FASTING (see 10.193).—The adoption of “hunger-striking” in prison by some of the militant suffragettes in England, just before the World War, and by Irish Sinn Feiners subsequently, has served to call attention to the physiological fact that the human body is capable of more prolonged fasting (abstinence from food) than had generally been realized. Before they gave these demonstrations of endurance, fasts of 40 or 50 days had been regarded as extreme cases. In 1920, however, the Lord Mayor of Cork, Terence McSwiney, maintained his hunger strike in Brixton prison during 74 days, and, though subject to fits of delirium, he was stated to have been conscious until within a few days of his death.
From a purely scientific point of view it is regrettable that no definite medical record of this and other long “hunger strikes” was officially published, in such a way as to provide positive evidence that no “food” (apart from water and medicines) was taken, since there were naturally suspicions to the contrary in spite of all questions in Parliament on that point being answered in the negative. It can only be assumed that such allegations were unfounded. It has been shown therefore that, if the hygiene of fasting is carefully carried out, the mere lack of food becomes of small moment to the preservation of life for several weeks. The beginning of a fast is its most painful period, for during the first 48 or 36 hours hunger pains, occasioned by peristaltic contractions of the stomach, persist. These pains at first increase in severity during some hours, then, if no food is taken, they begin to pass away. Once they have disappeared they do not, as a rule, return. The fasting individual passes into a condition of comparative ease and comfort. The future now depends on the care with which the debris, collecting in the alimentary canal, is evacuated—for the bowel goes on producing waste matter in spite of the absence of food. Purgation is therefore necessary, and enemata are usually administered. The skin tends to exude an oily detritus, and unless this is removed constantly a fæcal odour will be experienced. Here again, however, the beginning is the worst period. After some days the problem of maintaining health is much simplified, and the patient, though increasing in weakness, experiences small inconvenience. This period is, however, often characterized by hallucinations, the mind being dissociated from its material surroundings. Visions are frequently described and strange manifestations announced. The patient is now approaching the time when he must break his fast or die. Recent investigation suggests that death will be due to acid poisoning, and it is stated that the administration of what are called “buffer salts,” for example the acid phosphate of sodium, is instrumental in postponing the fatal issue. In any case the end is apt to occur suddenly, the patient becoming collapsed without warning. If the fast is broken with a little fruit juice and then milk given for a day or two no untoward results seem to follow. Indeed, many people derive benefit and practise occasional fasting for a short period as a therapeutic measure. The Allan treatment of diabetes is an instance in point. There are many cases on record of men walking considerable distances on the 40th day of a fast, and shorter fasts have been fairly common. It need scarcely be added that water is taken throughout the period of abstinence in all instances. (R. M. Wi.)