Ulcer syndrome in tropical Africa

Abstract

I. The exact relationship of Bacillus fusi - formis and Spironema to Ulcus tropicum remains unproved, but the evidence suggests that these organisms are causal.II. Ulcer, whatever the clinical type, is a physical sign, and is of much greater significance than the one or two page description, usually given in books, would indicate.III. Ulcer is a class disease, and is not found among the better classes or in institutions.IV. Ulcer seems to be closely related to calcium and/or parathyroid deficiency, and may be a manifestation of latent tetany.V. The calcium deficiency does not appear to be in the diet, but seems to be due to the diet, faulty absorption probably being a factor.VI. The exact connection of the parathyroid with the condition is not clear, but the gland appears to have factors controlling calcium regulation and skin vitality and résistance, and it may be affected by dietary deficiency.VII. One of the most important considerations is the quality of the protein in the diet. Ulcers are much more common in vegetarians than in those who include animal substance in their diet. It is essential that a fair proportion of the protein should be of animal origin,as even nuts and beans have the disadvantage of being covered with resistant fibre.VIII. The vegetarian diet, as consumed by the African native, is much too) bulky. Digestion of protein, fat and calcium may be greatly interfered with. The most important prophylactic measure, which would go far to prevent the appearance of the ulcer syndrome, is to include meat, eggs, fish, or fowl in the diet, and to reduce the amount of vegetable matter; the consumption of three smaller meals instead of two larger, would favour optimal utilisation.