Dr. Hazzard, Mr. Carrington, Mr. Sinclair and others, regard the enema as almost indispensible during the fast. This arises out of a distrust of the body's powers of self-adjustment. There is no more need for, nor benefit to be derived from the enema during the fast than at other times. What is more, if no enema is used, normal bowel action will be established much sooner after the fast than if the enema is employed.

Levanzin, who often advocated the frequent use of the enema during the fast, says that he uses the enema only when he desires to get faster results. If the enema really gives faster results, there would seem to be no reason, at least in the great majority of cases, why it should not be used in every fast. But Hygienists dispute that it gives faster results. We are convinced, on the contrary, that it retards recovery and impairs bowel function.

Mr. Carrington voices the same view in these words: "we can readily see that frequent flushing of the bowels--say one a day--will materially assist a return to health, and effectively shorten the fast. It is a most important hygienic auxiliary to the main treatment; and, though so essential, Dr. Dewey hardly mentions the enema in any of his books; but its omission seems to me a very great fault, since we can see that its use will both shorten and lighten the period of fasting." This is an a priori conclusion that is not borne out by actual test and experience. It is based on the mistaken assumption that bowel action is elimination, and the added assumption that poisons are absorbed from the colon. Dr. Hazzard, who should have known better, was so possessed with her fear of auto-intoxication from the re-absorption of waste from the colon that she conjured up such symptoms resulting therefrom as mild delirium, stupor, hiccoughs, etc. The fact is, as all may know who have given both plans a thorough test, that the enema neither shortens the fast nor makes it more comfortable.

While connected with the Macfadden Publications, I once had a controversy with a member of the staff of Physical Culture over a statement in an article of mine dealing with fasting, to the effect that no enema should be used after the fast, but that one may safely wait a week or more for a spontaneous movement. He said: "Surely steps must be taken to move the bowels at least once a day under any circumstances. If the movement is held up for several days or a week, or fourteen days, so much poison is produced in the organism that the advantage of the fast is counteracted and all its benefits lost. * * * It seems to me that the failure of the bowels to move for a week or more would be almost fatal. It certainly would lead to all sorts of complications dangerous to health."

These words voice the prevailing view of the matter, yet this view is wholly false. The fact that patients have gone for over thirty days without a bowel movement and have developed no complications, but have grown steadily better during these periods, proves positively that "failure of the bowels to move for a week or more" is not "almost fatal." One does not lose the slightest bit of the benefits of fasting nor does one develop "all sorts of complications dangerous to health." This is equally true when we wait upon the bowels after the fast is broken. The enema should not be employed when eating is resumed.

Dr. Hazzard claimed the dubious credit of having introduced the enema practice into the procedure of fasting. Dewey rejected the enema up to the time of his death. Dr. Tanner also rejected it. So did Jennings and Page, Dr. Claunch did not employ it. I have not employed it for over twenty-five years and find this more satisfactory than its use. Dr. Page observed: "Tanner had no movement during his fast; Griscomb's experience was similar, and Connolly, the consumptive, who fasted for forty-three days, had no movement for three weeks, and then the temporary looseness was occasioned by profuse water drinking, which in his case, proved curative"--The Natural Cure, p. 112.

It is rare that the colon ever fully empties itself of the water ingested. Carrington says of the retained water, that, since it is perfectly harmless, and will be absorbed and eliminated by the system in exactly the same manner as water that is drunk, is eliminated, no alarm should be felt over its retention. But one case I observed that retained water for twenty-four hours did not absorb it and eliminate it through the skin and kidneys. On the other hand, if the fear of toxic absorption from the colon is based on fact, such absorption of water would certainly result in far greater absorption of toxins than could ever occur without the water. Carrington mentions cases in which there was considerable difficulty in expelling the water (enema) and says that "retention beyond even a few minutes is impossible." In this connection, he is mistaken. Retention for considerable periods, even twenty-four hours, is possible, and we see it often.

Prof. Levanzin says that when enemas are not used during the fast, a "plug of hard feces is formed in the rectum, and another one at the duodenum (upper part of the bowels) is formed by the newly ingested food. The intestines are empty and full of air." To avoid the rectal plug, he advises the enema. The rectal plug is no myth. Were there an upper-bowel plug, the enema would never reach it.

Although a strong advocate of the use of the enema in the fast, Mr. Macfadden says: "enemas are somewhat enervating, and when the patient is already weak, he may find it a drain upon his vitality to take these."--Encyclopedia of Physical Culture, Vol. III, p. 1374. It does not seem to me necessary to resort to enervating practices in our conduct of the fast and for more than twenty-five years I have refrained from the use of the enema. The enema is at all times a drain upon the patient's powers and its use during the fast not only weakens the patient and thus prolongs his illness, but it impairs his colon and he is often weeks and months getting over the effects. The employment of laxatives, as advocated and practiced by some, has the same weakening and debilitating effects upon the colon and they exert their irritating influence upon the stomach and small intestine, also.

Major Austin conducted an experiment upon himself to determine the relative values of the enema and purgation during the fast. He fasted for sixteen days taking nothing but water and half-an-ounce to an ounce of Epsom salts every morning. He was energetic and carried out his ordinary duties, even engaging in and winning a walking match of two miles, most of the distance uphill, on the sixteenth day. He felt a little faint and giddy in the mornings upon arising and had the same sensations at times during the day upon arising after he had been sitting for some time.

Some months after this fast he underwent a second fast of ten days, taking nothing but water and employing a three-pint enema of water each morning instead of the saline purge. He again carried out his regular duties, as before, but had less energy, his tongue was more heavily coated and he did not sleep as well as during the previous fast.

Some weeks later he took a third fast, this one also ten days long. He again used the saline purge each morning instead of the enema. His experience during the third fast was the same as that during the first. He says: "Thus I proved to my own satisfaction, that the use of saline purgatives during a fast makes the ordeal a very much less trying one than is the case when only the enema is used." He advocates as do others (Dr. Wm. H. Hay, for example, in this country), the use of both the enema and the purge and also advocates drinking large quantities of water.

I realize that the foregoing experiment is not sufficient to establish Major Austin's contention; that the experiment would have to be repeated many times on many patients with uniform results, to prove what he claims to have proven. I have repeatedly seen the same excellent results, that he records for his fast during which the purge was employed, in patients who received neither purge nor enema. Patients who have previously fasted under the care of others and who were purged during the fast, have described to me their experience during this time and often they have had more discomfort and weakness than Major Austin had during his second fast when he employed the enema.

Individual actions vary so much during the fast and in the same individual at different times, that the apparent "effects" of purging and the use of the enema in one case cannot prove anything. Let those who perform these experiments now conduct an extensive series of experiments without the use of either enema or purge.

I know the evils of the enema as well as those of the purge. I know that the enema does not reach the small intestine, as the purge does. If we grant the need for either, the purge may be preferable, but I do not grant their need.

Major Austin says: "I may here explain that during a fast waste products and toxins are being continually deposited in the stomach and intestines, and unless these are washed away by large drinks of water and enemas or a saline purge, some of the morbid material is re-absorbed; this causes auto-intoxication and its attendant discomforts, weakness, headaches, etc."

It has never been explained how the re-absorption of a small amount of the large amounts of toxins thrown out will cause symptoms that the whole amount of the toxins failed to produce before they were eliminated. Re-absorption is assumed and symptoms are arbitrarily referred to this. I agree that if re-absorption occurs, it would occur in the intestine and not in the colon and the waste matter could easily be reached by a purge and not by the enema. But does re-absorption actually occur? If so, why does it occur?

I suggest that the practice of drinking large quantities of water, to "wash away" toxins, to "flush the system," may cause re-absorption of toxins. The water is absorbed. It does not pass out through the colon; but through the lungs, skin and kidneys. It will "pick up" and hold in solution, the waste and toxic matter in the stomach and intestine (it does not reach the colon) and it doubtless carries some of this into the body with it when it is absorbed. Drinking only when nature demands water and only so much as she demands will reduce this absorption to a minimum. Until my plan is thoroughly tested all argument to the contrary is wasted words.

Major Austin advises cold abdominal packs and cold sitz-baths to "tone up and improve the condition of the colon, which is left in a more or less flabby state after the warm-water wash-outs."

Reverse peristalsis, starting in the middle portion of the transverse colon and passing backward to the cecum, first noted by Prof. Cannon and now known to be constant in both man and animals, is normally confined to the colon; but in constipation, particularly in colitis, with spastic contraction of the descending colon, these reverse peristaltic movements are greatly exaggerated and, when the ileocecal valve is incompetent, these reverse movements push the contents of the cecum into the small intestine. Water, feces, toxins, waste matter--the whole foul collection--may be forced into the intestine and from here be absorbed and poison the body.

The daily enemas and the purges and laxatives employed by many during the fast, undoubtedly contribute to the nervous depletion against which they often warn us. The fast certainly does not. The claim is made that fasting patients recover more quickly from their ailments if they are given enemas than if their bowels are left to their own resources. This claim is not made by those who have thoroughly tested both methods. For five years I employed the enema in all fasting cases, giving from one to two and occasionally three enemas a day. For twenty-six years I have left the colon alone. If anything, patients who do not have the enema make the quickest recoveries and it is certain that their bowel function is a hundred per cent more efficient after the fast, if the colon has been permitted to attend to its own function in its own way.

Mr. Pearson, who thinks "enemas comprise 60 per cent of the treatment in fasting" and who, himself, took as many as three to four enemas a day during his own fasts, says: "The large quantity of water introduced into the bowels will cause a rapid infusion of the toxic poisons from the bowels to the surrounding tissues, thus inducing headaches" and that "it is advisable to use an antiseptic in the water to reduce these poisonous substances as far as possible." He says he "probably took two to four teaspoonfuls a day" of baking soda, "for about five years in enemas." With Pearson, as with Hazzard and Sinclair, the enema is a fetish. Dr. Hazzard, Mr. Pearson and others advise the use of two, or three and more enemas a day.

Fasting animals do not employ enemas nor anything that may be regarded as serving the same purpose. Fasting seals and salmon, hibernating bears and snakes, fasting sick and wounded animals, regardless of the length of their fasts, employ no measures to force bowel action. Since this thing has been tried out on the plane of instinct for unnumbered thousands of years, and has been approved by nature, we need have no fear of fasting without the employment of enemas.