The autopsy disclosed the lungs completely filled with an exudation of serous fluid, a condition that was the immediate cause of death. The surface of the body for several weeks had been discolored in spots, these blotches, or cyanosed areas, indicating an obstructed circulation. This symptom is sometimes present in cases of cirrhosis of the liver, and the latter organ was found in an advanced stage of atrophic hardening. The stomach held but eight fluid ounces, and it could hold no more, for its outside muscular coat was in a permanent state of contraction, while its mucus membrane was very much thickened, making the walls of the organ at least one inch in depth or thickness. As a result of the contraction of the outside coating of the stomach, it had become elongated into a tube, and its normal capacity was much diminished. The duodenum and the upper three feet of the small intestine were dilated so that their lumen was three inches in diameter, a structural change which suggests the thought that nature had attempted to remedy in this portion of the alimentary canal the deficiency in size and function existing in the stomach. It is said that cirrhosis of the stomach is a symptom very rarely observed in disease, but in this case and in the one that follows, this organic change was present in forms that could scarcely have been more perfect examples of their kind. Continuing the post mortem findings, below the dilated section of the small intestines the remainder of the tract including the entire colon was apparently normal in size and in functional ability. The gall bladder was small, while the kidneys, the pancreas, and the spleen all exhibited signs of tissue hardening.

Case 11, an unmarried woman of thirty-three, had never passed a year during infancy and girlhood free from acute illness, and had been a sufferer through all of her later life from nervous exhaustion that at frequent intervals was accompanied with morbid craving for food, a desire which was satisfied without reason whenever it occurred. About five years before death the medical adviser of the patient ordered that she take some sustenance every two hours during her waking moments, with a full meal just before retiring. In addition to her other suffering, for many years at the menstrual period, the young woman was compelled to lose four or five days from her duties. She had sought the world over for relief, and about two years before consultation had turned to natural agencies for health restoration undergoing then a fast of ten days. At the time the case was presented for examination there could be no doubt but that some aggravated form of organic disease existed, and no encouragement was offered in prognosis, but it was agreed that the treatment given should be aimed at the relief that a light diet, coupled with the essential eliminative accessories, would be certain to afford. This course was pursued for a period of eighty days, when death occurred. The case when first seen showed a cyanosed condition of the skin; the cheeks were blue and veined, as was the nose, and the entire surface of the body exhibited deplorable deficiency in venous circulation. This state improved to some extent after entering upon the dietary regimen.

Examination of the body after death revealed a liver and stomach cirrhosed, the stomach walls showing no evidence of recent function, being approximately three-quarters of an inch in thickness. The small intestines, infantile in size, were of the consistency of cartilage in sections, and adhesions were present at various points. The colon was no larger than an adult thumb throughout its length, and it also exhibited adhesions. The only organs of the body that were in anything like a condition of functional capability were the lungs and the heart. The kidneys, the spleen, and the pancreas, as in the previous case, were incipiently hardened.

In several of the cases quoted it has been mentioned that the patient after the beginning of a fast, experienced a renewal of vitality for which no solid physiological foundation existed. Nature, struggling to restore organic function, invariably makes the effort commensurate with the gravity of the existent defect. By the removal of the labor of digestion at least one-half of the total organic work of the body is lifted, and relief that simulates recuperation is manifested despite structural deficiency in the machine. In the presence of serious organic disease this seemingly favorable symptom is of short duration, and, as it passes, very evident decline begins and progresses until nerve centers and brain no longer receive adequate support and the body dies. In Cases 3 and 4 the relief experienced after the first fast was sufficient in each case, with organs still partially able to function, to enable the system to maintain itself until accumulation again became too great to permit of continuance. Defects in organism, too serious to have been corrected in the earlier treatment or in the interim, now reached the stage either of degeneration or of atrophy, until finally liberation of the life principle became no longer possible.

When a case is first presented for examination the presence of serious organic defect cannot always be determined, but no doubt is permitted shortly after entrance into a fast, for within a week or ten days symptoms are displayed that fix conditions. The third week positively decides the outcome. In the two cases last described signs of organic disease were such as not to be mistaken from the very first. Soon or late the result in these and like instances must be death, and all that can be done towards possible recovery must in the circumstances prove of no avail. Because of the hopeless outlook the cases described were placed upon restricted diet; a diet that put no undue strain upon failing function, but that, nevertheless, did not ameliorate the distress of disease as would an absolute fast. Family anxiety and outside criticism prevented the employment of the latter agency. In the circumstances life was prolonged for several weeks, but it is virtually certain that, if food had been entirely excluded, relief would have been greater and days would have been added to existence.

Disease that is functional in character is self-limited. The amount of poison manufactured within the body is determined by the intake of food or of drugs, and eradication of disease is fixed in limit of time by the ability of vital organs to resist and east out toxic products. The possibility always exists that these organs may prove unequal to their work, and this possibility becomes a certainty, with death as the outcome, in two situations--one, when the organs themselves are structurally defective, and the other, when, though fully capable of normal function, their powers are stimulated by food or by drugs, or by both, to the point of exhaustion. But one of these conditions, that of irreparable organic defect, presents itself when disease is treated by means of the fast. Both are encountered in the therapeutics of medicine.

In the majority of instances in medically treated cases the passing of life occurs under the influence of opiates that deaden pain and paralyze consciousness. Virtually from the beginning of a fast pain ceases, consciousness is usually maintained with exceptional mental clarity, and death, if it occurs, is like falling into gentle sleep.