Diet and hygiene in diseases of the skin

Front matter

BY THE SAME AUTHOR.

COMPENDIUM OF DISEASES OF THE SKIN,

based on an analysis of thirty thousand consecutive cases, with a Therapeutic Formulary. $2.00.

Preface

As in the case of my former series of lectures "On the Relations of Diseases of the Skin to Internal Disorders," and on the "Principles and Application of Local Treatment in Diseases of the Skin," these lectures are largely of a personal character, reflecting the experience of the writer, for the benefit primarily of those who have attended the Clinical Lectures at the New York Skin and Cancer Hospital. While recognizing the immense importance of diet and hygiene in connection with very many diseases of the skin, it is quite impossible during the brief hour of a clinical lecture to inquire into or to give careful directions concerning these matters to the patient, which would also be for the benefit of those attending the lectures: hence the subjects were treated of specially in six lectures at the end of the course.

In preparing these lectures the attempt was made not only to crystallize my own personal views and experiences along the lines of diet and hygiene in diseases of the skin, as observed mainly in private practice, but also to add scientific support from the vast and ever increasing literature dealing with the chemistry of foods and nutrition. It was quite impossible, however, to attempt

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to enter the journalistic literature, and one had to be content to utilize standard works and monographs, which are mentioned in the Bibliography.

With all that has been written in regard to the relation of food to nutrition, we must confess that we are yet very far from understanding some of even the simplest propositions concerning metabolism; and the scientific basis of our knowledge and action must be more or less uncertain until our knowledge of physiological chemistry is more perfect.

But the science of medicine is built up slowly by both clinical observations and laboratory studies, and in these lectures I have endeavored to make at least some small clinical contribution of matters which I have verified so continually for years in private practice, that I have no hesitancy in advocating the measures suggested. How much farther it will be possible to determine the dietetic relations of the diseases mentioned, or others, depends upon the careful observation and assiduous note-taking of the many now engaged in the practice of dermatology; for these questions will never be settled by the laboratory alone. The sooner and the more thoroughly the thought and attention, and work of those engaged in this branch of medicine is turned from purely local pathology and treatment, to the consideration of the deeper and fundamental elements of tissue disturbance from internal causes, the better it will be for science and for the practical relief of sufferers from many diseases

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of the skin. Every intelligent layman recognizes that what is eaten and drunk must have much to do with the character and integrity of the tissues of which it goes to form a part, and the profession should be more alive to study and observe the internal relations of many maladies which appear upon the skin. The intimate analytical study of the urine from time to time, by volumetric methods, often throws the strongest light upon the anabolism and catabolism of the system, which are in turn affected so greatly by the diet.

In the Appendix I have endeavored to be even more practical and definite, and have outlined a dietary with the exclusion of animal food, which often seems so very desirable in certain diseases of the skin. When such a diet is proposed very many object strongly, and cannot realize the great abundance and variety of the products of the ground, which can perfectly supply all the needs of the system ; in the menus presented I have endeavored to include a very great diversity of cereals and other vegetarian products from which a choice can be made.

In presenting this little book to the profession I recognize only too well that it comes far from what could be wished. But as a pioneer work in this much neglected branch of dermatological therapeutics I bespeak for it a kindly criticism. There is very little definite in regard to the subjects to be found in the standard works on diseases of the skin, and as far as I know, relx PREFACE

atively little in current literature, consequently there is little reference to the work of others in this line.

Of the matters concerning which I speak positively I am so fully convinced from observation in innumerable cases that I can only add that I trust that many others will put them to the test. In regard to the basic idea of this book, that metabolism, as influenced by diet and hygiene, can have the greatest effect upon the structure and diseases of the tissues of the body, including the skin, there can be no doubt. The hope is that this work may be the means of directing many others to study and record the effects of diet and hygiene in this class of diseases, and that the matter here contained may be the means of aiding many in overcoming certain diseases of the skin which are often so very obstinate.

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Contents

LECTURE I

PAGE

The Rebelliousness and Recurrence of Many Cutaneous Affections Indicate Some Underlying Cause — Even Tubercle Bacilli and Pus Organisms Require a Proper Soil — Faulty Metabolism and Auto-intoxication often Found with Skin Lesions — Dependence of These upon Diet — Errors of Diet and Mode of Their Operation upon the Skin — Overeating and Wrong Eating — Gratifying the Taste after the Appetite is Satisfied — Definition of Diet — Elements Affecting Digestion: Mental and Nervous Influence — Mastication, Insalivation, Fletcherism 3