(Source: Guidelines for the Differentiated Use of RDTfor Certain Internal and Neuropsychiatric Diseases, USSR Ministry of Health, Moscow, 1990.)
RDT is prescribed after a comprehensive clinical and laboratory examination (complete blood count, urine, stool ova test; biochemical blood tests: total protein, albumin, globulins, sugar, aspartate aminotransferase, alanine aminotransferase, bilirubin, creatinine, potassium, sodium), instrumental examination (fluorography, ultrasound, esophagogastroduodenoscopy, ECG), as well as doctors’ consultations –gynecologist, dentist, otolaryngologist, and others, if necessary.
A laxative salt is prescribed to cleanse the intestines: 40-60 g of magnesia sulfate internally, dissolved in 100 ml of warm water. At night, a cleansing enema is conducted using 2 liters of room-temperature water. After that, food intake is completely halted.
The duration of abstinence from food is prescribed individually, depending on the initial body weight, physical condition, and age. In most patients with normal initial body weight, the therapeutic effect of RDT is achieved after 12-21therapeutic fasting, less often after 25 or more days.
Clinical signs of the completion of therapeutic fasting are: the tongue is cleared from plaque, bad breath disappears, complexion improves, a strong hunger sensation, dreams of food, hypersalivation, increased irritability, excitability, and general weakness, almost complete cessation of feces excretion after an enema. On average, during the period of complete alimentary deprivation, patients lose about 10% of their body weight. A loss of over 10% of the initial weight should not be allowed.
As a rule, patients should be immediately informed about the therapeutic fasting timetable. Smoking and drinking alcoholic beverages are prohibited during fasting. Due to the ongoing acidotic shift in the body, daily liquid intake should equal 1-1.5 liters of regular water, rosehip decoction, or alkaline mineral water. During the entire therapeutic fasting period, the following daily regimen is observed.
In the morning, a cleansing enema is conducted with 1-1.5 liters of body-temperature water, colored with potassium permanganate to a light pink color. After the enema, the patients take a 10-minute hygienic bath or shower with a water temperature of 37-38°C.
In the morning, a full-body massage with soap is conducted to cleanse the skin. After resting, there is an outdoor walk. A moderate movement that does not lead to fatigue is recommended. Some patients may be engaged in respiratory and light gymnastic exercises. The walk lasts 2-3 hours, followed by bed rest.
Another walk is scheduled for the afternoon. Being outside for prolonged periods of time and active movement facilitate the tolerance of complete alimentary deprivation and improve the patients’ well-being. All the time that is free from walking and sleeping can be used for work therapy, reading, and playing board games.
Before going to bed, patients brush their teeth and tongue with a soft brush and gargle with a weak solution of potassium permanganate. Lips usually dry out during this phase of RDT, so it is advisable to lubricate them with petroleum jelly, lanolin, or baby cream.
Rooms should be well-ventilated during sleep. In winter, it is essential to dress warmly during the day and cover oneself well at night due to the increased chilliness that appears during therapeutic fasting.
Enemas, baths, and massage are discontinued when fasting ends. It is best to start refeeding patients with fresh fruit or vegetable juices. Restorative nutrition may begin with vegetable or oat broth, or with curdled milk whey. For the first 2-3 days of refeeding, partial bed rest is prescribed due to general weakness.