On the etiology of rickets / by Edward Mellanby.

  • Edward Mellanby
Date:
[1922?]
Catalogue details

Licence: In copyright

Credit: On the etiology of rickets / by Edward Mellanby. Source: Wellcome Collection.

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    also a matter of common experience that diets of high cereal content more particularly produce fat, lethargic, and contented children, whose small movements and general activity are subnormal, although the other environmental factors may be good. Nothing is more dramatic than the change in behaviour produced in rickety babies when the diet is altered to the type previously described. Clinical improvement and increased calcification and growth of bone are synchronous, and both are obvious within a few weeks of giving the good diet. It is true that cases of rickets in children occasionally appear where it is difficult to account for the disease on the basis of the facts as I have described them. Investigation often shows that these cases are associated with some exceptional condition —such, for instance, as premature birth, or twins, or, in some cases, the children may have just recovered from a severe infection. But these cases only indicate that we have still much to learn of the factors which control the growth and calcification of bone. In my experience, all rachitic children react favourably to a good diet such as I have described. There is one point about this dietetic treatment of rickets that may give trouble—namely, the fat dyspepsia that cod-liver oil may produce in some cases, more especially if the other fat in the diet is kept high. Some children in the early stages of treatment can only tolerate a moderate amount of fat, and are made ill by 2 ounces of beef dripping and 6 or more drachms of cod-liver oil per diem. If this happens, all recovery processes cease, and the sickness and other symptoms may be severe. It is well in these cases to cut down all the fat in the diet, and, starting with smaller quantities, to increase it step by step. References. E. Mellanby: Lancet, 1919, i, 407 ; Ibid., 1920, i, 550; Medical Research Council Special Reports, No. 61. 2 Korenchevsky : British Medical Journal, 1921, ii, 547. 8 McCollum, Simmonds, Shipley, Park : Journ. Biol. Cham., 1921, 47, 507. 4 Sherman and Pappenheimer : Journ. Exper. Med., 1921, 34, 189. 5 Pappenheimer, McCann, and Zucker : Journ. Exper. Med., 1922, 35, 447. 6 Cheadle : Artificial Feeding and Food Disorders of Infants, 1906, p. 200. 7 Huldschinsky : Zeit. f. Orthop. Chir., 1920, 89, 426. 8Riedel: Munch, med. Woch., 1920, 67, 838. 9Hess and Unger : Journ. Amer. Med. Assoc., 1921, 77, 39. 10Sachs: Milnch. med. Woch., 1921, 68, 985. 11 Huldschinsky : Zeit. f. Kinderh., 1920, 26, 5. 12Hess: Proc. Exper. Biol, and Med., 1922, 19, 238. is Findlay: British Medical Journal, 1908, ii, 13. 14 Findlay : Lancet, 1922, i, 825.
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