That Eczema is the direct result of auto-intoxication appears from its intimate relation with lithemia and gouty states, and from its dependency upon digestive disorders. The eczema and herpes which are such a source of discomfort to diabetics must be looked upon as the result of the acid intoxication of this disorder, and the eczema of children is usually only a part of the symptoms arising from disordered metabolism. True Zoster is probably not caused by intestinal poisons for the exhaustive researches of Head and Campbell (33) have shown it to be caused by lesions of the posterior ganglia of the cord and the Gasserian ganglia, and that in only a small percentage of cases do visceral disturbances accompany it. But the frequent occurrence of zosteroid with gastro-intestinal disorders and CO and C02 poisoning, suggests that it may be due to intrinsic poisons.

Gilchrist claims that Acne is not due to digestive disturbances but is purely a bacterial process, and states that a particular bacillus, which he has named the Bacillus Acnes was present in all smears taken from 240 lesions in 85 patients, and that pure cultures were obtained from 62 lesions in 29 patients. He suggests that the constitutional disturbances which are so commonly observed in acne are due to the absorption of the toxins of these bacteria, for he finds that the bacilli acnes are agglutinated by the sera of patients suffering from the disease, (34). The writer has been unable to find the bacillus in the majority of his cases.

Akin to these skin diseases are several minor affections of modified skin and mucous membrane which are undoubtedly the result of intoxication caused by digestive disorders. Among these are the minute ulcerations which frequently appear in the buccal epithelium, the enlargement and occasionally the ulceration of the filiform papillae of the tongue, and, in infants, a true stomatitis. These are usually accompanied by migrim, malaise, constipation, and urinary diminution followed by polyuria, and it is a significant fact that they yield promptly to measures directed towards the digestive system, rather than to antiseptics applied to the lesions themselves.

Talbot (35) urges that persons of sedentary habits do not require excessive nitrogenous or starchy diet, which is quite likely to cause inflammation of the gums and alveolar process with absorption. It is also claimed that interstitial gingyvitis is benefited by measures which improve the digestion.

Cases are occasionally seen in which temporary intestinal obstruction is followed by acceleration of the pulse, mydriasis and a scarlatinal redness of the skin resembling that of atropia or scarlet fever. When faucial angina, nausea and vomiting with a considerable rise of temperature accompanies these symptoms, the picture is even more convincing, but with a free evacuation of the bowels all these symptoms promptly disappear and the temperature falls to normal. Lèpine reports a case of this kind and the writer recalls two.

Punctate ecchymoses and emphysema are occasional skin manifestations of uremia.