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,
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
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.