There is a popular belief that the work of purification can be finished with a diet and, in many cases, this is true, providing the patient is willing to greatly restrict himself for a sufficiently long period of time; but it is the rule that the patient who will not carry the fast to completion will also refuse to control himself and stay with the requisite dietary restrictions sufficiently long to accomplish the desired end. Because it is easier to fast than to restrict one's eating, one is more likely to abandon a restricted diet. It should be known that there are no "seven day cleansing diets."

Carrington says: "We have now seen that it is impossible to tell a priori, when to break a fast. No arbitrary time limit can be set, no definite date fixed upon before hand and asserted that it would be the most advantageous for the patient were the fast broken on that day. Nature will always dictate when the fast is to be broken, if we but interpret her right. The return of natural hunger is the great point to note, and the most important indication that the fast is ended, and the system is able and willing to digest and assimilate nourishment, in the form of either solid or liquid--food. The spontaneous and precisely coincidental cleaning of the tongue, of the breath, and of other lesser phenomena which may be observed toward the termination of a 'finish fast,' all indicate that Nature and Nature alone, is the authority to be consulted as to when the fast should be broken; and inversely proves conclusively that fasting is Nature's cure . . . "--Vitality, Fasting and Nutrition, pp. 556-557.

I agree fully with Carrington that there is no means of determining in advance how long any patient needs to fast. No arbitrary limit should be set to the fast, except in those instances where the patient has but a limited time to devote to fasting. No definite time can be fixed in advance when the fast should be terminated. The body itself will always signify when the fast should be ended. Theoretically, this is all correct; but we deal with all types of patients, with all types of mentalities and of all degrees of economic wellbeing and with many and varied responsibilities. We are compelled, therefore, to break fasts when in our better judgement, they should not be broken, to break them far in advance of the time nature would indicate they should be broken. Levanzin says: "It is always inadvisable to break a fast before natural hunger appears; and as a rule, there is no reason why you should."

A few more words should be said about the return of hunger. We have many patients saying they are hungry when they are not. They mistake many different sensations, chiefly morbid sensations, for hunger. After a short wait, the supposed hunger passes, whereas, the genuine article persists until food is taken. It is necessary to differentiate between real hunger and the many sensations that are commonly mistaken for hunger.

Individuals undergoing a fast on their own and without supervision, have been known to push their fasts into the starvation period, refusing to eat after the return of hunger, merely because the tongue was not clear. This is a mistake and has proved fatal in more than one case. We may always avoid a mistake of this nature if we keep always in mind the fact that the return of hunger is the central indication that the fast should be broken.

Mr. Carrington writes of a race between the successful elimination of toxins and the amount of flesh upon the body, and hunger not returning before the starvation period or even death occurring, because there is not sufficient flesh upon the body to feed the vital organs while the work of elimination is being completed. I have never seen anything of this nature. I have seen cases in which hunger has returned and the tongue was still heavily coated. I have seen the tongue clear up days in advance of the return of hunger. I have said, as a result of such experiences, that if the tongue is clear and hunger has not returned, it means that the body has been cleaned before the reserves have been exhausted; while, if hunger returns and the tongue is still coated, it means that the reserves have been exhausted before the body is fully clean. I have seen a few cases in which the tongue never coated throughout the whole of a long fast. I am sure, also, that if the patient's reserves are carefully conserved by mental, physical and sensory rest, there is much less likelihood of his reserves being exhausted in advance of the completion of the work of elimination.

The man experienced in the employment of the fast does not start out to have his client break all records in fasting; but he does start the fast with definite objectives in view. He wishes to reduce weight, reduce blood pressure, relieve the organism of accumulated waste and of food excess, to rest the vital organs, and relieve the nervous system of irritations. If possible, he wants the fast always to continue until these objectives are accomplished.

We should not expect a few days of fasting to completely reverse pathological processes that have been decades in developing, or to enable the body to completely remove the pathological accumulations of years. Too many people go on a fast and, from ignorance of their own or that of their advisors, give up before they have achieved the desired results. These people may often be heard to say: "I tried fasting and it did me no good."

There are patients who do not need a complete fast, and those who should not have a complete fast, as well as those who do not get well without a complete fast.

No hard and fast rule can be set down to guide us here. Each case will have to be handled according to its own needs and according to the general condition of the patient. Ordinarily the fast should continue until the desired results are achieved; yet there are cases, as will be seen later, where this is not feasible. In acute "disease," one is always safe in continuing the fast as long as the acute symptoms continue and for as long thereafter as nature does not call for food. But in chronic "disease" one may not always fast to completion. If a chronic sufferer has begun a fast and it is giving him no difficulties there can be no reason for discontinuing it until the results desired are obtained, or until nature indicates that it should be broken. But it is not wise to arbitrarily set a goal of thirty days or more, as many fasters have done, and make a stunt of the fast. Where a long fast is required, nature herself can be depended upon to indicate when it should be broken. In many cases it is probably better to resort to a series of short fasts with careful feeding rather than to attempt a long fast.

One school teaches its students that "Generally speaking, the use of several fasts of four to seven days each is just as effective as one fast for several weeks." While there are cases where we are compelled to employ a series of short fasts in this way, it has not been my experience that a series of short fasts is as effective as one long fast. I do not know of any one who has had long experience with fasting who claims that such has been his or her experience. Dr. Hazzard does not favor this view. Neither does Carrington. The works of Macfadden are full of contrary expressions, as are the works of Tilden.

Those who cater to popular fears and prejudices and those without experience, favor short fasts, often a series of them. This plan is also preferred by those who desire to drag a case out as long as possible in order to get more money out of the patient. It is not always easiest and best for the patient to take a series of fasts. In his experiments with salamanders, Morgulis found that a single protracted fast was less injurious than intermittent fasting--a series of short fasts. With exceptions to be noted elsewhere, this is also our experience in fasting men, women and children. It should be known, also, that weak and underweight patients often stand fasting much better than strong and overweight patients.

It has been my experience that in all cases, where the long fast is possible, one long fast is far more effective and more satisfactory than a series of short ones. No plan of feeding between the fasts will accomplish what the fast will do, if continued. The length of the fast must be governed by the patient's condition and by the results obtained.

There are those who object to a long fast on the ground that it constitutes such a shock to the nervous system and such a drain on the vital resources that lasting injury results. I have not personally observed any of the evils attributed to the long fast and do not find such results described by those whose experience with fasting entitles them to speak on the subject. On the other hand, I find that when some of the examples cited, as showing that a long fast injures the body, are checked up, they are found not to prove any such thing, but the opposite.

In 1886 the painter, Merlatti, fasted fifty days in Paris. It is asserted that he was in bad condition at the end of the fast. I have been unable to check up on this assertion and do not know how true it is. His heart action and body temperature remained normal throughout the fast. Pashutin records that he was watched after the fast.

The statement is sometimes made that after his forty-two days fast in 1877, Dr. Tanner was in such bad condition he had to be placed under medical care. This statement is very misleading. Dr. Tanner had been in very bad health for years preceding his fast and undertook the fast to recover health. He was under the observation of a physician through the whole of the fast and thereafter for some time. He actually regained his health by and through the fast.

Dr. Tanner occupied a room in the home of Dr. Moyer, in Minneapolis, Minn., during this fast and was attended daily by Dr. Moyer. According to his own testimony he "had given up hopes of ever regaining what might be called normal health" and undertook the fast only after he had "virtually collapsed" and "was at such a low ebb physically and mentally that" he "did not care whether" he 'lived or died" and "determined," as he says, "that, since my drugs gave me no relief, I would starve myself to death ere I again would suffer the physical misery that had been mine for months preceding."

At the end of ten days of fasting all symptoms of his disorder disappeared and Dr. Moyer attempted to induce him to discontinue the fast. Tanner persisted to the end of the forty-second day. His health was distinctly improved.

His medical colleagues refused to believe that a man can go so long without food, so, "in order to relieve myself," he writes, "of the odium heaped upon me by the medical enemies" of his claims to have gone without food, in 1880, he underwent another fast of forty days beginning June 28, and ending at noon August 6. This fast was public and observed by many medical men and the whole story flashed to the world daily by the newspapers and telegraphs. Tanner's health was not impaired by this fast.

In general, it may be safely advised that if a fast is undertaken it should be done with satisfactory results as the end in view and stay with it until results are forthcoming. Thousands of sufferers attempt to do with a fast of two to four days what can only be accomplished by a fast of two to four weeks or more. "I tried fasting and it did not help me," they say. Playing around with short fasts and semi-fasts will seldom give satisfactory results. Fast for results or forget it--this is my advice.

The body cannot undo, in three to four days of fasting, the results of years of surfeiting and of unhygienic living. The most rapid recoveries are seen in acute "diseases" and three to four days of fasting is seldom enough in these. Longer fasts are required in chronic forms.

If the pathological condition of the patient does not demand or permit of a complete fast, it should not be insisted upon. The patient must be carefully watched and if any danger signals arise, the fast should be broken despite the fact that hunger has not returned and the tongue is still foul. These are cases in which it is better to be safe than sorry.

Long fasts are seldom or never advisable in advanced tuberculosis. Short fasts can aid but little in cancer. Catarrhal troubles are seldom or never overcome during a short fast. A long fast is usually required in rheumatism, arthritis, and gout. Long standing digestive complaints usually require a long fast. Diabetes and Bright's "disease" call for a long fast, as do most forms of heart trouble.

In inflammation of the digestive tract, such as gastritis, enteritis, peritonitis, dysentery, diarrhea, typhoid fever, typhus, cholera, typhlitis, appendicitis, etc., it is essential that fasting be continued for several days after fever and other symptoms have subsided. Even in mild acute disease, it is well always to continue the fast for at least twenty-four hours after the symptoms have subsided.