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DIET IN DISEASES OF THE SKIN.It is true that the diet can be made to exercise considerable influence upon diseases of the skin as well as upon diseases of the internal organs ; but it is not especially necessary to regulate the food in diseases of the skin, with certain exceptions to be presently mentioned. In every case it should be remembered that the plan of dieting does not mean to reduce the patient to the verge of starvation, but simply to grant him such articles of food and in such quantities as will, in the opinion of the physician, tend to restore his bodily functions to their natural condition. In most cases the patient needs to be built up rather than torn down; for most diseases of the skin, even those of local origin, such as ringworm, indicate that the patient is in a more or less debilitated condition, since these diseases do not ordinarily occur in persons of the most robust habits. There are certain affections of the skin which are provoked and aggravated by indulgence in particular articles of diet; the patient soon learns to discriminate for himself upon this point ; he soon discovers what articles of food are especially apt to provoke the outbreak of his complaint. Thus the sufferer from nettle-rash early ascertains that he has an attack of the disease whenever he eats strawberries, or oysters, or shellfish, or whatever his particular weakness may be. Aside from these personal peculiarities, there are certain principles which apply to patients affected with chronic diseases of the skin. In most cases the appetite is a reliable guide, though it sometimes needs direction. To begin with, it must be remarked that much of the difficulty frpm errors of diet arises not so much from the nature of the sub stances eaten, as from the imperfect and careless way in which they are eaten. In our country especially, rapid eating and hurried chewing are prevalent habits, which are responsible for many difficulties of other organs than the stomach. For digestion really begins in the mouth; here the food is not simply divided into small particles, so that it can be acted upon by the juices of the alimentary canal, but it is also mixed with the saliva, which effects certain changes in it. If the chewing be imperfectly performed, or if the saliva be but slightly mixed with the food, there will result first derangement of the stomach, and subsequently derangements of other organs. For the ill effects are not limited to the stomach alone. If this do its work but imperfectly, additional labor is required of other organs to piece out the work of the stomach ; while at the same time these other organs are supplied with imperfect blood, since the stomach does not digest and take up the food in a natural way. It is evident, therefore, that one of the first requisites for the diet of a patient affected with skin disease is that the food shall be easily digested. The patient's own sensations will usually indicate to him when he has indulged in indigestible food. As to the quantity of food which should be taken, it may be said that but very few of the skin diseases are caused or aggravated by excessive indulgence in food. Patients with acne are perhaps the only ones whose complaint is aggravated by simple over-indulgence. Such patients should avoid hot drinks and soups, since these provoke flushing of the face and favor the development of the rash. It is well for them to avoid desserts, since these are usually just so much more than the individual requires or really desires. A prevalent habit, which probably contributes largely to the prevalence of indigestion, is the habitual use of large quantities of liquids with the meals. Aside from the injury which may result from alcohol or tea or coffee in excess, it is not desirable to fill the stomach with any liquid, however harmless, during the process of digestion ; since the stomach juices are thereby diluted and weakened and the process of digestion is, to say the least, retarded. This is especially true if the liquids taken be cold, since the effect of chilling the stomach is also to arrest the digestive process. Patients with eczema are apt to dislike and avoid fatty food. It has been ascertained that the use of fats in the food generally exercises a good influence upon the course of the disease ; hence it is desirable that such patients take a moderate amount of fat with their food, even though they do not crave it. These patients with eczema are apt to eat vegetable food by preference, especially the starchy substances, such as rice, arrowroot and oat meal. It is well for them to bear in mind the popular idea that " oat meal is heating," since there seems to be some foundation for this idea in fact. One of the most frequent causes and one of the most constant means in prolonging the various diseases of the skin, is indulgence in fermented liquids. These generally exercise a decided influence in originating and in prolonging diseases of the skin. A patient suffering from such disease should, therefore, abstain from the use of beer, ale, wine, whisky, cider, etc., unless his condition is so debilitated as to require some of these liquids to increase and support his strength. Especial care must be taken in the food of infants who are afflicted with diseases of the skin. The great bane of infancy among skin affections is eczema. This is doubtless often caused by a poor quality of food, whether this food be artificial nourishment or the milk from a debilitated mother. In every case of eczema in an infant, the attention should be directed to the matter and manner of nourishment of the chiK ; the mother should scrutinize carefully her own condition : should see that she eats only suitable food and avoids articles which she knows to be harmful, even though she have a craving for them. She should also endeavor to avoid any mental disturbances, excitement or emotion of any sort, undue sexual indulgence, and she should secure sufficient rest by retiring in due season at night. Another habit which may assist in the development of eczema is the practice of giving the child the breast too frequently. The custom is almost universal of using the breast to soothe a crying infant ; this is usually a successful device, but it exerts a most injurious influence upon the child's digestion, and promotes the development of several skin diseases, especially eczema. As will be observed under the appropriate heading, the child should not have the breast, even in the early weeks of life, oftener than once in two hours ; and as time passes this interval should be lengthened, in the interests of the child as well as of the mother. Doubtless another factor in the production of eczema in nursing infants is the use of fermented liquors by the mother. It is well ascertained that the use of such liquors promotes the occurrence of eczema in adults and in infants through the mother's milk ; hence, unless the mother's general condition is such as to absolutely require the support which can be given only by fermented liquors, it is advisable that she avoid these, in spite of the counsels and remonstrances of friends. Eczema is especially frequent among artificially nourished or " bottle-fed'' infants. It is often impossible to relieve an infant from eczema until its diet be radically changed. Directions for the feeding of infants will be found in the section on " diseases of women and children." It is scarcely necessary to remark, that the habit of feeding suckling infants with scraps from the' table, pieces of cake " which won't do him any harm," sips of tea and coffee, and the like, should be avoided even when the child is perfectly healthy, in the hope of keeping him so. It is all the more necessary when the infant is afflicted with a disease of the skin. Much might be said also as to the hygiene of the skin during the existence of ailments affecting it. The popular idea that bathing is a ways desirable in all diseases of the skin, is a mistaken one; some o these diseases, especially eczema, are greatly aggravated and prolonged by frequent contact of the skin with water. Yet certain diseases, especially psoriasis, are certainly benefited by frequent bathing, especially at the sea shore. In fact everything which tends to increase the activity of the skin - muscular exercise in the open air, sunlight, fresh air in the bedroom, etc.- is highly desirable and important in the treatment of chronic diseases of the skin. Dr. Fox gives the following directions as to diet in skin diseases : First.-A distinction must be made between the diet of the private and the hospital patient. The latter often requires to be well fed and his disease then speedily goes ; the former, on the other hand, often needs to have a check put on the quantity and quality of his food. Second.-In children, skin diseases may arise directly from defective alimentation, as in the case of eczema ; and it is frequently the case that the child who is the subject of eczema or of psoriasis, has not a sufficient supply of milk, either from excessive dilution or otherwise. Third.-The regulation of the diet, setting aside the question of quantity or quality, is as a rule needed not so much to directly influence skin disease as certain states of the general health, which modify the particular disease present; for instance, to meet espe cially dyspeptic, gouty and rheumatic conditions, but particularly the former. In dyspepsia, in connection with eczema, acne, psoriasis or congestion of the face, it is advisable, especially if the urine be very acid, to avoid sugar, tea, coffee, alcoholics, beer, raw vegetable matter, unripe or uncooked fruit, veal, pork, seasoned dishes, pastry and the coarser kinds of vegetables, but especially all articles whose use is followed by heat or flushing of the face, and by flatulence and the like. Milk, the common meats, light kind of bread and some very light wine should be the diet of dyspeptic patients whose skins are at all in a state of irritation. In very many cases the stomach is at fault at the outset, and a careful regulation of the diet is of the utmost importance as an aid to the other means adopted to correct faults in other parts of the system. In gouty subjects much the same line of treatment is to be pursued. As regards stimulants, hock, a good light claret or whisky and water are the best beverages. In scrofulous patients the diet should consist of as much fatty matter as possible. Fourth.-In children who suffer from ringworm it is desirable to give plenty of fatty food by means of milk, cream, eggs, and fat meat, if they can be persuaded to eat it. Fifth.-In syphilis the greatest care should be taken to avoid everything beyond the most moderate use of stimulants; their abuse in this disease is a source of the greatest aggravation. Sixth.-In all cases in which the onset or early stage of a skin disease is accompanied by fever, however slight, stimulants should be avoided, and the plainest and simplest diet ordered. In marked cases of this kind a milk diet for a while is often found to be very beneficial. Seventh.- In some cases in which the disease is accompanied by flushing of the skin, this condition is much increased by the consumption of food, especially if dyspepsia exist, in consequence of the sympathy existing between the stomach and the skin of the part affected. This state of things is especially marked in such diseases as acne, congestion of the face and sycosis (barbers' itch). Stimulants must be avoided, unless they be diluted with some alkaline water. The use of a diet appropriate to the dyspepsia must be rigorously enforced. Eighth. - It is said that psoriasis requires an ample meat diet; but the patient must be dieted, and not his disease. That is, the diet should be plain and nutritious and adapted to the constitutional peculiarities, according to circumstances. Ninth.-In all cases where a skin disease has become chronic, and where there is debility, the patient should be allowed a full unstimulating diet. At the well-known hospital for diseases of the skin, Blackfriars, London, the following directions are issued, to be observed by patients: Remove flannel from next the skin affected, or line it with soft linen. Wash with warm water, and, as regards diseased skin, not more frequently than cleanliness requires. Avoid using soap of any kind to the affected parts. To cleanse the diseased skin, substitute instead of soap a paste or gruel made of bran, oat meal, linseed meal, arrow root, or starch and warm water. Rinse off with warm water or warm milk and water; and employ yolk of an egg and warm water to civ^^se the scalp. Dry the skin with soft linen, and smear it lightly with the ointments or liniments, or dress wounds with the same spread thin upon lint or linen. Afterward apply the bandages evenly should they be required. Bathe the affected part by means of a sponge or rag with the lotions or embrocations, or paint them over with a camel's hair brush, not more frequently than directed by the physician. Rinse the mouth with water, and brush the teeth after taking the medicines, and observe that neither more nor less than the dose ordered is taken. At the same institution the following rules of diet for patients are observed : For breakfast-Bread and milk, rice, milk or porridge instead of much tea, coffee or cocoa-with or without eggs, and bread and butter, or a little animal food. For dinner-Plain roast or boiled fresh meats, fish or poultry plainly cooked, egg or farinaceous (starchy) puddings, potatoes, and few other vegetables, plain boiled rice. For supper-Milk and water, or gruel or other farinaceous food, with bread and butter, a little cream, cheese or poached eggs. Beverages-Barley water, toast and water, thin gruel beef tea, soda, potash or seltzer water. N. B.- To be avoided-Salt meats, soups, sweets, acids, fruits, pastry and raw vegetables. No malt liquors, wine or spirits are to be taken without the sanction of the medical officers of the hospital. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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