The volume of urine excreted during a fast, as at other times of life, is determined by the amount of water consumed and by the amount of sweating done.

In the early days of the fast, the urine is invariably dark in color and high in specific gravity, strongly acid in reaction with abundance of urea, phosphates and bile pigment. Its odor is foul and strong. It becomes lighter in color and loses its offensive odor as the fast progresses. After the first increase in elimination has passed, specific gravity is lowered, and the quantity of mineral substances decreases. Specific gravity may go as low as 1.010. Its acidity is increased at first, but towards the end of a complete fast the urine may become neutral or even alkaline in reaction.

Dr. Hazzard says: "The hibernating bear never soils his den with urine or ordure, for no waste is formed, consequently none is voided." This is a very marked difference between hibernation and fasting.

Examination of the urine of Succi, made by Apollo and Solard, showed its toxicity to be much increased. Dr. Kellogg draws from the increased elimination of toxins from the body, the strange conclusion that it shows conclusively that fasting is not an efficient means of cleansing the body of poisons. The increased elimination of toxins, shown in the case of Succi, proved to Dr. Kellogg that elimination is checked.

True, he thinks the increased urinary toxicity results from absorption from the colon, but there is no reason why there should be more absorption from the colon during a fast than when one is eating, and certainly there is less in the colon to be absorbed.

Kellogg tells us that fasting produces all the evidences of intestinal auto-intoxication. This is decidedly not true, but on the contrary, fasting is the speediest means of eradicating such intoxication.

It has been my observation that intestinal auto-intoxication is found in those who habitually eat, and eat excessively. In discussing intestinal auto-intoxication Kellogg himself traces it chiefly to dietetic errors rather than to fasting.

The increased toxicity of the urine of the fasting person is due to increased elimination and not, as Kellogg reasons, to the fact that "fasting is not, as claimed, an efficient means of cleansing the body of poisons." I presume that to satisfy Kellogg that fasting is an efficient means of increasing elimination we would have to prove that the kidneys wholly cease to excrete toxins. He seems to think that fasting should send the toxins out of the body through some secret channel rather than through the organs of elimination, or else, that by some subtle alchemy, these toxins should be transmuted into angels of mercy and left in the body. The fact that they are eliminated in greater abundance somehow proves to him that elimination is checked by the fast.

Benedict says of the urine during a fast: "Complete fasting during which no water is consumed results in lowering in a marked manner the total amounts of urine voided per day. * * * In general, when water is taken during a fast, the volume of urine approaches more nearly that voided by people under normal conditions. Indeed, when moderate amounts of water are consumed, the volume of urine presents as a rule no noticeable abnormalities.* * * In general, then, during the early stages of a fast, with the exception of the first day, the volume of urine is in large measure determined by the quantity of drinking water consumed. If the amount of ingested water is small, the volume of urine may exceed it several times. When the volume of drinking water is over 1000 cc., the volume of urine is usually not far from that of the water consumed. * * * In all of the samples of urine, whether tested by periods or for the whole day, the reaction was acid. The pressure of other work prevented an accurate determination of acidity. According to Brugsch, however, the acidity, at least in the later stages of a prolonged fast, remains nearly constant from day to day. * * * All the specific gravities observed came well within what would be termed normal limits. * * * In general, the average amount of total solids during the different experiments is not far from 40 grams per day.* * * The only data regarding the ash elimination during fasting with which we are familiar are the quantities in the urine of J. A. On the last day with food the total ash of urine amounted to 23.0 grams; in the five fasting days, the total ash eliminated was 14.7, 6.7, 5.7, 5.0, and 4.5 grams respectively. * * * In general, the amount (of organic matter) eliminated ranges somewhere between 30 and 40 grams * * * The proportion of ash in total solids, as a rule, is greatest on the first day and markedly less on the second day. * * * There is a tendency for the nitrogen excretion to approach constancy on the fourth day.* * * In considering the long experiments, it is noteworthy that the carbon elimination is invariably lowest on the first day, and on the remaining days is relatively constant. * * * The excretion of total crea-tinine, namely, performed creatinine plus creatinine formed by heating the creatinine of the urine with acid, remains singularly constant on all days of the fast, even during the 7-day fast, experiment No. 75. * * * While the quantity of performed creatinine gradually diminishes as the fast progresses, the amount of creatinine, which in normal urine, is extremely small, gradually increases, and on the sixth day of the fast, there is excreted 0.585 grams of creatine. * * * The proportion of creatinine has a distinct tendency to diminish as the fast progresses. * * * During even a short period of inanition, the uric acid output may be greatly reduced.* * * The excretion of sulphur increases on the second day. There is an increase on the third day, and a steady diminution on the succeeding days of the fast.* * * There is, as a rule, a tendency for the phosphoric acid to increase for a few days after fasting begins and then subsequently diminish. * * * The chlorine elimination on the last food day is invariably larger and on the first fasting day there is usually a marked diminution in the amount."

Dr. Eales says: "I have a record of a case where on the twenty-eighth day a large amount of sediment appeared in the urine and the temperature, which had been sub-normal for years, immediately rose to normal after the urine cleared." This case is of interest, not merely as indicating increased elimination of toxins by the fast; but also as showing how the fast brings about a return to normal temperature in cases where sub-normal temperature exists. In this case, at least, it would seem to have returned to normal as a result of the elimination of material which had interfered with heat production or heat conservation.

One of my own cases passed a large quantity of sediment in the urine which was flaked and looked like flakes of iron rust. No analysis was made to determine the character of the sediment. Another case had an abscess of one kidney (which had been diagnosed, after being X-rayed, as a kidney stone and for which an operation had been advised) to drain, an eight-ounce glass full of pus passing at one time.

Daily determination of the specific gravity of the urine was made during the fast of Dr. Eales. On the first and second days of the fast his urine had a specific gravity of 1.015. On the third day the specific gravity of the urine was 1.018. It rose to 1.020 on the fourth day and to 1.023 on the fifth day. On the sixth day it dropped to 1.022; was 1.020 on the seventh and eighth days; 1.018 on the ninth and tenth days; 1.020 on the eleventh and twelfth days; 1.022 on the thirteenth; 1.020 on the fourteenth, fifteenth and sixteenth days; 1.018 on the seventeenth, eighteenth, nineteenth and twentieth days; 1.019 on the twenty-first day; 1.018 on the twenty-second and twenty-third days; dropped to 1.005 on the twenty-fourth day, due to the consumption of large quantities of water; rose to 1.012 on the twenty-fifth day; back to 1.018 on the twenty-sixth; 1.020 on the twenty-seventh; 1.016 on the twenty-eighth; and 1.018 for the last three days of the fast. During the day of the tenth day of the fast, following an enema and a bath, the specific gravity of the urine fell to 1.010.

Except during the first five days, the doctor consumed habitually during the fast two quarts of distilled water each twenty-four hours. The volume of urine kept up through the whole of the fast, about sixty-five ounces being excreted every twenty-four hours. On the last day of his fast his record shows his urine to have been normal in color and reaction.