her glasses) before the fast, and regained normal vision while fasting. She was able to discard her glasses on the sixteenth day of her fast and could see to read, sew, thread needles, etc., without her glasses. She did not return to the use of glasses until about seven years later.