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.
In Dec. 1932 and Jan. 1933 a patient fasted 31 days in my Health School. His bowels moved on the 2nd, 6th, 7th, 13th and 20th days of the fast. Another patient who took a short fast in December, 1932 had a bowel movement on each of the 4th, 8th and 9th days. This patient then took a longer fast in Jan. 1933 with bowel movements on the 1st, 3rd and 9th days, there being a diarrhea on the 9th day. Another case was that of a young lady who had a bowel movement on the 21st day of her fast.
On July 21, 1933, a woman, age 68 began a fast in my Health School. The fast was broken on the evening of the thirteenth day. She had a bowel movement on the first and second days of the fast, on the third and fourth days there were loose stools; there was no movement on the fifth day; on the sixth day there was one movement and a small movement, only one small piece of feces passing, on the seventh day. This woman had orange juice all day on the fourteenth day, six oranges on the fifteenth day and a good bowel movement followed on the morning of the sixteenth day.
On the same day the foregoing woman began her fast another woman, age 37, was placed on a fast. For a period of twelve days or more, this woman had suffered with a persistent diarrhea. The fast lasted for a period of twenty-eight days and the bowels did not move once throughout the whole of her fast after the first day. The fast was uneventful, there were no crises and no signs of poisoning, but a steady improvement in health.
In April and May of 1948 I had in the Health School a woman from Chicago who fasted ten days and had a bowel movement every day of her fast. This is a rare case, but fasters who have several bowel movements during the course of a fast are very common.
At the end of the year 1949 a woman came to the Health School from San Francisco and fasted thirty-five days. She had eleven bowel movements during the first three weeks of her fast and another movement on the thirty-fourth day.
Contrast these with the case of a young woman, age 25, who was placed on a fast on Feb. 24, 1933 in my Health School and whose bowels moved on the twenty-first day of the fast. In this case there were no crises, none of the symptoms "re-absorption of toxins" is said to cause, but a steady gain in health.
These few cases out of many prove that the bowels will move when there is need for a movement; also they show, as do hundreds of others, that there is no injury from waiting upon the bowels. These cases particularly refute the notion entertained in some quarters that a prolonged fast paralyzes the bowels. This notion finds lodgement in the minds of some who know nothing about fasting, and one usually finds that they do not want to know anything about it. Most of the foregoing cases all fasted before the first edition of this volume was published. Since that time hundreds of similar experiences have been observed here at the Health School.
Prof. Benedict says: "Fasting * * * affects first the amount and regularity of defecation.* * * Owing to long retention in the colon, fasting feces become hard, much dried and pilular, and frequently cause considerable uneasiness. Much difficulty is experienced in passing them, and at times they may cause considerable pain with slight hemorrhages. The use of an enema to remove the fecal matter during inanition is quite common. This method was employed throughout the 30-day fast of Succi — reported by Luciani. * * * Depending upon the amount of food consumed on the day previous, the defecation of the first day of fasting may be quite as regular as on the ordinary days. * * * The most important factor noted was that feces were frequently retained for a number of days together, during fasting with no apparent attempt on the part of nature to effect a movement."
The hard feces he mentions do sometimes form during a fast, but they are by no means the regular or usual developments. On the contrary, they are relatively rare and are usually easily voided. Only in cases of hemorrhoids do they give real trouble. A hard plug of feces stops the anus of the hibernating bear, but he has no difficulty in getting rid of it when he resumes eating in the spring. The feces of the faster is commonly soft, at times loose, only rarely large enough and hard enough to occasion difficulty in passing. In those cases where there is spastic constipation, and in hemorrhoids, the plug does sometimes, although by no means always, become sufficiently hardened as to occasion pain and bleeding in passing. In such cases, it is my practice to employ an enema after the fast is broken, when the patient feels the first urge for stool. No enemas are employed during the fast, even in these cases.
During the first five years of my practice I employed the enema, both in the fast and while my patients were eating, but I particularly employed it in the fast. I had been taught that it was necessary in the fast, that if the enema was not used to wash out the colon, waste matter that had been thrown into this would be re-absorbed and the patient would suffer from auto-intoxication. Two facts caused me, finally, to begin to doubt the wisdom of employing the enema. These were:
1. I found the enema painful when I took it myself and I noticed that most of my patients also found it painful.
2. I found it left me with a feeling of weakness when I took an enema and I found the same thing to be true when my patients were given enemas.
These experiences caused me to do some effective thinking. The first question I asked myself was this: Am I doing right in employing an enervating measure in my care of my patients? I could not get an affirmative answer to this question, no matter how I tried. Then I ran my mind back over my studies of fasting among animals. The question came naturally to mind: If fasting animals, many of which fast for much longer periods than man can ever fast, do not need enemas, why does fasting man require them? I could find no logical reason why man required them while fasting. Then I reviewed the literature of fasting and I discovered that Jennings, Dewey, Tanner and others had not employed the enema. Cautiously, I began to test the no-enema plan. I soon became convinced of its superiority over the enema plan. I found Dr. Claunch rejecting the enema. I discovered that Dr. Page was not an advocate of its use. I had arrived at my conclusion the hard way, only to find that I was not alone.
Dr. Tilden, a frequent and regular user of the enema, admitted that it was enervating. But why should we employ methods of care that further enervate our patients? It is our duty, in caring for our patients, to conserve the energy of each patient in every way possible and not to needlessly dissipate the precious energies of life.
It is our duty at all times to conserve the energies of our patients. All enervating practices should be eliminated from our care of the sick. We may say that no such practices are ever justifiable, except where they are the lesser of two evils and there are rare instances where the enema may be the lesser of two evils. Macfadden, himself a great advocate of the use of the enema and of its use in the fast, says: "But enemas are somewhat enervating, and when the patient is already weak, he may find it a drain upon his vitality to take many of these." — Encyclopedia of Physical Culture, Vol. III, p. 1374.
I soon became convinced from tests I made that there is no absorption of toxins from the colon. At that time, twenty-five years ago, physiologists were still teaching that toxins are absorbed from the colon. Since then, they have changed their minds. The lining membrane of the colon no more absorbs toxins than does the lining membrane of the bladder. If the bladder does not absorb urine which is liquid, how can the lining membrane of the colon absorb feces, which is more or less solid? Answer this question in any way you may, there is one thing of which I am certain and this is, that, no symptoms of auto-intoxication develop during a fast of the longest duration when no enemas are employed.
I am certain of another important matter, namely, that the frequent use of the enema during the fast, as at other times, impairs bowel function, so that after the fast is broken, bowel function is not as efficient as in those patients who have not had enemas. My good friend, Dr. Carlos Arguello, of Nicaragua, put this matter to a test by dividing his patients into two groups and giving one group enemas and the other no enemas during their fasts. After their fasts were broken he kept careful records of the bowel movements of the members of both groups. Those who received no enemas had nearly a third more movements in the same period of time following the breaking of their fasts.
The regular and frequent use of the enema induces several important evils in the colon and their use is not to be recommended at any period of life, certainly not when one is sick and weak and needs to conserve himself in every way possible. At the beginning of 1925 I ceased using the enema and I am much better satisfied with its non-use in the fast than with its use. My patients also escape the discomforts it induces.
The use of "purgative" drugs and mineral waters during a fast is even worse than the use of the enema. Taken by mouth, as these are, they occasion excited and wasteful action with the secretion of much watery mucus along the whole length of the alimentary canal; whereas, the enema reaches only the colon, except in those many cases of chronic constipation in which there exists insufficiency of the ileo-cecal valve. In these cases the water and the feces in the colon are frequently sent back, by reverse peristalsis, into the small intestine, and in some cases, the feces and water are carried all the way back to the stomach and from here vomited. The same thing occurs sometimes with the colonic irrigation, which is but an oversized enema which costs more and cannot be administered by the patient himself.
In these days when we live for our bowel movements and are miserable if they fail to move by the time we are ready to go to work in the morning, the truth about our bowels is hard to get into our heads. We have been well trained by those who have constipation "cures" to sell.
Dr. Tanner, during and after his first fast, had no bowel movement from the 15th of July to the 31st of August, a period of forty-seven days. In commenting upon this fact, Dr. Hazzard declares, "To carry out a fast today in this manner would be deemed a bid for disaster." Why a "bid for disaster?" Both Dr. Tanner and Dr. Dewey repudiated the enema, and to quote Dr. Hazzard, "preferred and insisted upon waiting upon the bowels to act 'naturally' as he (Dewey) termed it." Jennings did not employ the enema, nor did Page. In my own practice I have not employed it for twenty-five years. I had one patient to go for over fifty days without an evacuation and no disaster befell him.
Levanzin reports of his fast of 31 days that, "during my whole fast I had no defecations. I had a bowel movement just before I started the fast, and the next was thirty-two days afterward, when I broke it." He adds: "I did not try to provoke any, as I did not wish to spoil the scientific results; and so, the bad, bitter and upsetting taste in my mouth was very trying." The implication of this statement is that the use of the enema prevents the bad, bitter taste of the mouth. This is not true, as anyone who has ever fasted and employed enemas can testify. The tongue becomes just as heavily coated, the teeth just as pasty and the taste in the mouth just as foul when enemas are used as when they are not used.
Professor Benedict writes of Levanzin that "when discussing the question of defecation he stated that in some of his long fasts he had defecated only once or twice, often he did this shortly after the beginning of the fast, and then not again until after the fast was over, but after beginning eating he was quite normal."
Dr. Jennings reported cases in which the bowels did not act for weeks. I had one man to fast for thirty-six days in my institution without a bowel movement, the bowels acting for the first time on the third day after the fast was broken. Another man fasted forty-nine days with no bowel action during the time. His bowels also acted on the third day after breaking the fast.
One young lady began a fast under my direction on Dec. 3, 1929, and ended it on Dec. 28th. Her bowels did not act during the whole of this period, acting the first time on Jan. 4, 1930; a period of thirty-three days from one bowel action to the next. This lady suffered with the worst case of Psoriasis I have ever seen. Her whole body, face, neck and limbs included, being covered. The skin cleared up rapidly and beautifully during the fast.
Shortly after the foregoing case came to me, a young man suffering with constipation, digestive troubles and "nervousness" began a fast in my institution. He fasted twelve days, during which time his bowels did not act. They acted first on the fifth day after breaking the fast. During these seventeen days without a bowel movement the patient made great improvement.
No harm ever came from waiting upon the bowels. They may be depended on to function if there is a need for action. If no need exists, there can be no gain from forcing them to act. We should learn to distinguish between the forcing and the actual need for bowel action.
It has been noted that dogs and other animals do have bowel actions during a fast. In my own practice I have noticed that the stronger and more vigorous are more likely to have bowel evacuations. The weak, those who suffer with lowered gastro-intestinal tone or with visceroptosis are least likely to have an action of the colon while fasting. In any case no harm results from letting the colon alone and forgetting that it exists.
Dr. Harry Finkle makes the absurd claim that fasting paralyzes the colon. It does nothing of the kind, but improves colonic function in every instance. The enemas, colonic irrigations, purges, etc., almost do what he says the fast does. The great difficulties many men have with fasting arise out of the fact that they have not observed the effects of fasting, but fasting plus a lot of therapeutic measures. They think they are observing the effects of fasting, when they are merely watching the effects of something else. They insist upon treating their fasting patients with all of the harmful cure-alls which chance to be in fashion, and then attribute any evil results to the fast, although such evils are frequent results of these treatments when applied to non-fasters.
Fasting animals, whether hibernating, æstivating, fasting during the mating season, fasting during illness, or fasting because of a lack of something to eat, do not have and do not need enemas. Some of these animals fast for much longer periods than is possible for any man and do not die of nor suffer from the much-feared poisoning by absorption from the colon. I can find no proof that poisons are ever absorbed from the colon; but, assuming that they sometimes are, the absorption of a very small fraction of what was thrown into the colon can certainly produce none of the evils attributed to it. If it could, the whole of the material thrown into the colon would have killed the patient before it was thrown therein.
The Canadian bear enters upon hibernation with a flesh that is repugnant to flesh-eaters. When he comes out of hibernation his flesh is sweet and is considered a great delicacy by the people of the North. Canadian biologists describe the bowels of a bear that had just settled for the winter, and which they opened, after killing the bear, as emitting a stench that was "overpowering," the flesh "nauseating, fishy and unfit for food." By Spring the bear's flesh has undergone a complete and remarkable change, so that it is "the most sought-after of all northern foods." By this time very little residue is found in the digestive tract and "the bowel was odorless and quite sterile. No cultures of any of the usual intestinal flora or bacilli could be obtained."
This complete sterilizing and deodorizing of the intestinal tract together with the sweetening of the flesh of the bear, all without a bowel movement in four to five months, or in some cases longer, will not be easily explained by those who insist upon the urgent need of enemas in the fast. As the hibernating bear never suffers with autointoxication during the most prolonged period of hibernation, we are forced to accept the fact that he is not poisoned by any hypothetical re-absorption of waste from the colon.