Gerson Therapy — Coffee Enemas for Liver Detoxification

Table of Contents

1. Origins — Ancient Enemas, the First World War, and Goettingen
2. The Beneficial Action — Liver Detoxification
3. Wattenberg, Lechner, and Glutathione S-Transferase
4. Excretion of Cancer Breakdown Products
5. Pain Relief — The 1946 Senate Testimony
6. Coffee Enemas Stimulate Bile Flow
7. Summary of the Physiological Benefits
8. Preparing the Coffee Enema
9. How to Take the Enema
10. Variations, Night Enemas, and Flare-Ups
11. Safety Within the Combined Regime
12. Key Research Papers
13. Connections
14. Featured Videos

Origins — Ancient Enemas, the First World War, and Goettingen

The book begins by noting that enemas themselves are ancient. It cites the Manual of Discipline among the Dead Sea Scrolls, and quotes at length from The Essene Gospel of Peace, which describes a gourd filled with sun-warmed river water and hung from a tree branch so that “the water may flow through all your bowels.” Enemas, the authors write, “have been used for general purposes of detoxification since ancient times.”

The use of coffee, they state, probably dates only to the First World War. Retelling an account by Gerson exponent Dr. Jerry Walters: Germany was blockaded, and morphine, anesthetics and drinking coffee were all scarce. Wounded soldiers came back from the front needing surgery, often with only enough anesthesia to get them through the operation. Afterward, doctors ordered plain-water enemas. Coffee was kept brewing for the surgeons working around the clock, and nurses — looking for something more to help the men — poured the leftover coffee into the enema buckets. The soldiers reported that their pain was much relieved.

According to the book, these reports drew the interest of Professors O. A. Meyer, M.D., and Martin Heubner, M.D., at the University of Goettingen’s College of Medicine. During the 1920s they gave caffeine rectally to rats, observed that it stimulated the bile ducts to open, and published their findings in the German medical literature. Gerson describes this in a lecture reproduced as Appendix II of A Cancer Therapy: Results of Fifty Cases.

For a time Gerson added drops of caffeine and potassium citrate to enema water. He later found that a solution made simply by boiling coffee grounds “was more effective and was much more easily available to everybody,” and the book states that the same procedure remains in the therapy today.

Chapter Twelve opens with the account of Kent Gardner, a forty-six-year-old taxidermist from Phoenix with cancer of the esophagus and larynx, who wrote for the Gerson Healing Newsletter that the enemas were “a mental hurdle” until he took one and “could feel a difference.” He reports the tumor died and broke free about four months in, that he took three coffee enemas a day through the five bedridden days of toxic reaction that followed, and that on the sixth day he felt better.

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The Beneficial Action — Liver Detoxification

“Enemas made from drip-grind boiled coffee have proven themselves an advantageous means of restoring the liver,” the book states. Gerson himself wrote that the treatment “should be followed strictly, both in the clinic and later at home, for at least two years. … The liver is the main organ for the regeneration of the body’s metabolism.”

The authors paraphrase a 1985 conference talk by Harold Manner, Ph.D., who credited Gerson with the explanation he gave. As Manner describes it:

• While the enema is retained (optimally twelve to fifteen minutes), all of the body’s blood passes through the liver about every three minutes.
• The hemorrhoidal blood vessels dilate from exposure to caffeine, and the liver’s portal veins dilate in turn.
• The bile ducts expand, bile flow increases, and the smooth muscles of these organs relax; the blood serum is detoxified as it passes through the “caffeinated liver.”
• The quart of water in the bowel stimulates the visceral nervous system and promotes peristalsis, and dilutes the bile, increasing bile flow further.
• Glutathione S-transferase (GST) in the small bowel is increased by 700 percent; it quenches free radicals, which leave the liver and gallbladder as bile salts and are carried out through the colon.

In Chapter Two the book adds that when Gerson’s patients began releasing toxins from dissolving tumor tissue, he saw that the liver could become seriously damaged, even to the point of liver coma, unless the poisons were removed rapidly. The coffee enemas, given early on as often as every four hours, “relieved the liver and even, in most cases, relieved pain.”

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Wattenberg, Lechner, and Glutathione S-Transferase

The book draws on two later lines of work. Starting in the late 1970s, the laboratory of biochemist Lee W. Wattenberg, Ph.D., identified two palmitic-acid salts present in coffee — cafestol palmitate and kahweol palmitate — as potent enhancers of GST. The authors explain that this turns GST into a major detoxification system that binds electrophiles from the bloodstream to the sulfhydryl group of glutathione, and that because the reactive ultimate carcinogenic forms of chemicals are electrophiles, the GST system is an important mechanism of carcinogen detoxification. They report that in laboratory mice fed coffee beans, liver detoxification rose by 600 percent and small-bowel detoxification by 700 percent, with “analogous results” in humans taking coffee enemas.

The Austrian surgeon Peter Lechner, M.D., of the Landeskrankenhaus in Graz, had been studying Gerson’s treatment. In 1984 he wrote that “coffee enemas have a definite effect on the colon which can be observed with an endoscope,” and that Wattenberg and coworkers had shown in 1981 that the palmitic acid in coffee raises GST activity “by manyfold times above the normal.” In 1990, Lechner and colleagues reported that GST:

• binds bilirubin and its glucuronides so they can be eliminated from liver cells;
• blocks and detoxifies carcinogens that require oxidation or reduction to be activated, protecting against many chemical carcinogens;
• forms a covalent bond with nearly all highly electrophilic substances — the precondition of their elimination — including the intermediate products of hepatotoxic cytostatic drugs.

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Excretion of Cancer Breakdown Products

Citing Lechner, the book states that the coffee enema “lowers the quantity of blood serum toxins, literally cleaning the poisons out of fluids nourishing normal cells.” It ties this to Gerson’s potassium–sodium model: cells challenged by toxins, oxygen starvation, malnutrition or trauma lose their preference for potassium, take up sodium and excess water, and lose the capacity to make enough ATP to repair themselves “unless the challenge is removed.” Around almost any active malignancy, the authors write, lies a sphere of damaged normal tissue swollen with salt and water, with depressed energy, immunity and circulation.

Gerson held it as axiomatic that no cancer could exist in the presence of normal metabolism. His favorite example was that healthy laboratory animals kill transplanted tumors by inflammation, and that technicians must first damage the animals’ thyroid and adrenal glands to make a transplant “take.” His aim was a near-normal metabolism in the tissue around a patient’s tumor.

The book names four common tissue toxins — polyamines, ammonia, toxic-bound nitrogen and electrophiles — and states that the liver and gut enzyme systems that neutralize them are “massively increased in their beneficial effects by coffee enemas.” When Physiological Chemistry and Physics reprinted Gerson’s summary paper in 1978, the editors wrote: “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.”

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Pain Relief — The 1946 Senate Testimony

The book quotes Mark F. McCarty, writing in Medical Hypotheses in 1981: at the 1946 Senate subcommittee hearing on cancer research, “five independent medical doctors who had had personal experience with patients treated by Dr. Gerson, submitted letters indicating that they had been surprised and encouraged by the results they had seen, and urged a widespread trial of the method including taking coffee enemas. One of these doctors claimed that ‘relief of severe pain was achieved in about 90 percent of cases’.”

The authors write that those 1946 observations “remain correct today,” and that, whatever degenerative disease is causing symptoms, the coffee enema means relief from “confusion, general nervous tension, depression, many allergy-related symptoms, and, most importantly, from severe pain.”

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Coffee Enemas Stimulate Bile Flow

“The coffee enema is in a class by itself as a therapeutic agent,” the book states. Drinking coffee does not have the same effect; on the contrary, the authors write, it “virtually ensures reabsorption of toxic bile.” Other choleretics (agents that stimulate bile flow) increase bile production but do little to enhance the liver’s detoxifying enzymes and nothing to ensure that bile leaves the body — and bile is normally reabsorbed up to ten times before it finally passes out in the feces.

Because the coffee enema intensifies the liver and small-intestine enzyme systems while not allowing the toxic bile to be reabsorbed across the gut wall, the book calls it “an entirely effective means of detoxifying the bloodstream.” Since Gerson clinicians found the enemas well tolerated as often as every four hours, the authors propose that the coffee enema be classified in the medical literature as “the only non reabsorbed, effective, repeatable choleretic agent.”

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Summary of the Physiological Benefits

The book summarizes what Gerson hypothesized and observed. A quart of boiled coffee solution introduced into the colon:

• dilutes portal blood and, subsequently, the bile;
• supplies theophylline and theobromine, which dilate blood vessels and counter inflammation of the gut;
• supplies palmitates that enhance glutathione S-transferase, which removes many toxic radicals from blood serum;
• stimulates the visceral nervous system through the fluid itself, promoting peristalsis and the transit of diluted toxic bile out the rectum;
• acts, because it is retained up to fifteen minutes while all the blood passes through the liver nearly every three minutes, as “a form of dialysis of blood across the gut wall.”

Within the whole program — the sodium-restricted, high-potassium diet, potassium salts, thyroid and Lugol’s solution, and temporary animal-protein restriction — the book states that these mechanisms together reduce blood serum toxins, raise cell potassium, lower cell sodium, reduce cell swelling, increase mitochondrial count and activity, and supply the micronutrients for cell repair. “Unquestionably, taking coffee enemas is among the most vital aspects of the Gerson Therapy.”

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Preparing the Coffee Enema

Dr. Gerson’s original formula, from Chapter Thirteen:

1. Drop 3 rounded tablespoonfuls of ground (drip) coffee — not instant — into one quart of water.
2. Boil three minutes, then simmer fifteen minutes more.
3. Strain the solution.
4. Fill a quart glass container with the liquid and let it cool to body temperature.
5. Use the solution at body temperature.

The Gerson Institute’s refined method: add the three rounded tablespoons of drip-grind coffee to a quart of boiling water — distilled water if your drinking water is fluoridated, filtered water otherwise. Boil three minutes uncovered, then simmer fifteen minutes covered. Strain through a fine strainer, or a coarser one lined with filter cloth such as a piece of old white sheeting, to catch floating grounds. Top up with hot water to the one-quart mark, since some is lost in boiling and straining, and use it once it has cooled to body temperature.

Coffee concentrate for the day: bring 2½ to 3 quarts of water to a boil, add 15 rounded tablespoons of organic drip-grind coffee (3 per enema, enough for five), boil a few minutes, simmer about fifteen minutes and strain. Divide into five equal portions in 1-quart glass bottles, fill each to a quart with distilled water (or add a pint of chamomile tea if the enema is to be modified), and heat to body temperature before use.

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How to Take the Enema

Gerson wrote: “To make enemas most effective, the patient should lie on his right side, with both legs drawn close to the abdomen, and breathe deeply, in order to suck the greatest amount of fluid into all parts of the colon. The fluid should be retained ten to fifteen minutes.” The book’s instructions:

• Where: a padded floor with a cushioning mat, or a mattress protected with plastic, covered with a towel; some use a camp bed or an “enema bench.” A clean bathroom floor with a pad (a lawn chaise pad is excellent), plastic, towel and pillow often works best. Be comfortable and warm.
• Position: right side, legs pulled up and relaxed. If pain prevents this, lie on the back with legs up; the left side only as a last resort, since the enema goes deeper from the right side.
• Height: the bottom of the bag or bucket no more than about 18 inches (50 cm) above the body. Too much height causes excess pressure, counter-peristalsis and cramping.
• Cramping: pinch the tube closed or lower the bucket to body level for a while, then resume.
• Retention: ideally twelve to fifteen minutes, by which time almost all the caffeine has been absorbed. Do not hold longer than fifteen minutes, since the liquid itself will also be absorbed. If you can manage only six to nine minutes, release then rather than straining; it takes practice, sometimes three or four months.
• Can’t take a full quart: take what is comfortable, hold and expel it, then take the rest. The same applies during a healing reaction, when the book says toxic pressure from the liver may make even half a quart difficult.
• Frequency: Gerson advised that cancer patients and other very sick people may take enemas as often as every four hours, day and night, in the first months; the book reports that some terminal patients took five a day for months.

The bedfast patient needs a support person: cover the mattress with plastic and a towel, give the enema in bed, hold it twelve to fifteen minutes if possible and provide a bedpan. With incontinence, give the enema while the patient lies on the bedpan.

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Variations, Night Enemas, and Flare-Ups

Chamomile: with an irritated bowel, colitis, diarrhea, bleeding or cramping, half a quart of coffee plus half a quart of chamomile tea is soothing. In serious diarrhea, use chamomile alone, then add coffee concentrate back slowly (2–4 ounces, then 6–8 ounces, keeping the quart volume) until the full coffee enema is tolerated. If the 10:00 P.M. enema keeps a new patient awake, replace it with chamomile; the book reports that in three to four days the late coffee enema no longer disturbs sleep.

Night enemas: in severe reactions, heavy tumor absorption or night pain, Gerson suggested getting up at 2:00 or 3:00 A.M. for a coffee enema rather than lying awake; the book states it often lets the patient sleep again. Before a night or first-morning enema, eat a piece of fruit or some applesauce to raise blood sugar a little.

Flare-ups: frequency is reduced over time, but a patient who reduces too soon and feels ill, toxic or headachy should return to the more intensive level for a while. During a flare-up with new toxic releases, swelling, pain, headache or poor appetite, an extra coffee enema “has been known to work wonders.”

• Flare-up with diarrhea: perhaps two chamomile enemas daily; as it eases, one chamomile, a coffee enema four to six hours later, and chamomile at night, until the colon calms.
• Bile overflow with nausea and vomiting: omit the coffee enemas, since they stimulate more bile; drink plenty of peppermint tea, eat oatmeal gruel, use only chamomile enemas, and resume coffee once vomiting has stopped completely.
• Heavy gas: lower the bucket to body height or below so fluid can flow back and the gas bubble out.
• An enema that won’t release (colon spasm): lie on the right side with legs up and a warm water bottle on the abdomen; don’t panic; if needed take another coffee enema with 3 tsp of 3 percent hydrogen peroxide added; if still held, take castor oil by mouth; for the next few days add 3–4 tsp of the potassium compound to each enema, but not for more than a week, or the colon becomes irritated. The book states there is no danger even if the coffee is not released, since it is absorbed and excreted through the kidneys.
• Hemorrhoid flare: uncomfortable for a few days; apply zinc oxide ointment (not painkiller suppositories) and, the book says, do not stop the enemas.
• Persistent vomiting with dehydration: an 8-ounce rectal implant of carrot/apple or green juice warmed to body temperature (no orange juice, no added water), held until absorbed and repeated hourly, until the patient can drink again.

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Safety Within the Combined Regime

The book states that “coffee enemas are safe when used within the context of the combined regime of the Gerson Therapy” — Gerson’s sodium-restricted, high-potassium, high-micronutrient diet with its supplemental potassium salts. It gives these cautions:

• Chemotherapy-pretreated patients: two to three 32-ounce enemas a day, sometimes at half strength (16 ounces coffee, 16 ounces chamomile), increased only gradually, taking care “not to overstimulate the liver” and release chemotherapy residues too fast. Castor oil treatment is contraindicated for them, and may be considered only after six to nine months on the therapy, with great caution.
• Lupus and rheumatoid arthritis: enemas limited to two to three per day; reactions can be severe and patients must be monitored carefully.
• Retention: no longer than fifteen minutes; release early rather than strain.
• Pressure: bag or bucket no more than 18 inches above the body.
• Temperature: always at body temperature.
• Supervision: the book describes the therapy as the book describes the therapy as taken under physician supervision or at home after training, and advisesldquo;self-administered at home or under physician supervision,the book describes the therapy as taken under physician supervision or at home after training, and advisesrdquo; and advises always consulting a Gerson Therapy physician before adding anything to the program.

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Key Research Papers

1. Gerson M. (1978). The cure of advanced cancer by diet therapy: a summary of 30 years of clinical experimentation. Physiological Chemistry and Physics 10(5):449–464. — PubMed PMID: 751079
2. Gerson M. (1949). Effects of a combined dietary regime on patients with malignant tumors. Experimental Medicine and Surgery 7(4):299–317. — PubMed PMID: 15396126
3. Gerson MB. (1945). Dietary considerations in malignant neoplastic diseases; a preliminary report. Review of Gastroenterology 12:419–424. — PubMed PMID: 21005988
4. Cope FW. (1978). A medical application of the Ling association-induction hypothesis: the high potassium, low sodium diet of the Gerson cancer therapy. Physiological Chemistry and Physics 10(5):465–468. — PubMed PMID: 751080
5. McCarty MF. (1981). Aldosterone and the Gerson diet — a speculation. Medical Hypotheses 7(5):591–597. — doi:10.1016/0306-9877(81)90002-5
6. Sparnins VL, Wattenberg LW. (1981). Enhancement of glutathione S-transferase activity of the mouse forestomach by inhibitors of benzo[a]pyrene-induced neoplasia of the forestomach. Journal of the National Cancer Institute 66(4):769–771. — PubMed PMID: 6262554
7. Lam LK, Sparnins VL, Wattenberg LW. (1982). Isolation and identification of kahweol palmitate and cafestol palmitate as active constituents of green coffee beans that enhance glutathione S-transferase activity in the mouse. Cancer Research 42(4):1193–1198. — PubMed PMID: 7059995
8. Wattenberg LW. (1983). Inhibition of neoplasia by minor dietary constituents. Cancer Research 43(5 Suppl):2448s–2453s. — PubMed PMID: 6403236

PubMed Topic Searches

1. PubMed: Wattenberg coffee Phase II
2. PubMed: Cafestol kahweol GST
3. PubMed: Caffeine bile flow
4. PubMed: Hepatic Phase II
5. PubMed: NRF2 dietary inducers
6. PubMed: Hemorrhoidal-portal anatomy

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Connections

• All Remedies
• Benefits Deep Dive Hub
• Juicing Protocol
• Mineral Density and Sodium-Potassium
• Documentary Evidence and Critique
• Gerson Therapy Main Hub
• Coffee Enemas Overview
• Coffee Enema Protocol
• Coffee
• Liver Cleansing
• Detox Protocols
• Coffee Enemas — the detox-protocol treatment of the same practice, covering the Phase II mechanism and safety framing outside the Gerson context.
• Gastroenterology
• Hepatology
• Magnesium
• Potassium
• Sodium

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