Gandhi—In his autobiography, he describes his use of the fast and dietary restriction and its great influence on his life's work. It was his observation that passion and the hankering after pleasures of the palate were best brought under control through this means. He goes on further to elaborate that when the senses are subordinated to the rule of the mind, the special relish disappears and man can truly function as it was intended he should.(6)

It would seem that these illustrations reinforce the idea that in times of life's real need to find new sustenance, the fast with its physical cleansing, mental clearing and spiritual mountaintop experiences can open up new vistas on the path of life.

The Type of Fast and Its Length
The true fast is without doubt the water fast, but experience reveals that this is by no means desirable for all would-be fasters. Accordingly there are many modifications, some suitable and others that are of very questionable merit or even potentially injurious. The fast from both food and water will not even be considered because of the grave dangers that may be associated with its use. In the medical literature, as has been mentioned, the major, almost sole, subject of fasting has been in relation to the control of obesity. Here it has an important role, especially when used along with daily group therapy under staff guidance. When used on an outpatient basis, however, we would tend to restrict it to the overweight patient who has had previous experience with fasting and has been medically evaluated by a physician. Even in this instance we would feel that the patient should have available telephone contact with the guiding physician and a weekly evaluative office visit.

The water fast may also be used for patients other than those with weight problems if they have an adequate fat reserve, that is to say if the skin and subcutaneous tissues of the upper arm when pinched with a caliper measures no less than 20 mm. in the case of women and 15 in that of men. If less, consideration may still be given to a juice or a raw foods fast. In all the above instances, the fast should be supervised by a physician familiar with the procedure. Some of the problems most commonly well handled with fasting include hypertension, arthritis, allergies and headaches along with the detoxification from the use of multiple drugs or tobacco. In our experience this is a very valuable method of handling the problems of the undesirable side effects from long term cortisone therapy. However, in the latter instance, the procedure must be done very slowly, milligram by milligram over a period of time and usually will not be completed in the first fasting experience.

As cited in the medical literature, fasting for obesity has frequently been continued for sixty days and at times considerably longer. The most usually prescribed fast at Meadowlark lasts from two to three weeks. The maximum was 34 days. In that instance the patient was suffering from severe anklyosing arthritis of the spine, such that she had no possible neck motion and had to turn her body to look to the side. There was also associated moderate obesity. This particular guest discovered during the fasters' group therapy that her body stiffness bore a striking parallel to a very unbending religious system in which she felt enmeshed. Toward the end of her fast as she was increasingly allowing herself to express pent up feelings, she began to notice a beginning of motion in the upper spine.

A further use of water fasting is in the emerging field of medical ecology pioneered by Doctors Coca, Randolph, Philpot, Dickey and others.(7) This is in the nature of what is referred to by them as presumptive food testing. That is to say, after four to five days of water fasting when symptoms have quieted down and frequently been accompanied by a drop in the pulse rate, a large meal of the suspected food is given as a single meal, symptom return is noted and the suspect food either discovered or eliminated as a source of symptoms. A case to illustrate:

P.U., a 35-year-old housewife, was seen by me a few years ago complaining of depression, irritability, excruciating headaches, rapid heartbeat, a tremor of her hands, sinus congestion and urinary problems. After a four-day water fast at Meadowlark her symptoms were relieved. Presumptive food testing revealed that following the ingestion of milk her sinuses became congested; following a meal of corn her tremor developed; a headache became evident subsequent to the ingestion of a meal of bananas, and her bladder symptoms followed both rice and strawberries. Two months later she reported no further headaches, bladder trouble nor depression and her marital relationship was vastly improved. The subsequent month, as often happens when one feels much improved, she became lax with her dietary restrictions and practically all her symptoms returned.

The most common of the reacting foods are those which are consumed most regularly, frequently on a daily basis giving the impression that this frequency of ingestion probably exceeds the body's ability to supply the vitamins, enzymes and minerals required to ensure proper absorption and assimilation. The results often are the cited symptoms of toxicity. Also, life's stresses that are not adequately being handled seem to play a role in these events. And symptoms certainly may also be brought to light by pesticides and other chemicals in the foods, water, the air, clothing, or elsewhere in the immediate environment. While all of these factors play an important role in health, let us not for a minute become imprisoned in a world seemingly controlled by the environment. A hundred years ago a leading homeopathic physician, Dr. James T. Kent, gave good counsel in this regard:

The partial or juice fast also finds a place for all the conditions previously recounted and is less threatening to many. Needless to say, the time needed for results may be longer, but the patient's emotional attitude will be superior, particularly if there is a lack of self-confidence with its frequently accompanying feelings of self-deprivation. I prefer the patient to have a choice in the type of fast and the length of fast. For some, even a juice fast is too severe, and in such cases there is a real place for a partial fast, limited to raw fresh vegetables or fruits as practiced at the BircherBenner Clinic.(8)

Fasting, When and for Whom?
In the past the progress of life and the consciousness of one's relationship to the universe as a whole was mirrored in the observance of the fast. Man was very conscious of the fact that he was part of a whole that far surpassed the boundaries of his physical body. He intuitively knew that if he lost sight of his own body rhythms and got out of step with the seasons of the world about him he would likely fall ill. It is of interest that we are only recently rediscovering the importance of these rhythms and their part in everyday life.(9)

In accordance with this principle, times of fasting have in the past coincided with the seasons and the solar system's inherent rhythm. Note the Lenten fast in conjunction with the full moon of Easter in the Christian tradition, and the corresponding Passover fast associated with the same full moon of the Hebrew month of Nasar. Certain cultures have timed the planting and harvesting of their crops according to similar time schedules. Moses and Jesus were both aware of the needed season for a fast and each picked a period of forty days. In Islam, where the fast is adhered to more strictly than in the Judeo-Christian culture, Ahmad Sakr reports that the faithful Moslems all over the world are required to fast throughout the month of Ramadan, the ninth month of their calendar. In his words:

Further, not only does the season of the year but also the exact time of day have significance. When the human body approaches a state of homeostasis, it once again picks up these universal rhythms. This is obvious in the case of menstruation. It may also be observed in many blood determinations such as the pituitary clock and its maximum output of ACTH between 4 and 8 a.m. And even further, observation will reveal the relationship of the human endocrine system to this all-pervasive timepiece. The endocrine clock in association with the advent of puberty has been a time for a fast for the American Indian." I would like to think that once again we may discover the influence of these natural rhythms and their effect on health and their relationship to times for fasting.

It is the person who has become aware of his inner environment, its discovery and cleansing, that usually benefits the most from the fast and its attendant therapy. It was from this standpoint that Moses, Jesus and Gandhi were led into their fasts. During the last decade, approaching as we are the so-called Aquarian Age, there is much evidence of a new hunger to obtain sustenance capable of replacing the spiritual vacuum so prevalent in the materialistic world. The heart is sick! Through all eternity, this centrally placed human organ has symbolized the all-powerful role of love. Could this be the reason for the increasing number of deaths from heart disease? In spite of coronary care units in hospitals, by-pass surgeries and trained resuscitation teams, the long-term results have been to accomplish little toward increasing the span of human life. And so it is not only the outward aspects of health that prompt people to come to Meadowlark, and once there to choose the fast as an aid to finding new avenues of meaning in their lives, to finding fresh contacts with their spiritual natures. This desire for the fast often comes to them as an inner feeling of guidance.

But if considering only the traditional manifestations of health problems, who should avoid the fast? The medical literature is by no means clear cut when considering the possible relative contraindications to fasting. However, I would like to list these with my own feelings:

• The hypochondriacal patient with deep emotional needs
• Pregnant women, and for the most part, children
• Severe bronchial asthma
• Diabetes
• Epilepsy
• Malnutrition
• Ulcerative colitis
• Terminal illness

In the first instance, as related in the book, Some Unrecognized Factors in Medicine,(l2) the anonymous physician authors state that the hypochondriacal, hysterical patient, as we have also found, is a poor candidate for the fast. So often these persons have never really lived a life of their own. They have tended to live at the beck and call of some other individual and as a result have never truly felt fulfilled. To ask them to make the sacrifice of their food for a period of time can be just too devastating for their inner development and growth.

Concerning pregnancy, I can see a juice fast with juices being prepared daily under a skilled nutritionist (and I am not referring to the usual hospital dietician) as a possibility in toxemia or marked obesity. Such a patient should also be evaluated daily by the physician.

A similar, partial fast may also be appropriate in the case of a child. From the physical standpoint, juvenile onset diabetes or adult type where there have been spells of coma or severe acidosis, severe asthma, frequently necessitating hospital admission, and epileptic seizures might be considered contraindications to the fast unless carried out in a suitable hospital setting. I have in the past found this possible in our own local hospital.