[pullquote_left]A Coffee Enema? Now I’ve Heard Everything.What does it do? How does it work? – by Gar Hildenbrand[/pullquote_left] It is difficult to describe the incredulous facial expressions, which ripple across a medical school lecture audience as the topic of coffee enemas is introduced. Embarassing noise is heard from several seats in the hall. A wise guy heckles, “How do you take it”? Charlotte Gerson doesn’t miss a beat, answering, “Black” without cream and sugar. Laughter relaxes the entire room and Gerson goes on to explain this aspect of her famous father’s (Max Gerson, M.D.) treatment: 3 tablespoons of regular grind coffee, boiled in a quart of distilled water for 3 minutes, covered and simmered for ten minutes, cooled to body temperature, filtered and admitted to the colon using a short tip while lying on the right side. This is held for 12-15 minutes and released. Responses from the audience are typical: Boy, I’ll bet you get a buzz out of that! Couldn’t you just drink three or four cups of coffee? And the eventual big question is… What does a coffee enima do? Why go to all that trouble for a caffeine high? The coffee enema is, without question, the most unusual part of Gerson’s combined regimen, and often evokes astonishment and mirth in persons who have never experienced an enema and who emphatically prefer to drink their coffee. Practitioners and patients who have had experiences with coffee enemas, however, know that they are far more than a means of introducing stimulating caffeine into the bloodstream. From the patient’s point of view, the coffee enema means relief from depression, confusion, general nervous tension, many allergy related symptoms and, most importantly, relief from severe pain.

The Coffee Enema

The coffee enema has a very specific purpose: lowering serum toxins. Dr. Peter Lechner, who is currently conducting a trial of the Gerson cancer therapy in the post surgical treatment of liver metastasized colorectal cancers under the aegis of the Landeskrankenhaus of Graz, Austria, reported in 1984. Coffee enemas have a definite effect on the colon which can be observed with an endoscope. Wattenberg and coworkers were able to prove in 1981 that the palmitic acid found in coffee promotes the activity of glutathione S-transferase and other ligands by many fold times above the norm. It is this enzyme group which is responsible primarily for the conjugation of free electrophile radicals which the gall bladder will then release.

The Importance of the Coffee Enema

The importance of this action of coffee enemas is best described against the background of modern concepts of cell ion and water content. In most, probably all, chronic degenerative diseases there exists a “tissue damage syndrome” first described by Cope. When cells are challenged by poison, oxygen starvation, malnutrition, or trauma (a physical blow), a uniform set of reactions takes place: cells a) lose potassium, b) accept excess sodium and chloride, and c) swell with excess water. According to the work of Ling, recently summarized in his monograph “In Search of the Physical Basis of Life” (Ling, G.N., Plenum Press, New York, 1984), the cellular cytoplasm is latticed with a protein-lipid macromolecule through which an electron current flows. Energy-storing adenosine triphosphate (ATP), the main product of metabolism, is complexed with this macromolecule, polarizing and energizing it, and forming many interactive, cooperative association sites, which prefer potassium over sodium. In a resting, healthy cell with sufficient ATP, water is highly organized in polarized multiple layers forming an “ice-like” structure. Water and ice are different not because their molecules are different, but because their molecules relate differently. According to Ling”s Association-Induction Hypothesis, being “alive” requires not only the presence of the right composition of chemical compounds, but also requires that they be maintained in special electronic and steric (atomic spatial) relationships. The living state is a high-energy state in the same sense as a cocked gun, a drawn bow, or a set mousetrap. In the living cell, potassium and nearly all water (except that vacuoles, etc.) exist in an adsorbed state. Potassium is preferentially adsorbed on the beta- and gamma-carboxyl groups of certain cellular proteins while water is adsorbed in polarized multilayers on a matrix of extended protein chains. Low levels of sodium in the cell are due to the reduced solubility of structured water. This mechanism also controls water content.

Coffee Enema and Toxins

Cope reasoned that challenge to the cell by toxins, oxygen starvation, malnutrition, or trauma will result in an altered molecular configuration state in which the macromolecule will lose its preference for potassium. Sodium competes with potassium for association sites in damaged cells. Loss of cell potassium and increase of cell sodium in turn results in decreased electron flow through the macromolecule. This in turn causes decreased attraction of paramagnetic ions and subsequent disorganization of water molecules. Because bulk phase water, structured in a high energy state, is the main mechanism controlling cell water content and purity, any disturbance in water structuring will result in the cell swelling with excess water and extracellular solutes. Once the internal environment of the cell is polluted with excess water and extracellular materials, mitochondrial production of ATP is greatly impaired with the result that cells cannot produce sufficient energy to repair themselves unless the challenge is removed. Endogenous serum toxins can be generated by cells with impaired metabolism, by bacteria, and by malignant cells. NMR studies have suggested that surrounding active malignancies there may often be a sphere of damaged normal tissue in which water structuring is impaired by the chronic insult of tumor toxins. Energy production and immunity are depressed in these cells, which are swollen with excess salt and water. Such damaged tissue has decreased circulation because oversized edematous cells crowd arterioles, capillaries, and lymph ducts. Gerson taught that improved circulation and tissue integrity would prevent spread and, in fact, cause the destruction of malignant tumors. He held as axiomatic the observation that no cancer could exist in normal metabolism. A favorite example of his was the well-known resistance of healthy lab models to tumor transplants. Such transplanted tumors are quickly killed in many cases by inflammation in the healthy host. In order to cause transplanted tumors to take easily, it is necessary to impair the metabolism of the host by damaging the thyroid and adrenal glands. Gerson’s efforts were directed toward creating a near normal metabolism in tissues surrounding tumors. Enzyme systems in the liver and small bowel are responsible for conversion and neutralization of the most common tissue toxins, poly-amines, ammonia, toxic bound nitrogen, and electrophiles, all of which can cause cell and membrane damage. Such protective liver and gut enzyme systems are probably enhanced many fold by coffee enema. Editors of Physiological Chemistry and Physics stated ?Caffeine enemas cause dilation of bile ducts, which facilitates excretion of toxic cancer breakdown products by the liver and dialysis of toxic products from blood across the colonic wall.? In the late 1970s and early 1980s, researchers in the lab of Lee Wattenberg identified salts of palmitic acids (kahweol and cafestol palmitate) in coffee as potent enhancers of glutathione S-transferase, a major detoxification system that catalyzes the binding of a vast variety of electrophiles from the blood stream to the sulfhydryl group of glutathione. Because the reactive ultimate carcinogenic forms of chemicals are electrophiles, the glutathione S-transferase system must be regarded as an important mechanism for carcinogen detoxification. In mice, this system is enhanced 600% in the liver and 700% in the small bowel when coffee beans are added to their diet. Because this system in lab models is close, if not directly analogous to that of humans a parallel stimulation by coffee of glutathione S-transferase in humans is probable. With this rationale in mind, we can expand on Gerson?s hypothesized physiological actions and effects of coffee enemas. Gerson wrote that Heubner and Meyer of Goettingen University, Germany had shown in animal models that rectal administration of caffeine would dilate bile ducts and promote bile flow. The introduction of a quart of coffee solution into the colon will dilute portal blood and subsequently, the bile. Theophylline and theobromine, major constituents of coffee, dilate blood vessels and counter inflammation of the gut. The palmitates of coffee enhance glutathione S-transferase which is responsible for the removal of many toxic radicals from serum. Finally, the fluid of the enema itself stimulates the visceral nervous system promoting peristalsis and the transit of diluted toxic bile from the duodenum out the rectum. Because the stimulating enema is retained for 15 minutes, and because all the blood in the body passes through the liver nearly every three minutes, these enemas represent a form of dialysis of blood across the gut wall. It is obvious in light of the above that oral administration of beverage coffee cannot have the same effect. On the contrary, it virtually insures reabsorption of toxic bile. As a medication, the coffee enema is in a class by itself. While other agents classed as choleretics do increase bile flow from the liver, they do little to enhance detoxifying enzyme systems, and they do not ensure the passage of bile from the intestines out the rectum. Bile is normally reabsorbed up to 9 or 10 times before working its way out the intestines in feces. The enzyme enhancing ability of the coffee enema is unique among choleretics. Because it does not allow reabsorption of toxic bile by the liver across the gut wall, it is an entirely effective means of detoxifying the blood stream through existing enzyme systems in the liver and small bowel. Because clinical practice has shown coffee enemas to be well tolerated by patients when used as frequently as every four hours, the coffee enema may be classed as the only non-reabsorbed, effective, repeatable choleretic in the medical literature. These enemas are safe when used within the context of the combined regime of Gerson. It is apparent that Gerson?s intention in supplying a sodium restricted, high potassium, high micronutrient dietary of fruits, vegetables and whole grains, was to supply all nutrients, known and unknown, which are necessary for cell respiration and energy production. High potassium, low sodium environments tend to return cell macromolecules to normal configuration states and to improve water structuring and water content. The addition by Gerson of supplemental salts of potassium (acetate, gluconate, and phosphate monobasic) to the diet in which malate are supplied by frequent use of apples probably greatly improves the efficiency of the Kreb?s cycle in mitochondrial energy production. Protein restriction employed by Gerson as a temporary aspect of treatment, has been observed empirically since before the turn of the century to aid in the reduction of cellular edema. Administration of high loading dosages of thyroid and Lugol?s solution (iodine and potassium iodide in dilute solution) probably result in multiplication of mitochondria, which have their own DNA and RNA and replicate independently of the cell. Additionally, thyroid is known to enhance cell oxidation of sugars and therefore ATP production. In this way cell energy production is probably markedly increased. Through these mechanisms, the therapy of Dr. Max Gerson appears to a) reduce serum toxins and eliminate chronic challenge to damaged normal cells, b) improve cell potassium ion content, c) reduce cell sodium content, d) reduce cell swelling through improved water structuring, e) increase cell mitochondria count and activity, and f) supply micronutrients necessary for cell energy production and repair. The contribution of low serum toxin levels by regular administration of coffee enemas is basic to increased cell energy production, enhanced tissue integrity, improved circulation, improved immunity, and improved tissue repair and regeneration which have been observed clinically to result from the administration of the combined regime of Gerson.