Eczema is undoubtedly a disease excited by local irritation. It is most easily excited and most likely to be prolonged and severe when metabolism is disturbed. Eating and foods therefore play a part in causing and in prolonging the disease. It occurs frequently as a complication of diabetes, of a gouty or strumous tendency, and of Bright's disease. Dietetic treatment appropriate to these disorders is an important aid in the management of eczema.

Whatever the condition of the patient may be as regards flesh, the diet should be so adjusted as to prevent digestive disorders, and to avoid overworking the liver or surcharging the blood with effete matter. Food should, as a rule, be taken in moderate quantities.

When eczema occurs, as it often does, in those who are stout, the diet should be simplified and flesh reduced. A milk diet for a few days, with gentle purgation, will help to make the gastrointestinal canal cleaner, will stimulate diuresis, and thus wash from the blood unwholesome ingredients. Even when two quarts are consumed in twenty-four hours, less nourishment will be taken than is habitual. Such a diet maintained for a few days and subsequently gradually modified, will lead to a diminution of flesh and to healthier metabolism. Fruits, the simple vegetables, breads, fish, and eggs, may be used after the first few days, and the quantity of milk lessened. Red meats should be forbidden for a time and later used sparingly.

L. D. Bulkley recommends in acute generalized eczema and other acute inflammations of the skin a diet of rice, bread and butter and water for from three to five days, during which time usually the acute symptoms subside or disappear. The quantity of food eaten by a patient upon such a diet is necessarily small. It will produce calories but will not tax the liver and kidneys.

Stout infants who suffer from eczema are sometimes benefited by simplifying the diet of the nurse. In bottle-fed babies too much farinaceous food and too much sugar are often harmful. The diet of the mother must be studied and prescribed carefully if she suckles the babe, and if she feeds it from a bottle, care must be taken to adapt the food to the child's power to digest and assimilate.

Too little food, because of poverty, and lack of cleanliness are also causes of eczema. Many patients of this class are strumous as well. Sufficient food, well cooked, quickly causes stubborn eczema to disappear in such cases, in which cream, butter, olive oil, and cod-liver oil may also be given with great advantage. Every attempt should be made to improve nutrition.

In other cases it is necessary to forbid rich foods, fried food, especially sweet food and all other kinds tending to produce indigestion. The vegetables that are least digestible, such as cabbage, turnip, sweet potato, and egg plant, must be forbidden; occasionally, also, oatmeal, bananas, peaches, pears, and strawberries, and usually pork, 'high' game, salt and smoked meats. In certain cases dyspepsias must be cured and a diet that overloads the urine with phosphates, urates, and oxalates must be corrected.