The Phase Of Tuberculosis Known As Lupus Vulgaris , constantly illustrates for us the importance of attending to the deficient resistance of the soil. It often occurs in persons who have inherited a deficient standard of nutrition with a feeble circulation, and there is added to this a chronic poisoning from the tubercle bacilli and the wounds which may be produced. Such patients require to be placed under the most favourable conditions as regards diet, in order to increase the resistance of the tissues as far as possible. Fatty foods are an important indication. In regard to syphilis a special point to be noted in regard to diet is that the state of the gastro-intestinal tract must be carefully supervised and green vegetables given with caution whilst mercury is being pushed. Lastly, there are acute febrile infections, such as acute pemphigus, and the infective purpuras which must be dieted like the acute specific fevers.
Group II includes a huge heterogeneous group of dermatoses which Brocq characterizes as cutaneous reactions. An eruption very similar in appearance may be excited by several causes, and possibly one and the same cause may set up different types of reaction. The etiology is often complicated or obscure and some of the factors determining the phase of reaction often escape our recognition. It is in some of these reactions that dermatologists most strongly advocate special diets, and though such treatment has a sure foundation in some cases, in others the dieting is largely due to the belief arising from exclusion of other agencies that a metabolic disturbance must be the cause.
Class I of this group consists of the cutaneous reactions proper, and includes a series of reactions with pruritus as a leading symptom, e.g. the functional disorder known as pruritus, uncomplicated or associated with a special vulnerability of the skin leading to inflammatory or other reactions known as lichenification, urticaria, acute circumscribed oedema, auto-graphism, lichen urticatus and the prurigos, eczema, dermatitis herpetiformis, and generalized erythrodermias.